IV - Dealing with and Treatment of Parental Alienation Syndrome
Or Parental Alienation
Ludwig.F. Lowenstein Ph.D
Southern England Psychological Services
The treatment of children who suffer from the effects of Parental
Alienation (PA) or Parental Alienation Syndrome (PAS). The latter
still has not as yet been accepted as a syndrome by DSM-IV. Treatment
approaches vary with the preference of the therapist. The three
main protagonists requiring help are the child or children, the
alienated individual and the alienator. Many orthodox approaches
are unlikely to lead to a positive result and so pioneering work
is needed to ensure successful remediation.
Part IV - Dealing with and Treatment of Parental Alienation Syndrome
Or Parental Alienation
Johnston et al (2001) described goals and strategies for family
focussed counselling and therapy when children are alienated from
a parent after separation and divorce. The confidential intervention
takes place within a legally defined contract and is based upon
a careful assessment on the dynamics of the multiple factors that
contribute to the alienation and how the child’s development
is affected. Strategies for forming multiple therapeutic alliances
with often reluctant, recalcitrant, and polarised parents are discussed
together with ways of helping the child directly.
It has already been indicated how important it is to diagnose
the problems associated with possible parental alienation or parental
alienation syndrome. Lee & Olesen (2001) describe in-depth child
custody evaluations which are critical in forming an accurate understanding
of families in which alienation of children is a concern. By integrating
interviews and psychological test data of parents and children along
with collateral information, the evaluator can differentiate an
alienated child from children with other forms of parental rejection
and can form a thorough understanding of the multiple contributing
factors in the alienation process. This comprehensive and integrated
understanding is then used to develop a clear and specific intervention
Cases entering the family court with an alienated child require
intensive and coordinated case management to intervene effectively
(Sullivan & Kelly, 2001). It is critical to link the authority
of the court with the delivery of mental health services to address
the complex systemic factors that may entrench the child’s
unwarranted rejection of a parent. Similar results were obtained
by Gardner (2002) who considers that it is vital that the psychologist
or psychiatrist involved in these cases adopts a very different
attitude to the usual therapeutic methods practised by these two
professionals. Efforts were made Bernet (2002) to summarise the
procedures as to how a mental health professional such as a psychologist
or psychiatrist should conduct a child custody evaluation. The article
addressed the format for the evaluation including the initial conference
with both parents, the individual meetings with each parent, the
meetings with the children, outside information that should be collected,
psychological testing, and the ‘wrap up’ conference
with the parents and their attorneys. The current psychologist adopts
a different approach of never seeing all the individuals together
initially but always individually before commencing treatment Lowenstein
(2005). The article by Bernet also lists the discussions and the
critical factors considered in drawing conclusions and making recommendations,
such as a child’s attachment to the parents, the child’s
preference, and the possibility of indoctrination and parental alienation.
A number of case studies were presented by Vassiliou & Cartwright
(2001). They examined 5 alienated fathers and 1 alienated mother’s
perceptions of parental alienation syndrome (PAS). The data was
collected via semi-structured open-ended interviews and questionnaires
to identify whether there were shared characteristics among alienated
families, common issues in the marital conflicts that contributed
to the marriage dissolution. An attempt was made to understand the
nature of the participant’s reports of alienation and what
things an alienated parent might do differently. Overall, these
findings indicate that there are several possible attributes, such
as changes in relationships among family members, the roles of mental
health and the legal professionals, as well as custody arrangements.
These may be precursors or indicators of PAS.
A way of preventing parental alienation and the dire condition
to which it leads was suggested by Thayer & Zimmerman (2001).
They examined the conflict, divorce, and the children involved.
This guide showed how to avoid the hot spots and the common traps
of hostility, inflexibility, and constant squabbling. It also developed
ideas on how to promote skills to sustain a co-parenting partnership
based on love and concern for the children. Children of divorced
parents benefited best from two parents living separately but working
together. This book offers families a solution and a chance to move
beyond the high-conflict divorce experiences and suggests a parenting
system that allows the children to keep their family despite it
being in the reconstituted manner.
The authors focus on co-parenting the children even after the divorce
indicating that parents can learn to put their issues aside and
deal directly and fairly with one another for the good of the children.
New rules and communication styles were capable of being developed
by the parents to accommodate the change in their marital status.
It was also felt by the authors, that parents can learn to undo
the past errors, regroup, and restructure their post-divorce parenting
so the children can grow up in a loving environment in both parents
homes. This rather idealistic approach, while necessary, is unfortunately
not always successful.
Gardner (2001) comments that there has been a significant amount
of controversy among legal and mental health professionals in regards
to the question of whether the courts should order children with
PAS or PA to visit or reside with their alienated parent. Gardner
describes 99 PAS cases in which he was directly involved, cases
in which he concluded that the court should order visitation with
or transfer of primary residential custody to the alienated parent.
The outcome when such orders were implemented was compared with
the outcome when this recommendation was not followed. Unfortunately
the premature death of Richard Gardner in 2005 may result in no
further information being provided concerning this important question.
Other investigators need to verify Gardner’s views regarding
change of custody.
A great advocate of joint custody and shared parenting is Lowenstein
(2002). The question of whether there should be sole custody or
split custody (one child with one and another with another parent),
after separation or divorce has in recent ways given way to a preference
for “joint custody” and “shared parenting”.
This eliminates the need for visitation rights and unsupervised
or supervised contact for the non-custodial parent, and is preferable
whenever possible. Lowenstein focussed on four main issues: (1)
the problems and advantages associated with joint custody; (2) what
should be done if joint parenting and custody does not work; (3)
what happens to the children when there is alienation and hostility
between the parents; and (4) the role of judges and the courts.
Novick (2003) in reviewing Gardner’s book on PAS appears
to agree with the conclusion that the process of alienation must
be reversed to prevent it becoming an ongoing way of life. Novick
suggests that the strength of the book rests in Gardner’s
clinical experience and expertise and that it is useful for clinicians
to study Gardner’s clinical style and manner in dealing with
most difficult individuals. Meister (2003) concurs that Gardner’s
book is undoubtedly of great assistance to therapists in how to
deal with parental alienation problems. Meister considers that Gardner
has effectively placed parental alienation treatment “on the
map” especially in high conflict family cases.
Other authors have commented on the pioneering work of Gardner
including Goncalves & de Vincenzi (2003). The authors note that
when there is a ‘war’ between parents it often leads
to PAS. Different interventions and techniques are described, inspired
by that of Gardner. They stress that there are some potential traps
and that there is the need to coordinate therapeutic interventions
with the courts involved in custody decisions.
The objective of such therapy is to prevent children and adolescents
as well as adults suffering in later life from the parental alienation
syndrome process. Drieu (2004) reviewed recent research into the
involvement of parents in the treatment of adolescents with social
alienation disorders. Characteristics of adolescents with alienation
disorders often have the potential for violence. Here there is value
for parental consultation in determining causes and treatment for
alienation. It was felt vital to open good communication between
the parents so that they may work together more effectively.
Drieu illustrates the importance of involving parents in the treatment
process with a case study of a 17 year old male adolescent in France
with drug dependence and internet addiction. It is unfortunate that
sometimes, therapists are alienated in the process of attempting
to heal or forestall parental alienation conflicts (Garber, 2004).
This results when there is an impasse or rupture in the psychotherapeutic
relationship between the psychologist and the patient dyad. There
is therefore the need for the therapist to be both sensitive in
preventing this from occurring while at the same time standing firm
as to their findings observed between the parent in conflict.
In the United States a program funded by the Health and Human
Services has been developed (Neff & Cooper, 2004). It was introduced
in Phoenix, Arizona and has served more than 1000 families in several
jurisdictions. Whereas other programs dealt with entrenched, high
conflict cases and were found to be time consuming requiring an
intensive 2 to 6 months, this was a program of 4 hours for the less
serious alienation cases. Good results were reported.
Another study concerned itself with the evaluation of the efficacy
of structural and therapeutic interventions for interrupting parental
alienation towards the severe end of the spectrum (Rand et al, 2005).
Follow-up was obtained on 45 PAS children from a custody evaluators
practice. The child’s adjustment and relationship with both
parents at evaluation and follow-up were compared. Children who
had enforced visitation with the target parent or were in target
parent custody, maintained relationships with both parents unless
the alienator was too disturbed. In the completed alienation outcome
group, the alienating parent had custody before and after the evaluation,
and was able to violate court orders with impunity. Therapy as the
primary intervention was ineffective and sometimes made things worse.
There are several possible reasons for this including the lack of
involvement of the court to make definite decisions of possibly
changing custody and the lack of skill of the expert witness in
providing the courts with the necessary information to act more
Perhaps the best way forward in advocated by Boyan & Termini
(2005) who recommends that over time divorced parents experience
moderate to severe levels of parental conflict, should be ordered
by the juvenile court, family court, and superior court judges to
participate in parent coordination programmes. Attorney’s,
mediators, guardians ad litem, custody evaluators, physicians, and
psychotherapists have referred parents to such a program. Some parents
include the services of parent coordination in their settlement
agreement. Two areas critical to the ongoing development of parental
coordination are psychotherapists, working as parent coordinators
and the need for unique training and professional support in order
to provide competent assistance to these challenging families.
One thing is clear from all the information on therapeutic intervention
by alleged experts, and that is the need for further research into
the effects of a variety of approaches in curtailing an possibly
reducing the level of alienation practised against children. Needless
to say the most important ingredient in all this is the need for
a close working relationship between the expert carrying out assessments
and treatment and the court listening to these experts.
- Bernet, W. (2002). Child custody evaluations. Child & Adolescent
Psychiatric Clinics of North America, 11(4), 781-804.
- Boyan, S. M., & Termini, A. M. (2005). The psychotherapist
as parent coordinator in high conflict divorce: Strategies and
techniques. Binghamton, NY: Haworth Clinical Practice Press
- Drieu, D. (2004). Therapeutic progress in parents of adolescents
who are alienated from their social environment. Pratiques Psychologiques,
- Garber, B. D. (2004). Therapist alienation: Foreseeing and forestalling
third party dynamics undermining psychotherapy with children of
conflicted caregivers. Professional Psychology: Research &
Practice, 35(4), 357-363.
- Gardner, R. A. (2001). Should courts orders PAS children to
visit/reside with the alienated parent? A follow-up study. American
Journal of Forensic Psychology, 19(3), 61-106.
- Gardner, R. A. (2002b). Parental alienation syndrome vs. parental
alienation: Which diagnosis should evaluators use in child custody
disputes? American Journal of Family Therapy, 30(2), 93-115.
- Goncalves, P., & de Vincenzi, A. G. (2003). Co-parenting
after a conflicted divorce: Growing from enemy to ally. Therapie
Familiale, 24(3), 239-253.
- Johnston, J. R., Walters, M. G., & Friedlander, S. (2001).
Therapeutic work with alienated children and their families. Family
Court Review, 39(3), 316-333.
- Lee, S. M., & Olesen, N. W. (2001). Assessing for alienation
in child custody and access evaluation. Family Court Review, 39(3),
- Lowenstein, L. F. (2002). Joint custody and shared parenting:
Are the courts listening? Family Therapy, 29(2), 101-108.
- Lowenstein (2005). The psychological effects and treatment of
parental alienation syndrome worldwide. In Gardner, R., Sauber,
- Lorandos, D. (Eds.). (2005). International Handbook of Parental
Alienation syndrome: Conceptual, clinical and legal considerations.
Binghampton, NY: Haworth Press
- Meister, R. (2003). Therapeutic interventions for children with
parental alienation syndrome. American Journal of Family therapy,
- Neff, R., & Cooper, K. (2004). Parental conflict resolution:
Six, twelve, and fifteen month follow-ups of a high conflict program.
Family Court Review, 42(1), 99-114.
- Novick, M. R. (2003). Therapeutic interventions for children
with parental alienation syndrome. Journal of the American Academy
of Psychoanalysis & Dynamic Psychiatry, 31(2), 418-421.
- Rand, D., Rand, R., & Kopetski, L. (2005). The spectrum
of parental alienation syndrome part III: The kopetski follow-up
study. American Journal of Forensic Psychology, 23(1), 15-43.
- Sullivan, M. J., & Kelly, J. B. (2001). Legal and psychological
management of cases with an alienated child. Family Court Review,
- Thayer, E. S., & Zimmerman, J. (2001). The co-parenting
survival guide: Letting go of conflict after a difficult divorce.
Oakland, CA: New Harbinger Publications Inc.
- Vassiliou, D., & Cartwright, G. F. (2001). The lost parents’
perspective on parental alienation syndrome. American Journal
of Family Therapy, 29(3), 181-191.