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Book Review

Parental Alienation: The Handbook for Mental Health and Legal Professionals

Theodore A. Petti, MD, MPH

Published: August 26, 2014

Parental Alienation: The Handbook for Mental Health and Legal Professionals

edited by Demosthenes Lorandos, PhD, JD; William Bernet, MD; S. Richard Sauber, PhD. Springfield, IL, Charles C. Thomas Publisher, 2013, 550 pages, $89.95 (hardback with CD-ROM).

Advances in clinical understanding sometimes outpace our ability to classify particular symptom patterns. Patterns and situations in which one parent alienates a youngster from the other parent have been described for decades. Parental Alienation strives to synthesize and integrate past and current data and insights into a highly readable and informative work for a phenomenon that has had various labels. Parent alienation syndrome or disorder (PAD) essentially concerns and is defined by the authors as a mental illness in a child that usually follows a high-conflict separation or divorce by the parents, with one parent forging an alliance with the child such that the child rejects a relationship with the other or targeted parent "without legitimate justification." Any clinician who is working with children or parents or is entrusted with assuring the best interests of children will benefit from reading at least chapter 1, "Overview of Parental Alienation." This chapter leads off Strategies for Mental Health and Legal Professions, the first of the book’s 2 sections.

Written by the 3 editors, this overview chapter succinctly summarizes the book’s essence in easily comprehensible language. It begins by providing the historical context of PAD and defines its critical dimensions. Of greatest assistance is the differentiation of parental alienation that occurs with impaired child-parent relationships resulting from various factors outlined in the text (eg, parental abuse or neglect in the presence of conflict) and PAD, in which the child is intentionally programmed to be alienated from the other parent. The discussion of the characteristics of alienating parents is particularly informative for clinicians in formulating a specific case, as is the description of external markers indicating the presence of high-conflict separation or divorce generally associated with PAD. Discussion of methods used by one parent to cause alienation from the victim parent, and why the authors believe that these interventions constitute child abuse, is particularly useful for the clinician or consultant who must evaluate the situation or treat a youngster caught in the throes of extreme parental conflict. The authors emphasize that a PAD diagnosis is based on the severity level of symptoms in the child and not those of the alienating parent. Through the presentation of vignettes, subsequent chapters in section 1 elaborate more fully on mild, moderate, and severe cases of parental alienation; consider allegations of sexual abuse during disputes over custody and visitation; and discuss the process of reunification and therapy in the presence of PAD. Appearing almost extraneous to the clinical nature of section 1, the section’s final 2 chapters address legal interventions in the presence of PAD and the importance of protecting the integrity of the family law system. The information fosters greater insight for clinicians and consultants, who can then inform how best to utilize the Court in protecting the child’s best interests.

Section 2, Foundations of Parental Alienation: Historical, Scientific, and Legal, contains material for any mental health or legal professional who works with children and families, but it may be of less utility to mental health clinicians and consultants than section 1. This section includes a discussion of PAD and its consideration for inclusion in DSM-5 and ICD11, as well as a chapter titled "A Judge’s Perspective on Parental Alienation." The section also provides an international perspective that may be of less immediate usefulness but rounds out the presentation of the phenomena.

Finally, an attached CD-ROM includes a bibliography of over a thousand articles, books, and book chapters published in the legal and mental health literature and particularly relevant and important media articles and presentations that support the scientific foundation for the multidisciplinary group of professionals who require greater knowledge in this area. The CD-ROM also includes a large number of representative cases from most American states and many Canadian provinces. The themes in these cases are repetitive but should be of some interest as to the range of issues and nuances associated with PAD. Also of value for attorneys and of interest to clinicians are 25 sample legal motions.

In summary, perusal of Parental Alienation is a wise use of professional time when we consider the breadth of services required by youth and their families who face multiple degrees of conflict associated with separation and divorce. It is an essential read for health and human service workers, legal professionals, and the Court. Whether we must consult or testify; simply provide consultation, assessment, and care; or understand a judicial decision, the book exposes readers to multidisciplinary and interdisciplinary perspectives that we as professionals should understand and utilize to inform our practice or responsibilities.

Theodore A. Petti, MD, MPH

Author affiliations: Rutgers-Robert Wood Johnson Medical School, Piscataway, New Jersey.

Potential conflicts of interest: None reported.

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