1. Parent-Child Contact Problems: News You Can Use
William Bernet, M.D.
AFCC 12th Symposium on Child Custody Evaluations
Atlanta, Georgia – November 2016

2. Definition: “Parental Alienation”
A child – usually one whose parents are engaged in a high-conflict separation or divorce – allies himself strongly with one parent (the preferred parent) and rejects a relationship with the other parent (the alienated parent) without legitimate justification.

3. Causing PA is Child Maltreatment
Alienated
Parent
Alienating
Parent
Blame
Blame
Child

4. First Topic WHAT HAPPENED WITH THE ATTEMPT TO
HAVE PARENTAL ALIENATION INCLUDED
IN DSM-5?
BREAKING NEWS: The concept of parental alienation is in DSM-5, although the actual words are not.

5. Published 2010
Edited by
William Bernet
With
70 contributors

6. Published 2013

7. The DSM-5 Task Force said …
Parental alienation did not meet the standard definition of a mental disorder, that is …
“the requirement that a disorder exists as an internal condition residing within an individual” (letter from D. A. Regier, January 2012).
Parental alienation should be considered a relational problem because it involves a problem between the child and one or both parents.

8. DSM-5 Terminology
MENTAL DISORDER = all the common mental illnesses in Section II of DSM-5.
MENTAL CONDITION = all the topics in the chapter, “Other Conditions That May Be a Focus of Clinical Attention.”
“OTHER CONDITIONS” includes
Relational Problems
Child Maltreatment
Adult Maltreatment
etc.

9. Parental Alienation – a Relational Problem
The words, “parental alienation,” are not in DSM-5, but the concept of parental alienation is expressed in three diagnoses in DSM-5 …
Child affected by parental relationship distress
Parent-child relational problem
Child psychological abuse

10. What is CAPRD? Child affected by parental relationship distress =
“This category should be used when the focus of clinical attention is the negative effects of parental relationship discord (e.g., high levels of conflict, distress, or disparagement) on a child in the family, including effects on the child’s mental or other medical disorders.”

12. What is CAPRD?
Intimate partner distress (frequent arguing) → anxiety, depression
Intimate partner violence (physical abuse) → PTSD
Intense loyalty conflict → somatic, psychological symptoms
Parental alienation → false beliefs, false memories

13. Important Differences …
IPD vs. IPV
CAPRD vs. parent-child relational problem
Loyalty conflict vs. parental alienation
Alienation vs. estrangement

14. What about ICD-11? The people who are developing ICD-11 say,
“Parental alienation is used as an example in the expanded diagnostic guidelines” for caregiver-child relational problem.
See chapter on “Factors Influencing Health Status or Contact with Health Services.”

15. Why does it matter for parental alienation to be in DSM and ICD?
Training programs for mental health professionals will include parental alienation
Insurance companies might pay for treatment
Acceptance of parental alienation in legal settings

16. Second Topic
IS THERE A WAY (FOR CLINICIANS AND FORENSIC EVALUATORS) TO DISTINGUISH ALIENATION AND ESTRANGEMENT? BREAKING NEWS: A simple psychological questionnaire clearly demonstrates “splitting,” which occurs in alienation, not in estrangement.

17. What’s the difference?
PARENTAL ALIENATION – rejection of a parent without a good reason.
PARENTAL ESTRANGEMENT – rejection of a parent for a good reason, such as abuse or neglect.

18. What’s the difference?
ALIENATION – rejection is very strong – defense mechanism of splitting.
ESTRANGEMENT – feelings toward rejected parent are ambivalent – no splitting.
Results are counterintuitive, but convincing.

19. Parental Acceptance-Rejection Questionnaire

20. Parental Acceptance-Rejection Questionnaire
PARQ – self-report instrument measures children’s perceptions of parental acceptance and rejection.
Most items refer to parental behavior, not attitudes.
Lowest possible score = 60 = very positive.
Highest possible score = 240 = very negative.

21. Alienation vs. Estrangement

22. Conclusion
The PARQ is useful for both clinicians and forensic practitioners in evaluating children or divorced parents, when there is a concern about the possible diagnosis of parental alienation.
Of course, this research needs to be replicated.

23. Join Parental Alienation Study Group www.pasg.info