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Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Wednesday, December 2, 2015

Parental Alienation Advocates Cite-- WHO?

Like advocates of other ideas, proponents of the idea of parental alienation (PA) like to list their intellectual ancestry and show how their beliefs have a respectable history. But as I was glancing at some PA material, I came upon a citation that rather astonished me: PA advocates attributed the earliest reference to the PA idea to Wilhelm Reich! This was done in an article by the usually meticulous and cautious Richard Warshak and picked up again in a book edited by William Bernet.

Now, I would not want to fall into the trap of assuming that just because most of what a person wrote was pernicious nonsense, he or she could not have had any ideas worth following up. I’m also aware that Reich has some admirers to this day and they continue to publish the Journal of Orgonomy. However, most of Reich’s beliefs and practices were such that I can’t imagine that most psychologists or psychiatrists would care to associate themselves with them, and I can’t fathom why the PA group want to do so.

Here are some facts about Wilhelm Reich:

He was part of a group rejected as doing “wild psychoanalysis” by conventional Freudian analysts. This group, including Sandor Ferenczi, was characterized by hands-on, physical treatment methods, among other things. The “wild psychoanalysts” owed much to Georg Groddeck, who had earlier claimed, for example, that problems of childbirth, such as an awkward positioning of the fetus, resulted from the mother’s psychological reluctance to give birth.

Reich believed that an energy form called “orgone” was involved in sexuality and physical health, and that sitting in a box insulated against the escape of orgone would cure cancer and other diseases. His insistence on continuing to sell orgone boxes led to charges and conviction of fraud, and he died in prison.

Reich claimed that through hands-on treatment he had cured his infant son of the Moro (“startle”) reflex; this reflexive movement pattern largely disappears by about five months of age, as voluntary movement patterns take over, and this is presumably what happened in the case of the Reich baby. Why Reich, a M.D., would not recognize a normal infant movement pattern and would try to “cure” it is a difficult question to answer.

Reich’s theory of personality involved “character armor”, a stiffening of muscles accompanied by rigid thinking, emotion, and behavior, and caused by birth and other early experiences. Relaxing the muscles was claimed to restore flexibility of thinking and feeling to a normal and desirable level; without such restoration, a person could not experience life fully. (I should note that in the 1940s and ‘50s, this belief, although not widely accepted, was not considered necessarily to be a “fringe” notion, and was described briefly in an abnormal psychology textbook published about 1960.)

Reich’s treatment for “character armor” as a psychological disability involved a semi-nude patient and therapist. The therapist treated the stiff muscles that were thought to cause psychological rigidity by thrusting his fingers or hand into the patient’s armpits or against the ribs. (Does anyone remember Rolfing? How about Holding Therapy?) Bruising and considerable pain resulted.

None of these disturbing beliefs and practices indicates that Reich never made a correct statement in his life. However, it’s hard to belief that PA advocates really wanted to take on the Reichian baggage just in order to claim an early reference to their ideas. Could this have been like Darwin’s fox terrier—the reference was cited again and again until no really knew how big a fox terrier was or how peculiar Reich had been?


Whatever the rationale for citing Reich, I would think that PA advocates would do well to delete these references and concentrate on determining the incidence and prevalence of the family issues that concern them, not to speak of assessing the efficacy of the interventions proposed as treatment. 

20 comments:

  1. Although Wilhelm Reich had more than his share of flakey and even disturbing notions about psychology, he also had some good ideas, such as his writings about personality disorders. Sigmund Freud had a few flakey ideas; Carl Jung had many flakey ideas. Reich was mentioned in our book, Parental Alienation, DSM-5, and ICD-11, because it seemed remarkable that an experienced psychiatrist described in some detail the features of parental alienation 40 years before Richard Gardner did. We wanted to show that Gardner did not "invent" parental alienation, as critics have claimed, but that various writers before, during, and after the time that Gardner coined "parental alienation syndrome" described the same phenomenon. The comments about Reich took up one paragraph of the book. What did you think of the rest of the 240 pages?

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    1. Identifying a problem is not the same as "inventing" it, and there is no particular problem about recent identification, so to my way of thinking it's a mistake to try to establish this longer intellectual history to the point of including Reich. Reich was far flakier than anyone else you mention, and to bring him into your argument strikes me as grasping at straws.

      As for the rest of the book, I am still looking for answers to a number of questions:

      1. What are estimates of the incidence and prevalence of PA (for want of a better term), and how were these calculated?

      2. To what extent does PA, or similar problems, exist outside of high-conflict divorces?

      3. How should diagnosis and treatment of PA be fine-tuned to take into account developmental differences and differences related to disabilities? (You may remember that in Toronto I asked what was the youngest child who could be said to said to show PA effects-- I don't think there was a clear answer to this.)

      4. Do some children show responses to non-parental people that parallel PA effects? Under what circumstances do these come about, and how might they be analogous to PA?

      5. What evidence do you use to support the claim that children must have relationships with both parents in order to develop within the normal personality range?

      6. What is the evidence that children who reject a parent for reasons attributable to PA had a good relationship with that parent to begin with?

      7. Can the concept of PA now be separated from the use of the term as a legal strategy-- a use that calls up the "woozle" category?

      There is another question that I'd like to ask you, but it's not really about PA in itself. What do you think of the fact that a PA advocate acquired an exhibitor booth at APA in 2015 by what he himself described as deception? What does that action imply about the capacity of a hybrid parent-professional group to maintain its intellectual integrity? It worries me a good deal.

      Thanks for any answers you can give me--

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  2. You are asking very good questions. I gather from your writings that you agree that PA exists, but you are not sure about some of the details. Some of your questions I can answer. SEE BELOW.

    You said: Reich was far flakier than anyone else you mention, and to bring him into your argument strikes me as grasping at straws. THE FACT THAT REICH DESCRIBED PA LONG BEFORE GARDNER IS INTERESTING HISTORY. PHILOSOPHERS DESCRIBED THE UNCONSCIOUS BEFORE FREUD. CHILD ABUSE WAS DESCRIBED BEFORE KEMPE. SCHIZOPHRENIA WAS DESCRIBED BEFORE BLEULER.

    1. What are estimates of the incidence and prevalence of PA (for want of a better term), and how were these calculated? SEE PP. 96-98 OF PARENTAL ALIENATION, DSM-5, AND ICD-11. WE VERY ROUGHLY ESTIMATED THE PREVALENCE OF PA AT 1% OF CHILDREN AND ADOLESCENTS IN THE U.S., AND WE EXPLAINED HOW WE ARRIVED AT THAT FIGURE. OBVIOUSLY, MORE RESEARCH NEEDS TO BE DONE.

    2. To what extent does PA, or similar problems, exist outside of high-conflict divorces? I AM SURE THAT IT OCCURS TO SOME EXTENT IN “INTACT” FAMILIES. SEE WRITINGS BY DAVID M. LEVY FROM THE 1940s. ANOTHER EXAMPLE OF INTERESTING HISTORY!

    3. How should diagnosis and treatment of PA be fine-tuned to take into account developmental differences and differences related to disabilities? (You may remember that in Toronto I asked what was the youngest child who could be said to said to show PA effects-- I don't think there was a clear answer to this.) THESE ARE VERY INTERESTING TOPICS. I DO NOT KNOW THE ANSWERS.

    4. Do some children show responses to non-parental people that parallel PA effects? Under what circumstances do these come about, and how might they be analogous to PA? YES! BENJAMIN GARBER HAS WRITTEN ARTICLES ABOUT “THERAPIST ALIENATION,” IN WHICH A PARENT INDOCTRINATES A CHILD TO FEAR OR RESIST THE CHILD’S THERAPIST.

    5. What evidence do you use to support the claim that children must have relationships with both parents in order to develop within the normal personality range? NO DOUBT MANY CHILDREN DO JUST FINE WITH ONE PARENT. PA IS MUCH MORE COMPLICATED THAN SIMPLY HAVING ONLY ONE PARENT. IN PA, A CHILD IS TAUGHT TO DISCOUNT HIS/HER OWN EXPERIENCE WITH A LOVING PARENT AND SUBSTITUTE THE FALSE BELIEFS OF THE FAVORED OR PREFERRED PARENT. EVENTUALLY, THE CHILD COLLABORATES IN COMPLETING THE PARENTECTOMY, WHICH IS LIKELY TO CAUSE LONG-TERM REMORSE AND GUILT IN THE CHILD.

    6. What is the evidence that children who reject a parent for reasons attributable to PA had a good relationship with that parent to begin with? THE DETAILED HISTORY OF EACH CASE MUST BE STUDIED. USUALLY, THE EVALUATOR COLLECTS INFORMATION FROM COLLATERAL SOURCES SUCH AS EXTENDED FAMILY MEMBERS, TEACHERS, FAMILY PHYSICIANS, DIARIES, FAMILY PHOTOS, AND PREVIOUS STATEMENTS WRITTEN BY THE PREFERRED PARENT AND THE CHILDREN (BACK WHEN THEY HAD A FINE RELATIONSHIP WITH THE NOW REJECTED PARENT).

    7. Can the concept of PA now be separated from the use of the term as a legal strategy-- a use that calls up the "woozle" category? I DO NOT SEE HOW THE WOOZLE PROCESS APPLIES HERE. CAN YOU PHRASE THE QUESTION USING OTHER TERMINOLOGY?

    There is another question that I'd like to ask you, but it's not really about PA in itself. What do you think of the fact that a PA advocate acquired an exhibitor booth at APA in 2015 by what he himself described as deception? What does that action imply about the capacity of a hybrid parent-professional group to maintain its intellectual integrity? It worries me a good deal. I AM MORE CONCERNED ABOUT THE “INTELLECTUAL INTEGRITY” OF THE AMER. PSYCHOLOGICAL ASSOCIATION. THE APA APPEARS TO HAVE AN UNWRITTEN, INFORMAL POLICY OF SUPPRESSING DISCUSSION OF PA. THE PEOPLE IN CHARGE OF THE EXHIBIT AREA AT THE RECENT APA MEETING REJECTED THE BOOTH FOR THE PA ADVOCACY GROUP ON BLATANTLY FALLACIOUS GROUNDS.

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    1. Reich: You are right, it is interesting history, but what is the point of establishing history in this way, except that it is an attempt to provide some intellectual credentials for an idea? If you really wanted to do history, you would be looking at the case as described by Reich and the way he was involved in it. I am not saying you should do this! I simply point out that those of us who are familiar with the "crazy therapies" recoil with horror when we see Reich cited in a serious way. Indeed, I had dinner last night with a sociologist and attorney who had read this post, and they both volunteered their concerns about Reich. If I were you, I would not cite him, and I think the reasons for this advice are clear.

      Prevalence: As I understand it, your data come only from high-conflict divorces in which a parent is rejected by a child, and at least one parent is sufficiently well-off to seek therapy, legal help, etc. But you generalize this to a percentage of all children and adolescents in the U.S., I think. The math is faultless, but the problem is the possibility of overgeneralization from the target group to a much less homogeneous population. Bala and Hunter's recent comments compare the number of allegations of PA in one city to the number of substantiated cases, which opens up another important issue about how how PA is defined and whether it has been defined in the same way in the existing studies.

      Developmental and other differences: I want to press the point that this is absolutely essential information if anyone is really concerned with the child's needs. Patterns like the "independent thinker" are common among preoperational and even concrete operational children, and any person under emotional stress is likely to show these relatively primitive thinking patterns. Can anyone show that children of a given age in a PA situation are more likely to be "independent thinkers"
      than same-age children in other situations
      are?

      This issue about age differences is especially important with respect to any interventions attempted, which may have very different effects at different stages of development.

      Effects of PA: Your evidence that alienated children later suffer from remorse and guilt, to a greater extent than other people do?

      Woozles: As I am sure you know, a "woozle" is something that is accepted and believed simply because the audience has heard of it before; the more they've heard of it, the less evidence they require. I think it's especially easy for phenomena that have been medicalized as syndromes and pathogens to become woozles. Warshak has discussed the woozle status of concerns about overnight visits to parents by infants and toddlers (a la Jennifer McIntosh). Psychological woozles have caused enormous difficulties in the past-- for example, the repressed memory woozle fueled much litigation with associated costs, family distress, and even imprisonment of innocent people who were convinced that although they could not remember a crime, they "must have done it". On a smaller scale, we now have the "RAD defense" for child abuse and even murder, hingeing on the woozle that children with Reactive Attachment Disorder are viciously aggressive and drive caregivers to harm them. And how about attachment theory-- how many goofy and developmentally inappropriate decisions have been made on the grounds that someone's attachment would or would not be harmed, basically because this term has been tossed around freely for 40 years, Similarly, repeating PA concepts and terminology makes it easier for attorneys and judges to accept this belief system without asking many questions, potentially leading to serious injustice.... not to speak of distorting statistics by increasing the probability that any given case will be seen and adjudicated as PA. That's why I would like to see research in this area separated from the courts-- very difficult, I know, and that's why I asked you if it could be done.

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    2. Intellectual integrity: Did APA give a reason for rejection? You may know that the organization is really tightening up on the evidence-based requirements and has cancelled CEUs for some non-evidence-based presentations in recent years. I don't know that I'd call this suppression ; the rules seem clear enough to me, but then I don't know what answer you got.

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  3. Your comments are interesting but rather nit-picky. Obviously there needs to be more research on PA (but also on autism spectrum disorder, paranoid schizophrenia, major depressive disorder, and every other mental condition). Aside from the nuances, do you agree with the basic premise, i.e., that some children of high-conflict divorce strongly gravitate to one parent and strongly reject the other parent without a good reason? Also, that those children may develop false beliefs that the rejected parent is evil, dangerous, and not worthy of their love?

    Regarding remorse and guilt experienced by alienated children, take a look at Amy Baker’s book, Adult Children of Parental Alienation Syndrome. That was qualitative research, but still pretty convincing. The chapter of the book on the long-term impact of PAS says, “Another source of self-hatred was the guilt the adult children of PAS experienced from betraying the targeted parent.” Then she has quotations from five of her subjects regarding strong feelings of guilt related to their rejection of a parent. Amy Baker also said that 70% of her subjects reported “significant episodes of depression in their adult lives,” which is no doubt higher than the prevalence of depression in the general population.

    Regarding woozles, I am sure that later authors quote and repeat what was said by earlier authors regarding PA. However, that does not detract from the ground truth, i.e., that PA is real and affects thousands of families all over the world. The extensive international bibliography regarding PA in Parental Alienation: The Handbook for Mental Health and Legal Professionals is fascinating to peruse. We collected hundreds of peer reviewed articles, book chapters, and books from the professional literature of almost 40 countries. Mental health and legal professionals in diverse countries and cultures (e.g., Argentina, Cuba, Latvia, South Africa, Israel, Sweden, Germany, Malaysia, Australia, Japan) have described their own experiences and their own cases of PA, not simply recycled information from Richard Gardner and Janet Johnston.

    Regarding the rejection of the PA information booth from the exhibit area of the American Psychological Association annual meeting, this is what the APA staff stated: “After review of your organization and the concept of parental alienation, the decision to decline your application was based on currently not having the support of a well-established body of peer reviewed research.” If you are looking for a woozle, there it is! Critics of PA have stated over and over the meme, “There is not enough peer reviewed research about PA.” I urge you and others to take a look at the Parental Alienation Handbook (2013) and its enormous bibliography to decide whether there is enough peer reviewed research to establish that PA is real and affects thousands of families all over the world.

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    1. Thanks for your discussion and questions. I think the issue of the APA response, and the question of whether I think the events you call PA happen, have to do with the same points, so I will comment on them together.

      I am certain that the PA set of events occurs sometimes, and it might happen as often as you suggest. This does not provide evidence for calling it a syndrome, however. There are many cases of a divorced parent abandoning all communication with a child, temporarily or permanently, but we don't speak of mother-or-father-abandons-contact syndrome. There are quite a few cases where parents or practitioners have harmed or even killed children because of misunderstandings of attachment disorders, but there is no misunderstanding-RAD-and-harming-child syndrome. There needs to be evidence that the symptom pattern of a syndrome does not overlap with other patterns that are diagnosed differently, and that means that the evidence basis has to involve comparisons to similar symptom patterns, not just a description of the posited pattern.

      To establish such a pattern requires good evidence for inclusion of various claimed symptoms or characteristics-- I notice, by the way, that in a recent paper Richard Warshak stated that PA causes deficits in children's critical thinking-- this is a very testable hypothesis, but I did not see that he offered any evidence for it. Similarly, there seem to be a number of claims (like the previous good relationship of a child with a parent, or the guilt and remorse in later life) that are based purely on retrospective work and which can be given strong support only be prospective research.

      Over and above that, diagnostic approaches to children's mental health issues need to take a developmental approach and to consider the earliest and the latest developmental stages at which a diagnosis would be given, as well as looking at developmental changes in the way a disorder is addressed.Until this kind of work has been done,there is no clearly-defined diagnostic approach and therefore no statistical description can be established.

      One of the real problems about PA is the connection between the posited diagnosis and suggested interventions. The evidence for the effectiveness of these interventions is weak indeed. As long as PA and PA interventions are presented as a package, as they seem to be, it is not surprising that the existing research is questioned, however big the bibliography.

      Finally,let me point out the fact that PA proponents, in alliance with lawyers and parents' rights groups, have allowed PA to become a ritual hammer for use in custody cases. One parent accuses the other of sexual abuse, the second accuse the first of PA, and around and around we go until everyone's pockets are empty. If proponents would refuse to engage in this kind of conflict, and would use their energies for better diagnostic approaches, followed by the development of evidence-based interventions if needed, APA and others would be far more open to discussion.

      Of course it's frustrating to read "more research is needed",just like the discussion section of an undergraduate paper. I will rephrase: "better research is what we need".

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    2. I would also point out that the idea that a child does something "without a good reason" really begs for discussion. Is there a list of good reasons that you can provide instead of making this vague statement?

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  4. Much has been written about the difference between parental estrangement (when the child rejects a parent for a "good reason," such as a history of abuse or neglect) and parental alienation (when the child rejects a parent without a "good reason"). Obviously, even in parental alienation the rejection occurs for some kind of reason, but it is not a legitimate or logical reason. Another way to say it is that in parental alienation the child's rejection is far out of proportion to anything the rejected parent has done. (This type of wording is not unusual. In DSM-5, a specific phobia is characterized by "fear or anxiety out of proportion to the actual danger posed by the specific object or situation.")

    If you or other readers want more information regarding parental alienation, take a look at Parental Alienation: The Handbook for Mental Health and Legal Professionals. If you or other readers want to stay in touch regarding parental alienation, consider joining the Parental Alienation Study Group. More information at www.pasg.info.

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    1. I asked what was a good reason, in the hope that you might mention some child characteristics, such as temperament or anxiety level, that should contribute to the understanding of "good reasons". Like any other attitudinal position, rejecting a parent emerges not just from what one or both parents do, but from the child's personality, just as moral development is described by Kochanska as emerging from the interaction of child characteristics with parents' disciplinary techniques.

      As far as I can see, the tendency of PA proponents is to interpret "unreasonable" rejection of a parent as indicating the prior alienating actions of the other parent. There seems to be little consideration of the possibility that some children are exceptionally ready to become and stay frightened of some person or event, with a minimum of or perhaps no evidence that the person or event is dangerous. Even in less extreme cases, developmental level, temperament, etc., may contribute to a child's hostility toward one parent,which may be triggered simply because of the child's observation that the preferred parent cried or looked worried while interacting with the rejected parent. This child reaction appears disproportional unless it is seen in the context of the child's own personality characteristics and general response to the world. As Kochanska points out with respect to conscience, children with these characteristics are not likely to respond well to intense discipline, e.g. abrupt separation for considerable periods from the preferred parent,home, and all familiar routines.

      In developmental psychology, an important principle is that all relationships, and many other phenomena of development, grow transactionally. Each person affects the other, and the way they do so changes over time, as a result of experience and of maturational change.

      This matter of interactions and transactional processes is one that I think may have been badly skimped because of the PA association with the courts and custody decisions. Courts dealing with these conflicts are naturally inclined to say that one parent must be right and the other wrong; when you add to that tendency the claim that PA is child abuse, the conclusion that one parent should be punished (by blocking of access to the child) is almost inescapable, in part because of confirmation bias. It seems to me that a real understanding of children's rejection of a parent can only occur through work outside the courts, and that work will need to examine what the children bring to the situation, as well as what each parent may or may not have done.

      Although I have disapproved of quite a few actions of APA, I must stand with them on the statement that better research is needed before anyone can claim to understand PA-like events.

      I do want to thank you for this polite and rational discussion. Although we remain opposed on some issues, I think we both genuinely
      wish for good outcomes for children and families.

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    2. William I am interested to know why you are not supporting Childress theory and a life coach? Are you aware that it is the same program as family bridges? I have your book that was written with Lorandos. Are you aware of why he got into trouble with the licensing board? It is very interesting that he had a romantic relationship with his client and has not be able the practice since. Interesting to that his fights criminal cases of sexual abuse. Why is "threat therapy" still being pushed on children when they have substantiated documentation of abuse? And admitted profiles being reunified with High Road to Reunification? Are you aware if these cases or are you not researching the facts?

      Amy Baker also did a journal with a woman who accused her stepchildren of having pa. Yet one year later, she is divorcing him because he went crazy and the children who claimed they walked in on him Trying to kill himself were NOT LYING! Yet, they had to win in court. The truth always comes out. Seems like a money sham to me.

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    3. I am hoping he will answer these queries.

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  5. Jean can you comment on the statements made by Steve Miller, M.D. of Harvard Medical in the following video. https://www.youtube.com/watch?v=5fgRJh26Jho

    thank you!

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  6. Jean, Could you also comment on Dr. Craig Childress's attachment based model of Parental Alienation?

    His model corrects Gardner’s initial error in proposing a “new syndrome” which is unique in all of professional psychology and by instead defining the pathology entirely within standard and established psychological principles and constructs, he's provided defined domains of professional knowledge (personality disorder pathology, attachment trauma pathology, family systems pathology) that are necessary for professional competence and expertise, and to which all mental health professionals can be held accountable.

    See a more in depth explanation here.

    http://drcachildress.org/asp/admin/getFile.asp?
    RID=109&TID=6&FN=pdf as well as a lecuture here.

    http://www.calsouthern.edu/content/events/parental-alienation-an-attachment-based-model/

    thanks in advance for your thoughtful consideration.

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  7. I don't know what is happening with blogspot, but this seems to be the only way I can publish and respond to the following comment:

    Jean can you comment on the statements made by Steve Miller, M.D. of Harvard Medical in the following video. https://www.youtube.com/watch?v=5fgRJh26Jho

    thank you!

    I (Jean) looked at this and have some comments to make. First, like most of the PA advocates, Miller does not appear to take a developmental perspective. A minor is a minor, whether three or 17 years old. Failing to consider developmental differences ignores the real attachment needs of the younger child as well as the autonomy needs of the teenager, and all the developmental differences in between. Ninety days of separation from a preferred parent has a very different meaning at different ages.

    More importantly, however, Miller's presentation follows the classical lines of the "alternative therapy" (psychological version of CAM) advocate. First, he proposes the use of treatments for which there is insufficient empirical support. Rather than reporting mood and behavioral changes, he describes the treated children as "happy as clams", and he reports only immediate results rather than the long-term effects and possible adverse events associated with the treatment. Second, he warns that conventional treatments are not only ineffective, but can create catastrophic outcomes, which he does not describe.

    Like many PA proponents, Miller seems to work with only two categories: either a non-preferred parent has been abusive, in which case rejection is rational, or the preferred parent must be manipulating the child. He ignores the possibilities of poor parenting skills and of behavior that is well within the parent's rights but is obnoxious to the child at the present age-- e,g., father wants teenage daughter to like his girlfriend who has just moved in.

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  8. Somehow, this comment did not make it to moderation, so I am publishing it this way:

    Jean, Could you also comment on Dr. Craig Childress's attachment based model of Parental Alienation?

    His model corrects Gardner’s initial error in proposing a “new syndrome” which is unique in all of professional psychology and by instead defining the pathology entirely within standard and established psychological principles and constructs, he's provided defined domains of professional knowledge (personality disorder pathology, attachment trauma pathology, family systems pathology) that are necessary for professional competence and expertise, and to which all mental health professionals can be held accountable.

    See a more in depth explanation here.

    http://drcachildress.org/asp/admin/getFile.asp?
    RID=109&TID=6&FN=pdf as well as a lecuture here.

    http://www.calsouthern.edu/content/events/parental-alienation-an-attachment-based-model/

    thanks in advance for your thoughtful consideration.

    I commented on Craig Childress' views at http://childmyths.blogspot.com/2015/08/craig-childress-tries-to-drag.html and on a subsequent post.

    I have several concerns about Childress' approach. Like some other proponents of unconventional treatments, he seems to be piggybacking on the popular view that attachment theory is entirely "proven" scientifically and that any ideas that reference attachment are by definition to be considered supported. However, in fact no one has developed a way to evaluate attachment in children between 7 and 12 years of age, so to attribute any mood or behavior to attachment status is completely moot. In addition, Childress has failed to provide adequate evidence of empirical support for his treatment, and has not reported on the possibility of adverse effects for children from this distressing experience, or any long-term benefits or risks.

    In his intense emphasis on attachment, Childress seems to forget the growing importance of autonomy in the lives of developing children. He recommends forced separation of children from a preferred parent and home, even at ages when the child would be asked to give informed consent to medical procedures or research participation. Unfortunately, he appears to have persuaded judges to order compliance with this very questionable and sometimes age-inappropriate procedure.

    Childress appears to have forgotten or to have ignored some evidence-based treatments that can be used to improve relationships between children and non-preferred parents-- but of course these require openness to change on the part of the parent too, so perhaps it is not surprising that they are not necessarily favored by rejected parents.

    As for the syndrome bit, this is not included in DSM-5 or ICD-10, and although no doubt the PA faction is pushing it for ICD-11, I don't think they have the data to support such a diagnosis.

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  9. Jean,
    Are you saying that PA proponents actively take children from their preferred parent, give them to their non-preferred parent, and forcing them to stay away from the preferred one for a prescribed period of time? How is that not "reverse PA?" Wouldn't that have the same negative effects on that preferred parent, as they claim occurred for the non-preferred parent?

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    1. Yes, that is exactly what they do. They don't think it has the reverse effect, because they assume that the original preferred parent is mentally ill in ways that produce mental illness in the child, who needs to be rescued and fixed-- the non-preferred parent, who hires the PA therapist, is okay, so doesn't cause mental illness. I'm just reporting the news here!

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  10. I work in CPS now, and even in pretty severe cases, we don't advocate for complete alienation from the abusing parent. We may request a judge require supervised visitation, but it's generally considered bad practice to just take a child from a familiar caregiver, even an abusive one. Furthermore, if the PA proponents believe that the preferred parent is mentally ill, wouldn't they be ethically responsible to try and help that parent as well. I mean, can a person who is mentally ill truly be held accountable for their manipulation? And what happens if they get a second (or third or fourth) opinion and those therapists say that the preferred parent is not mentally ill? What if they want a second opinion for their child? Or for the "okay" non-preferred parent? I've been catching up on your blog and I've seen you talk about systems theory and a lot of what you have been saying goes along with the Person in Environment perspective in social work. Do these "therapists" really think that these kids personalities are formed in a vacuum?

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    1. The thing is, these aren't CPS cases. They are private child custody battles, so whoever is lawyered up most can usually win. Some courts have fallen for the PA idea and will order a parent to put their children in the treatment-- and pay for it too.Incidentally, they are told what practitioners they may work with, so a second opinion is not an option. Some attorneys have learned that this is a powerful way to get what their client wants.

      Ironic, that CPS deals with these issues more sensibly than expensive private legal proceedings!

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