Lee Maturana Whole Thesis

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The forgotten parents : experiences, consequences and coping mechanisms of targeted parents of parental
alienation
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Lee Maturana, S-LG
Bibliographic citation
Lee Maturana, S-LG (2020). The forgotten parents : experiences, consequences and coping mechanisms of
targeted parents of parental alienation. University Of Tasmania. Thesis.
https://doi.org/10.25959/100.00035874
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Rights statement: Copyright 2020 the author Chapter 4 appears to be the equivalent of the pre-peer reviewed
version of the following article: Lee‚ÄövÑv™maturana, S., Matthewson, M., Dwan, C., Norris, K., 2019.
Characteristics and experiences of targeted parents of parental alienation from their own perspective: A
systematic literature review, Australian journal of psychology, 71(2), 83-91, which has been published in final
form at https://doi.org/10.1111/ajpy.12226. This article may be used for non-commercial purposes in
accordance with Wiley Terms and Conditions for Use of Self-Archived Versions Chapter 5 appears to be the
equivalent of a pre-print version of an article that has been accepted for publication in American journal of
family therapy, published by Taylor & Francis Chapter 6 appears to be the equivalent of a pre-print version of
an article published as: Lee-Maturana, S., Matthewson, M. L., Dwan, C., 2020. Targeted parents surviving
parental alienation: consequences of the alienation and coping strategies, Journal of child and family studies,
29(8), 2268-2280
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The Forgotten Parents:
Experiences, Consequences and Coping
Mechanisms of Targeted Parents of Parental
Alienation
By
Sau-lyn Lee Maturana, Psy. Mg.
Submitted in fulfilment of the requirements for the Degree of Doctor of

Philosophy (Psychology) in the College of Health and Medicine, School of
Psychological Sciences.
University of Tasmania
July 2020
II
Declaration of Originality
I declare that this thesis contains no material which has been accepted for a degree or
diploma by the University or any other institution, except by way of background information
duly acknowledged in the thesis, and to the best of my knowledge and belief no material
previously published or written by any other person except where due acknowledgement is
made in the text of the thesis, nor does the thesis contain any material that infringes
copyright.
Signed: Date: 15 June 2020

III
Statement of Authority of Access
This thesis can be made available for loan. Copying of any part of this thesis is
prohibited for two years from the date this statement was signed; after that time limited
copying is permitted in accordance with the Copyright Act 1968.

IV
Statement of Ethical Conduct
The research associated with this thesis abides by the international and Australian
codes on human and animal experimentation. Ethics approval was obtained from the
University of Tasmania’s Social Sciences Human Research Ethics Committee, Ethics Ref
No: H0015333 (See Appendix D).

V
Statement of Co-authorship
The following people and institutions contributed to the publication of work undertaken
as part of this thesis:
Candidate: Sau-lyn Lee Maturana (SLM), School of Psychological Sciences.
Author 1: Dr. Mandy Matthewson (MM), School of Psychological Sciences, University

of Tasmania.
Author 2: Dr. Corinna Dwan (CD), School of Pharmacy and Pharmacology, University
of Tasmania.
Author 3: Dr. Kimberley Norris (KN), School of Psychological Sciences, University of

Tasmania.
Contribution of work by co‐authors for each paper:
PAPER 1: Located in Chapter IV
Lee-Maturana, S.L., Matthewson, M., Dwan, C., & Norris, K. (2018). Characteristics and
experiences of targeted parents of parental alienation from their own perspective: a
systematic literature review. Australian Journal of Psychology, 71(2), 83-91. DOI:
10.1111/ajpy.12226
Author contributions:
Conceptualised the paper: Candidate
Assisted in conceptualising the paper: Author 1, Author 2
Conceived and designed the study: Candidate
Designed and conducted the systematic literature review: Candidate
Analysed the data: Candidate

VI
Assisted in analysing the data: Author 1
Wrote the manuscript: Candidate, Author 1
Review and edit drafts: Candidate, Author 1, Author 2
Review and provided feedback: Author 1, Author 2, Author 3
Help with the development of resubmission letters and revisions: Author 1
PAPER 2: Located in Chapter V
Lee-Maturana, S.L., Matthewson, M., & Dwan, C. (accepted). Understanding targeted

parents’ experiences of parental alienation: a qualitative description from their own
perspective. American Journal of Family Therapy.
Collected and analysed the data: Candidate
Wrote the manuscript: Candidate
Review and edit drafts: Author 1, Author 2
Review and provided feedback: Author 1, Author 2
PAPER 3: Located in Chapter VI
Lee-Maturana, S.L., Matthewson, M., & Dwan, C. (2020). Targeted parents surviving
parental alienation: a qualitative description of the consequences and coping strategies.
Journal of Child and Family Studies, 1-13. https://doi.org/10.1007/s10826-020-01725-1
VII
Collected and analysed the data: Candidate
Wrote the manuscript: Candidate
Review and edit drafts: Author 1, Author 2
Review and provided feedback: Author 1, Author 2
We, the undersigned, endorse the above stated contribution of work undertaken for
each of the published (or submitted) peer‐reviewed manuscripts contributing to this
thesis:
Signed:
______________________ ______________________ ______________________

Sau-lyn Lee Maturana Dr. Mandy Matthewson Dr. Lisa Foa
Candidate Primary Supervisor Head of School
School of Psychological Sciences School of Psychological Sciences School of Psychological Sciences
University of Tasmania University of Tasmania University of Tasmania
Date:
15 June 2020 28 June 2020 13 July 2020

______________________ ______________________ ____________________
VIII
Statement regarding Published Work contained in this Thesis
The publishers of the papers comprising Chapters IV and VI hold the copyright for
that content and access to the material should be sought from the respective journals. The
remaining non-published content of the thesis may be made available for loan and limited
copying and communication in accordance with the Copyright Act 1968.

IX
Acknowledgements
There are many people who I would like to acknowledge and express my sincere gratitude to,
for they have contributed to this journey full of challenges and good experiences. And because
without them, achieving this goal would not have been possible.
First and foremost, I thank to my husband, Mauricio, who gave me the motivation to initiate
this challenging journey, for being part of this family and academic project, and for his faithful
support and love, at home and at Uni. Thanks to my sweet and beautiful Matilda and my handsome
and brave Agustín. Both are the centre of my life, the light that guides me, the energy that moves me,
my happiness, my everything.
Thanks to my family for their unconditional love and support. Dad, mum, Hugo, my brothers
Giovanni and Yat-sen, and my parents in law, especially my mother-in-law Norma, who was willing
to come several times to help us with the kids.
I would like to express my sincere gratitude to my primary supervisor Dr. Mandy Matthewson
for the continuous support of my PhD study, for her patience, motivation and immense knowledge.
Mandy has guided me all the time of research and writing of this thesis. I appreciate all her
contributions of time, ideas, and specially providing tweaks to my English grammar. I could not have
imaged having a better supervisor and mentor for my PhD study. Also, I would like to thank my
supervisor team, especially to Dr. Corinna Dwan for her insightful comments that encouraged me to
consider different perspectives of my research.
I gratefully acknowledge the funding sources that made my Ph.D. possible. I was funded by
the Chilean Government, through Conicyt BecasChile and sponsored by the Universidad de Tarapacá
in Arica. Thanks to the University of Tasmania, BecasChile, Universidad de Tarapacá and the
Parental Alienation Study Group (PASG) for the financial support and for trusting my project.
Last but not least, my most sincere gratitude to Eeny Meeny Miney Mo Foundation, to
Amanda Sillar (CEO and founding director) and to each and every targeted parent who participated
in my research sharing their stories with me. This research is about and for them.
Sau-lyn L.M.
X
Table of Contents
Declaration of originality………………………………………………………. II
Statement of authority of access……………………………………………….. III
Statement of ethical conduct…………………………………………………… IV
Statement of co-authorship…………………………………………………….. V
Statement regarding published work contained in this thesis………………….. VIII
Acknowledgements…………………………………………………………….. IX
Table of contents……………………………………………………………….. X
List of tables……………………………………………………………………. XV
List of figures…………………………………………………………………... XVII
List of abbreviations……………………………………………………………. XVIII
Publications…………………………………………………………………….. XIX
Abstract…………………………………………………………………………. XX
Chapter I.
1. Introduction……………………………..............……………………………………........25
Chapter II.
2. Theoretical and historical background...…………...…..…………………………….........32
2.1. PA definitions……...….………........................……………………….………...32
2.2. Syndromes that describe PA.................................................................................34
2.3. History of PA........................……………………………………………………42
2.4. The alienating parent…………………………………….……………………....56
2.5. The child…………..............……………………………………………………..60
2.6.The targeted parent……………………………………………………………….61
Chapter III.
3. Methodology and Methods.......…..…………………………………………......................65

XI
3.1. Research questions and aims.................................................................................65
3.2. Research design.....................................................................................................66
3.3. Sample strategy and recruitment process..............................................................69
3.4. Data collection.......................................................................................................70
3.5. Data analysis.........................................................................................................74
3.6. Trustworthiness of the study.................................................................................76
Chapter IV.
4. Study One: A systematic literature review.......................…………………………………80
4.1. Introduction……………………………………………………………………...81
4.2. Material and methods……………………………………………………………83
4.2.1. Design………………………………………………………………….83
4.2.2. Procedure and search strategy…………………………………………83
4.2.3. Inclusion and exclusion criteria………………………………………..84
4.2.4. Data analysis……………………………………………………....…..84
4.3. Results…………………………………………………………………………...84
4.4. Discussions………………………………………………………………………92
4.4.1. Characteristics of targeted parents…………………………………….92
4.4.2. Targeted parents’ experiences of alienation and its impact…………...94
4.4.3. Cultural concerns……………………………………………………....96
4.4.4. Recommendations for practitioners…………………………………...97
4.4.5. Limitations of this study and recommendations for research…………97
4.5. Conclusion………………………………………………………………………98
Chapter V.
5. Study Two: A qualitative description of targeted parents’ experiences.............................100
5.1. Introduction.........................................................................................................101
XII
5.2. Methods...............................................................................................................103
5.2.1. Participants...........................................................................................103
5.2.2. Procedure and materials.......................................................................104
5.2.3. Design...................................................................................................105
5.2.4. Data analysis........................................................................................106
5.3. Results.................................................................................................................107
5.3.1. Demographic information of targeted parents.....................................107
5.3.2. Targeted parents’ experiences..............................................................108
5.3.2.1. TPs experiencing family violence before the alienation.......109
5.3.2.2. TPs experiencing the alienation............................................112
5.4. Discussion...........................................................................................................119
5.5. Limitations of this study and recommendations for research.............................124
5.6. Conclusion...........................................................................................................125
Chapter VI.
6. Study Three: A qualitative description of the consequences of the alienation on targeted
parents and their coping strategies.........................................................................................126
6.1. Introduction.........................................................................................................127
6.2. Methods...............................................................................................................129
6.2.1. Participants...........................................................................................129
6.2.2. Design and Procedure...........................................................................130
6.2.3. Data analysis........................................................................................131
6.3. Results.................................................................................................................131
6.3.1. Consequences of the alienation on targeted parents.............................133
6.3.1.1. Emotional..............................................................................133
6.3.1.2. Behavioural...........................................................................141
XIII
6.3.1.3. Finances/work.......................................................................143
6.3.1.4. Cognitive...............................................................................144
6.3.1.5. Physical.................................................................................146
6.3.1.6. Social.....................................................................................148
6.3.2. Coping strategies used by targeted parents..........................................149
6.3.2.1. Mental activities....................................................................150
6.3.2.2. Social activities.....................................................................150
6.3.2.3. Professional help...................................................................150
6.3.2.4. Being busy.............................................................................151
6.3.2.5. Family support......................................................................151
6.3.2.6. Physical activities..................................................................152
6.3.2.7. Hobbies..................................................................................152
6.3.2.8. Faith.......................................................................................153
6.3.2.9. Not coping well or not coping at all......................................153
6.4. Discussions..........................................................................................................154
6.5. Conclusions.........................................................................................................159
6.6. Limitations and recommendations for future research........................................159
Chapter VII.
7. Discussions and final conclusions......................................................................................162
7.1. Key findings and contribution to the literature...................................................165
7.2. Suggestions for interventions with targeted parents...........................................189
7.3. Evaluation: strengths, limitations and future research........................................197
References.............................................................................................................................202
Appendixes.
Appendix A- Information sheet..................................................................................214

XIV
Appendix B- Consent Form.......................................................................................216
Appendix C- Targeted parents’ screening tool..........................................................217
Appendix D- Ethical approval....................................................................................220
Appendix E- Reflexive Statement..............................................................................222

XV
List of tables
Table 2.1 Other syndromes or alternative names describing the essence of PA..............35
Table 2.2 Historical timetable of contributions to the literature on PA...........................47
Table 2.3 Alienating strategies proposed by Baker and Darnall (2006) .........................59
Table 3.1 Research questions and aims............................................................................66
Table 3.2 Participants’ sociodemographic information...................................................72
Table 3.3 Interview guide.................................................................................................73
Table 3.4 Criteria and strategies for judging trustworthiness in Study Two and Study
Three.................................................................................................................77
Table 4.1 Reasons of articles excluded............................................................................86
Table 4.2 Demographic synthesis....................................................................................87
Table 4.3 Articles synthesis..............................................................................................89
Table 5.1 No. of participants according to range of age and gender..............................103
Table 5.2 Time of alienation and time separated from alienating parent according to
gender of targeted parent................................................................................107
Table 5.3 Description of the theme ‘family violence experienced by targeted parents
before the alienation’......................................................................................109
Table 5.4 Elements of psychological violence reported by targeted parents by
gender.............................................................................................................112
Table 5.5 Description of the theme ‘targeted parents experiencing the alienation’.......112
Table 6.1 Consequences of the alienation in targeted parents.......................................133
Table 6.2 Terms describing the emotions displayed by targeted parents while
experiencing the alienation in their own words.............................................135

XVI
Table 6.3 Negative emotions displayed by targeted parents experiencing the alienation
using Roseman’s Emotion system..................................................................139
Table 6.4 Terms describing how targeted parents feel about parental alienation in their
own words......................................................................................................140
Table 6.5 Behavioural consequences due to alienation reported by targeted parents....142
Table 6.6 Finances/Work consequences experienced by targeted parents because
parental alienation..........................................................................................143
Table 6.7 Cognitive consequences of PA reported by targeted parents.........................145
Table 6.8 Physical consequences reported by targeted parents as a result of the
alienation........................................................................................................147
Table 6.9 Social consequences reported by targeted parents as a result of the
alienation........................................................................................................148
Table 6.10 Coping strategies used by targeted parents to deal with the alienation..........149
Table 7.1 Research Questions, their Answers and Key Findings..................................164
Table 7.2 Family violence identified in targeted parents’ narratives.............................174
Table 7.3 Aspects of the ambiguous loss (Boss, 2007) related to the narratives of
targeted parents who participated in this study..............................................178
Table 7.4 Comparison between the consequences of ambiguous loss according to
Weiner (1999) and the consequences of parental alienation reported by
targeted parents who participated in this study..............................................180

XVII
List of figures
Figure 4.1 Summary of literature search adapted from PRISMA flow diagram...............85
Figure 5.1 Themes of the targeted parents’ experiences.................................................108
Figure 6.1 Themes and subthemes of the targeted parents’ experiences of parental
alienation........................................................................................................132
XVIII
List of abbreviations
AP Alienating Parent
CCV Coercive Control Violence
FV Family Violence
IPV Intimate Partner Violence
MSP Munchausen Syndrome by Proxy
NHMRC National Health and Medical Research Council
PA Parental Alienation
PAS Parental Alienation Syndrome
TMS Threatened Mother Syndrome
TP Targeted Parent
XIX
Publications
In Chapter IV:
Lee-Maturana, S.L., Matthewson, M., Dwan, C. & Norris, K. (2018). Characteristics
and experiences of targeted parents of parental alienation from their own perspective:
a systematic literature review. Australian Journal of Psychology. 71(2), 83-91. DOI:
10.1111/ajpy.12226
In Chapter V:
Lee-Maturana, S.L., Matthewson, M., & Dwan, C. (accepted). Understanding
targeted parents’ experiences of parental alienation: a qualitative description from
their own perspective. This paper was submitted to the American Journal of Family
Therapy.
In Chapter VI:
Lee-Maturana, S.L., Matthewson, M., & Dwan, C. (2020). Targeted parents
surviving parental alienation: a qualitative description of the consequences and coping
strategies. Journal of Child and Family Studies, 1-13. https://doi.org/10.1007/s10826-
020-01725-1
XX
Abstract
Background: Parental alienation (PA) is a phenomenon that occurs among families during
and after separation. It can be defined as the influence of one parent over a child to turn him
or her against the other parent (Bernet, von Boch-Galhau, Baker, & Morrison, 2010; Garber,
2011) without legitimate justification (Bernet & Baker, 2013). The child is encouraged to
refuse or resist a relationship with the other parent, the targeted parent, and align themselves
intensely with the other, the alienating parent (Garber, 2011). The experience of the targeted
parent is under-researched. Although some studies identified common emotions experienced
by targeted parents such as frustration, stress, fear, powerlessness, helplessness and anger at
the constant interference by the alienating parent (Baker, 2010b; Baker & Andre, 2008; Baker
& Darnall, 2006; Vassiliou & Cartwright, 2001); this literature relies on the reports from
children and mental health and legal professionals rather than the views of targeted parents
themselves. In addition, most of these studies have small sample sizes with data
predominantly from United States, United Kingdom and Canada.
Aims: This thesis aimed to explore, identify and describe targeted parents’ experiences of
being alienated from their children, the consequences and their coping mechanisms from their
own perspective. This research provides a greater understanding of targeted parents’
experiences and needs, and may aid in the development of future appropriate support services
and intervention programs.
Methods: This thesis consists of three related studies. Study One is a systematic review of
the literature following the Preferred Reporting Items for Systematic Reviews and Meta-
Analysis protocol, PRISMA-P (Shamseer et al., 2015). The study was registered in
XXI
PROSPERO, ID= CRD42017062533 (Booth, Clarke, Ghersi, Moher, Petticrew, & Stewart,
2011). The findings were analysed using “guidance on the conduct of narrative synthesis in
systematic reviews” (Popay et al., 2006). Study Two (exploring participants’ experiences of
PA) and Study Three (exploring the consequences of the alienation on participants’ and their
coping strategies) employed a qualitative descriptive design (Sandelowski, 2000), and used a
purposive sample by criterion sampling method (Patton, 2002). Participants were recruited
through advertisement in the media, online support groups and psychology and legal
practices who agreed to advertise the study on behalf of the researcher. Fifty-four self-
referred targeted parents alienated from their children participated voluntarily in the studies.
Data were collected through a demographic survey developed by the researcher and in-depth
semi-structured interviews conducted in person, via telephone or Skype. The interviews were
audio recorded for data accuracy purposes and transcribed verbatim. Each participant was
provided with a copy of their transcript to give them the opportunity to modify or confirm the
information provided. Data were analysed thematically and inductively following the six
phases proposed by Braun and Clarke (2006): familiarisation with the data, generation of
codes using NVivo-11 (QSR International, 2015), searching for potential themes, reviewing
the themes, defining and naming the themes and weaving together the narrative and data
extracts contextualising the analysis to existing literature. Trustworthiness strategies (Lincoln
& Guba, 1985) were used to ensure the quality of the thesis such as: peer debriefing and
members checking (credibility); purposive sampling (transferability); audit trail, code-recode
procedure and peer examination (dependability); and reflexivity (confirmability). Ethical
approval was obtained from the University of Tasmania’s Social Sciences Human Research
Ethics Committee (Ethics Ref No: H0015333).

XXII
Results: Study One demonstrated the lack of studies focusing on the views of targeted
parents. Only 11% of articles pertaining to PA focused directly on targeted parents, with only
3.6% describing their characteristics and experiences from their own perspective. In addition,
gaps in the literature regarding the experiences and consequences of targeted parents and
their coping mechanisms used to deal with the alienation were identified. Study Two found
that targeted parents were equally likely to be mothers and fathers and family violence was
found to be a key aspect of the alienation process. The targeted parents in this study were
active in their efforts to maintain a relationship with their children despite alienation.
Moreover, extended family members and schools could also be alienators. Study Three found
that targeted parents suffer ambiguous loss and disenfranchised grief manifested as
psychological difficulties. Targeted parents described experiencing sadness, distress,
frustration, anger, guilt and shame. They appeared to be at risk of suicide thoughts/attempts,
and they tended to engage in negative automatic thoughts. Their social networks had been
affected by the alienation however, they were involved in different types of activities that
work as coping strategies.
Conclusion: This thesis has shown PA is not bound by geographical borders and the
experience of targeted parents is universally the same. This thesis adds valuable information
that can be used by practitioners working with targeted parents. Understanding targeted
parents’ experiences of PA involves understanding how they feel, how they behave and how
they think about being separated from their children. Targeted parents are active in their
attempts to reunite with their children. Targeted parents can be considered survivors of
family violence perpetuated by the alienated parent and their allies. As such, targeted parents
can present with symptoms of trauma. There appears to be specific events that trigger the
alienation. Understanding these events and the sequalae of these events is important in the
XXIII
development of prevention programs. In conclusion, this thesis allows for a greater
understanding of targeted parents’ experiences of parental alienation. It also illustrates how
targeted parents’ lives are affected in a range of ways including ongoing emotional pain,
displayed as psychosomatic symptoms of unresolved grief, placing them in need of
appropriate psychological interventions.

24
Chapter I
Introduction
25
1.- Introduction.
Parental alienation (PA) is a phenomenon that occurs among families, often during
and after separation when child custody decisions are involved. It can be defined as the
influence of one parent over a child to turn him or her against the other parent (Bernet, von
Boch-Galhau, Baker, & Morrison, 2010; Garber, 2011) without legitimate justification
(Bernet, 2010; Bernet & Baker, 2013). The child is encouraged to refuse or resist a
relationship with the other parent (targeted parent) and align themselves intensely with the
other (alienating parent) (Garber, 2011). Some authors have suggested that PA is a form of
child abuse and family violence (Baker & Ben-Ami, 2011; Harman, Kruk, & Hines, 2018;
Kruk, 2018; Reay, 2015). It is important to note that a child rejecting a parent on reasonable
grounds, such as when true parental abuse or neglect is present is considered estrangement
(Garber, 2011) not PA (Gardner, 2001; Reay, 2015). PA can occur even if the relationship
between the child and targeted parent was previously positive (Bernet & Baker, 2013;
Darnall, 2011).
The concept of PA has had a difficult history. This is largely the result of the
controversy surrounding the view of PA as a syndrome. Gardner (2002b) stated that Parental
Alienation Syndrome (PAS) consists of a cluster of eight symptoms that usually appear
together in almost all cases of moderate and severe PA. In addition, the same author claimed
that PAS must be included in the Diagnostic and Statistical Manual for Mental Disorders -
Fifth Edition (DSM-5; American Psychiatric Association, 2013), stating it was the only
solution to help families with PAS. However, at that time there was not enough evidence to
support this claim, and consequently PAS was not considered a valid construct (Kelly &
Johnston, 2001; Walker & Shapiro, 2010) because it lacks a pathological basis (Kelly &
Johnston, 2001).
26
Currently, research about PA is increasing in an effort to recognise PA as a legitimate
and serious problem that affects the child, their parents and the family system. Moreover,
these efforts have been supported in the work of Bernet et al. (2010) proposing and justifying
the clinical reasons for including a diagnosis of PA in the DSM-5 and in the International
Classification of Diseases 11th version, ICD-11 (World Health Organization, 2018) as
Parental Alienation Disorder or as Parental Alienation Relational Problem. The authors claim
there is enough research regarding validity, reliability and prevalence to support this
inclusion. However, Bernet et al.’s (2010) proposal was rejected by the DSM Taskforce
(Harman & Biringen, 2016), mainly because the DSM already has codes to diagnose the
consequences of PAS.
The three main “players” involved in the PA dynamic are: the alienating parent, who
uses strategies to distance the child from the other parent; the targeted parent, who is
alienated from the child; and the child, who the alienating parent distances from the targeted
parent and supports the alienating parent. Further, PA may include the extended family as
part of the alienating parent’s strategy to support their campaign against the targeted parent
and their family (Baker, 2005b; Ellis, 2005; Gardner, 2001; Reay, 2015; Vassiliou &
Cartwright, 2001).
There is extensive literature describing the characteristics and behaviours of
alienating parents. Alienating parents have been described as having narcissistic and paranoid
personalities, they tend to have abnormal grief reactions; they tend to have a family history of
unresolved problems and conflict; and have difficulty emancipating themselves from their
parents (Baker, 2005a, 2006; Ellis & Boyan, 2010; Kopetski, 1998a, 1998b; Lund, 1995;
Rand, 1997a, 1997b). Additionally, alienating parents’ behaviour has been compared to the
behaviour of cult leaders due to their use of emotional manipulation techniques aimed at
enhancing dependency and obtaining psychological benefits at the expense of their child’s
27
wellbeing just as cult leaders foster dependence in their followers (Baker, 2005b; Baker &
Darnall, 2006; Darnall, 2011; Kopetski, 1998a). Research has also shown there are serious
consequences of PA to the child. These consequences include: low self-esteem, depression
and anxiety, sleep disturbances, relationship difficulties, social isolation, and drug and
alcohol misuse (Baker, 2005b, 2010b; Ben-Ami & Baker, 2012; Friedlander & Walters,
2010; Godbout & Parent, 2012; Johnston, Walters, & Olesen, 2005; Kopetski, 1998b).
Despite a large body of literature describing alienating parents and children, research
about targeted parents, their characteristics and experiences is scarce. Nevertheless, some
authors have identified that targeted parents can be passive, overly accommodating or
emotionally repressed, and tend to have symptoms of psychological distress, such as
depression and anxiety (Kopetski, 1998b), fear, post-traumatic stress disorder, insomnia
(Giancarlo & Rottmann, 2015), frustration, powerlessness, helplessness and anger due to
constant interference from the alienating parent (Baker, 2010a; Baker & Andre, 2008; Baker
& Darnall, 2006; Vassiliou & Cartwright, 2001). Most recently, targeted parents have been
described as competent parents whose well-being has been affected by being alienated from
their child (Balmer, Matthewson, & Haines, 2017), who are suffering the burden of financial
costs and poor mental health as a result of the alienation (Poustie, Matthewson, & Balmer,
2018).
The majority of current literature on targeted parents relies on the reports of alienating
parents, children, and mental health and legal professionals rather than the reports of targeted
parents themselves. Despite an increase in research about targeted parents, no research
specifically describing targeted parents’ experiences, the consequences of the alienation on
them and their coping strategies have been conducted. Moreover, most of the articles had
small sample sizes with data mostly from the United States, United Kingdom and Canada.
This research was aimed at addressing the gap in the literature. Specifically, by exploring:
28
1. What is known in the existing academic literature about the characteristics and
experiences of targeted parents of PA from their own perspective?
2. How do self-referred targeted parents alienated from their children experience the
alienation?
3. How have self-referred targeted parents been affected by the alienation and how have
they coped with the alienation?
The present thesis seeks to answer these research questions in order to develop a
greater understanding of targeted parents’ experiences and needs; which may assist in the
development of future appropriate support services and intervention programs for them.
Thesis structure.
The thesis is organised into seven chapters. This Chapter, is the introduction to this
thesis. Chapter II discusses the theoretical and historical background of PA, including
definitions and a description of the three ‘players’ involved in the alienation dynamic: the
alienating parent, the child and the targeted parent. Chapter III describes the methodology
and methods used, presenting the research questions, aims and the theoretical framework of
the design chosen: qualitative description. In addition, a description of the sampling methods,
data collection, data analysis and trustworthiness of the three studies is provided.
Chapter IV presents a systematic review of the literature on the characteristics and
experiences of targeted parents of PA, seeking to answer the first research question: What is
known in the existing academic literature about the characteristics and experiences of
targeted parents of PA from their own perspective? The academic databases Web of Science,
PsychINFO, PubMED, Embase-Elsevier and the Cochrane Central Register of Controlled
Trials were systematically searched to identify what has been published about the topic and
29
what are the gaps in the literature. This section corresponds to Study One of this thesis ‘A
systematic literature review’ and the findings have been published in the Australian Journal
of Psychology under the title ‘Characteristics and experiences of targeted parents of parental
alienation from their own perspective: a systematic literature review’ (See Publications in
page XIX).
Chapter V presents Study Two of this research ‘A qualitative description of targeted
parents’ experiences’, seeking to answer the second research question: How do self-referred
targeted parents alienated from their children experience the alienation? This study aims to
describe and understand targeted parents’ experiences of PA from their own perspective.
Conducting and analysing in-depth semi-structured interviews, it was possible to obtain a
qualitative description of their experiences, reporting what happened with targeted parents
before the alienation and what targeted parents have experienced during the alienation. Some
common demographic characteristics were also found. This section has been submitted to the
American Journal of Family Therapy under the title ‘Understanding targeted parents’
experiences of parental alienation: a qualitative description from their own perspective’ (See
Publications in page XIX) and it has been accepted.
Chapter VI describes Study Three ‘A qualitative description of the consequences of
the alienation on targeted parents and their coping strategies’, seeking to answer the third
research question: How have self-referred targeted parents been affected by the alienation
and how have they coped with the alienation? In this section the consequences of the
alienation on targeted parents and their coping strategies are described after analysing the
interviews. This study has been published in the Journal of Child and Family Studies under
the title ‘Targeted parents surviving parental alienation: a qualitative description of the
consequences and coping strategies’ (See Publications in page XIX). Chapter VII discusses
the results of the three studies and provides an overall conclusion of this research including:
30
key findings and contribution to the literature; suggestions for interventions with targeted
parents; strengths and limitations of this thesis; and directions for future research.
Hence, the following sections will allow the reader to delve into the experiences of
targeted parents who have been alienated from their children. The three studies presented
below, will increase the understanding of the phenomenon of PA from the perspective of
targeted parents. It will also serve as a contribution to the academic literature and to the
professionals working in PA matters.
For the purposes of this thesis, the term ‘parental alienation’ was used in regard to the
dysfunctional phenomenon that occurs among families when a child rejects or refuses contact
or a relationship with the targeted parent with no reasonable justification but a perceived
campaign from the alienating parent. ‘Parental alienation syndrome’ (PAS) was used when
referring to published or original material using that terminology.

31
Chapter II
Theoretical and Historical
Background
32
This section provides a theoretical background on how the literature defines PA and
how the concept has evolved overtime; particularly in the efforts to distinguish PAS and
other related syndromes from PA. A general overview of the main ‘players’ involved in the
dynamics of PA is discussed, and attention is drawn to how research about targeted parents
has been understudied.
2. Theoretical background.
2.1. Parental alienation definitions.
As previously described, PA can be defined as the influence of one parent (alienating
parent) over a child to turn him or her against the other parent, the targeted parent (Bernet,
von Boch-Galhau, Baker, & Morrison, 2010; Garber, 2011), without legitimate justification
(Bernet et al., 2010; Bernet & Baker, 2013); often PA occurs when child custody decisions
are involved. The child and the alienating parent form an alliance against the targeted parent,
often supported by third parties such as the family and friends of the alienating parent. This
rejection can occur even if the relationship between the targeted parent and the child was
positive, close and loving in the past. Some authors highlight that PA is a form of child abuse
(Baker & Ben-Ami, 2011; Harman, Kruk, & Hines, 2018; Kruk, 2018; Reay, 2015); others
claim it is a form of family violence (Harman, Kruk, & Hines, 2018; Harman & Matthewson,
2020; Poustie, et al., 2018).
Definitions of PA are described in the literature containing different nuances in the
focus of attention. Two perspectives were identified in an attempt to define the phenomenon:
definitions with a focus on the child and definitions with a focus on the alienating parents’
behaviours.
The concept of PA used to describe the behaviours of the child are:
Parental alienation is defined as that dynamic which occurs when a child’s
internal working model of Parent B is disproportionately corrupted by her

33
experience of Parent A’s damning words and actions concerning Parent B
(Garber, 2013).
Parental alienation is a serious mental condition in which a child usually one
whose parents are engaged in a high conflict separation or divorce allies
himself or herself strongly with an alienating parent and rejects a relationship
with the targeted parent without a legitimate justification (Lorandos, Bernet,
& Sauber, 2013).
Parental alienation refers to the child’s strong alliance with one parent and
rejection of a relationship with the other parent without legitimate
justification (Bernet, 2010; p.4).
The concepts used to describe the behaviours of the alienating parents are:
Parental alienation is when one parent turns the child against the other parent
through powerful emotional manipulation techniques designed to bind the
child to them at the exclusion of the other parent (Baker, 2005a).
Parental alienation is a set of behaviours that have a very negative impact on
children and the entire family dynamic. It is emotionally abusive and affects
how children perceive past, current, and future relationships (Harman &
Biringen, 2016; p.18).

34
Although, differences in definitions and emphasis exist (considering PA as a dynamic,
a mental condition on the child, an alliance or a set of behaviours), the basis of this
phenomenon remains the same, reflecting two aspects:
1) in PA there is a child who rejects and turns against a parent, and
2) this rejection does not have a reasonable or legitimate justification.
In addition, the clinical literature has discussed syndromes and diagnoses over the
time that in essence, describe what the PA phenomenon is or how the PA phenomenon
behaves. The following section presents some of the syndromes discussed in the literature
and how they relate to PA.
2.2. Syndromes that describe PA.
During the last seven decades, the literature has described at least 19 syndromes or
concepts that might be considered to be examples of PA. These are included in Table 2.1,
described in more detail. The presentation of the description of the syndromes has been
organized into two groups: the first one, groups those that focus on the behaviour of the
parents; and the second one, groups those that focus on children.
35
Table 2.1
Other Syndromes or Alternative Names Describing the Essence of PA
Alternative name Author
Narcissistic Injury Reich, 1945
Pathological Alignment Wallerstein & Kelly, 1976; Johnston, 1993
The Munchausen Syndrome by Proxy Meadow, 1977
Unambivalent Preferences Levy, 1978
Parental Alienation Syndrome Gardner, 1985
Strong Alignments, Loyalty Conflict and Shifting Johnston, Campbell, & Mayes, 1985
Allegiances
The Medea Complex Syndrome Jacobs, 1988
The Modern Medea Wallerstein & Blakeslee, 1989
Entangled with Medea-like rage Wallerstein & Blakeslee, 1989
Visitation Refusal Wallerstein & Kelly, 1980
Programming or Brainwashing Clawar & Rivlin, 1991
Parental Disengagement / Paternal Disengagement Kruk, 1992ab, 1994
The Contemporary -Type of Munchausen Syndrome Rand, 1993; Jones, Lund, & Sullivan, 1996.
Toxic Parent Cartwright, 1993
Divorce Related Malicious Mother Syndrome Turkat, 1995
Divorce Related Malicious Parent Syndrome Turkat, 1999
The Alienated Child Kelly & Johnston, 2001
Pathological Alienation Stahl, 2003; Warshak, 2006, 2010a
The Threatened Mother Syndrome Klass & Klass, 2005
Syndromes that describe PA with a focus on the parents
The Munchausen syndrome by proxy.
In 1977, Dr. Roy Meadow described for the first time what was previously termed
Munchausen syndrome by proxy (MSP). Today, this term can be found under the name
‘factitious disorder imposed on another’ in the DSM-5 (American Psychiatric Association,
2013). He identified this form of child abuse in which a parent, usually the mother, fabricates
36
illnesses in a child by exaggerating and/or fabricating the child’s symptoms, sometimes
inflicting harm on him/her to deliberately make him/her sick, resulting in unnecessary
medical and psychological treatments and hospitalisations (Meadow, 1985). A contemporary-
type of this syndrome was recognised by Rand (1989, 1993), occurring when a parent,
usually the mother, creates the appearance that the child has been abused by someone else,
usually the father, in a divorce, custody or visitation dispute to obtain the attention and
recognition from professionals such as police, social workers or therapists, who act as
protectors of the abused child. The ‘contemporary-type’ of Munchausen by proxy syndrome
has been compared with some cases of PA, especially with those that involve false
allegations of abuse (Rand, 1993).
Jones, Lund and Sullivan (1996) explain that MSP is utilised in PAS cases when: (1)
the MSP mother during the marriage precipitates the divorce through the false allegations of
child abuse; (2) the MSP parent who feels angry or rejected in divorce uses the false
allegation of abuse or manipulates the child’s medical care as revenge towards their now ex-
partner, or to maintain the symbiotic bond with the child preserving the freedom to continue
the MSP behaviours; (3) the MSP parent dealing with the losses and stress of divorce wants
to obtain social support from the child and care providers; and (4) an alienating parent might
present MSP behaviours by manipulating the child’s medical care just to further their
alienation agenda.
Another syndrome, the Medea Complex/Syndrome or the modern Medea, has been
also compared to the alienating behaviours manifested in PA.
The Medea Complex/Syndrome.
In simple words, the Euripides’ Greek tragedy Medea tells the story of a woman who
kills her two children to take revenge on her husband who left her to marry the King’s
37
daughter. Some authors have compared Medea’s tragedy with what happens in PA and the
desires of the alienating parent to hurt and avoid contact between the children and the other
parent. In 1988, John W. Jacobs’ analysed and compared psycho-dynamically the case of a
divorcing family with Euripides’ tragedy. He calls it ‘Medea Complex’ and he described it in
the following way:
Analysis of Euripides’ play, Medea, and a divorcing family suggests that
divorce between a narcissistically scarred, embittered, dependent woman and
a pathologically narcissistic, devaluating man may lead to the mother’s
attempt to sever father-child contact as a means of revenging the injury
inflicted on her by the loss of a self-object her hero-husband (Jacobs, 1988).
Also, Wallerstein and Blakeslee (1989) describe the ‘modern Medea’ as parents who
want revenge on their spouses by destroying the relationship between the other parent and the
child, not by literally killing the child. They described the Medea syndrome in this way:
The Medea syndrome has its beginnings in the failing marriage and
separation, when parents sometimes lose sight of the fact that their children
have separate needs [and] begin to think of the child as being an extension of
the self... A child may be used as an agent of revenge against the other
parent...or the anger can lead to child stealing (Wallerstein & Blakeslee,
1989).
The Medea Complex/Syndrome or the modern Medea is diagnosed in the parent who
wants to hurt the other parent in the context of separation or divorce. Another Syndrome, the
Divorce Related Malicious Parent Syndrome, describes parents behaving with the aim of
hurting the other parent resulting in the alienation from their children.
38
Divorce Related Malicious Parent Syndrome.
In 1995, Turkat presented the concept of Divorce Related Malicious Mother
syndrome, later modified to Divorce Related Malicious Parent syndrome (Turkat, 1999) to
describe the behaviours of some parents in the context of divorce and which matches some of
the alienating behaviours involved in PA described in the literature (Baker & Darnall, 2006).
According to Turkat (1999), there are four behaviours presented as a taxonomical criterion
that a ‘malicious parent’ manifests: (1) unjustifiable punishment against his or her divorcing
or divorced spouse by attempting to: alienate their mutual child(ren) from the other parent,
involving others in malicious actions against the other parent or engaging in excessive
litigation; (2) attempts to deny child(ren)’s: regular uninterrupted visitation with the other
parent, telephone access to the other parent or participation by the other parent in the
child(ren)’s school life and extra-curricular activities; (3) a pervasive pattern that includes
malicious acts towards the other parent such as: lying to the children, lying to others or
violating the law; and (4) the author clarifies that the Divorce Related Malicious Parent
syndrome is not specifically due to another mental disorder although a separate mental
disorder may co-exist.
Parents can manifest different maladaptive behaviours as a reaction to divorce or
separation. Another syndrome, The Threatened Mother Syndrome, also has been compared
with AP and the alienating behaviours when describing how some mothers react when they
feel their relationship with their child/ren is threatened.
The Threatened Mother Syndrome.
Klass and Klass (2005) define Threatened Mother Syndrome (TMS) as the reaction
that a caretaker manifests when his/her bond with a young and dependent child is
immediately threatened. These reactions are impulsive and episodic in nature including rage,
39
screaming, manipulation, intolerance, subterfuge, irritability and aggressiveness; however,
they decrease when the threat is removed. Comparing to PAS, the authors clarify that TMS
behaviours can be more reactive and in short-term than the PAS behaviours, which are more
persistent and calculated.
Shifting focus from the behaviours of the alienating parent and instead considering
how PA presents in the child, the following syndromes are discussed next: Parental
Alienation Syndrome, Strong Alignments and Pathological Alienation.
Syndromes that describe PA with a focus on the children
Parental Alienation Syndrome (PAS).
Parental Alienation Syndrome is a cluster of eight symptoms diagnosed in the child
that usually appear together in almost all cases of moderate and severe PA (Gardner, 2002a).
The child, programmed by the alienating parent, initiates a campaign of denigration against
the targeted parent in an attempt to indirectly harm him/her (Gardner, 2003). PAS is defined
as:
... A disorder that arises primarily in the context of child custody disputes. Its
primary manifestation is the child’s campaign of denigration against a parent,
a campaign that has no justification. It’s caused by a combination of a
programming (brainwashing) parent’s indoctrinations and the child’s own
contributions to the vilification of the targeted parent (Gardner, 1998).

40
The following eight behaviours or symptoms (Gardner, 1992) of PAS are:
1) Campaign of denigration against the targeted parent. The child presents complaints
with no legitimate or reasonable reasons against the now hated and feared targeted
parent who was once loved and valued.
2) Frivolous rationalisations for the child’s criticism of the targeted parent. The child’s
complaints against the targeted parent are unjustified and disproportionate to what
they describe.
3) Lack of ambivalence. The child idealises the alienating parent as the good and perfect
parent providing automatic support to him/her, while devaluating and seeing nothing
good in the targeted parent. It is “all-or-nothing thinking”.
4) Independent thinker phenomenon. The child asserts that the rejection toward the
targeted parent is his/her own and their opinion and behaviour have not been
influenced by the alienating parent.
5) Reflexive support of the alienating parent against the targeted parent. The child
automatically takes the alienating parent’s side without doubt or hesitation, while
unwilling to consider the targeted parents’ point of view.
6) Absence of guilt over exploitation and mistreatment of the targeted parent. The child
shows no guilt or remorse when treating the targeted parent in a rude, disrespectful,
oppositional and even, at times, a violent manner.
7) Borrowed scenarios. The child makes statements or accusations toward the targeted
parent utilising the same language used by the alienating parent. The child adopts the
phrases and ideas from the alienating parent that seems to be misunderstood, being
unable to provide details of the events they allege, using words not appropriate for
his/her age or recalling situations prior to his/her ability to remember them. The child
41
may even describe events they were uninvolved in detail as though they were present
at the event.
8) Spread of the child’s animosity toward the targeted parent’s extended family.
Formerly beloved extended family and friends of the targeted parent are suddenly
hated and rejected.
These symptoms can be classified as mild, moderate or severe depending on the
intensity of the child’s rejection of the targeted parent. In cases of mild PAS, the child resists
contact with the targeted parent but still enjoys the relationship with him/her when parenting
time is underway. In cases of moderate PAS, the child strongly resists a relationship with the
targeted parent and shows oppositional behaviours during parenting time with that parent. In
severe cases of PA, the child persistently refuses any contact with the targeted parent,
choosing to avoid them, abscond or engage on violence towards them.
Strong Alignments.
Johnston, Campbell and Meyes (1985) introduced the term strong alignments or
strong alliances to describe how the child consistently denigrates and rejects a parent, often
accompanied by refusal of visitation and communication with the rejected parent. Years later,
Johnston (1993) acknowledges that her description might be related to Gardner’s PAS. Most
recently the term pathological alienation has emerged in the literature.
Pathological alienation.
Warshak (2006, 2010a) describes ‘pathological alienation’ as a disturbance in
children involved in a context of sharing negative attitudes with a parent, showing
unreasonable aversion toward a person or people who formerly had normal relationships or
42
affections. The author mentions that the child’s aversion usually acts in the shadow of the
favoured parent denying the extent to which that favoured parent shapes this view. Later,
Warshak (2010b) questions the use of the term ‘pathological’ in referring to the alienation,
due to an association with the medical model.
Another author who uses the term pathological alienation is Stahl (2003), who
explained it is caused by the attitudes and behaviours of all three parties: the aligned parent,
the rejected parent and the child. He states that a child being caught up in the middle of a
parental conflict has devastating consequences in his/her development because of the child’s
distortions and confusions.
In summary, there appears to be some consensus in the literature on what constitutes
PA. All definitions describe damage in the targeted parent- child relationship as a result of
the influence of an alienating parent. These definitions correspond either to the phenomenon
of PA or to a description of it under the name of other syndromes. However, all definitions
have used different labels and none described the phenomenon from the targeted parent’s
perspective. Below is an historical review of the literature about PA as a concept over the
years, to contribute to the understanding of what is known about it today. It is important to
note that most of the authors mentioned below do not include targeted parents as an object of
their study.
2.3. History of PA.
As early as the 19th century, the phenomenon of PA has been described in the
literature. The first documented case of PA dates from 1804 (King v. De Manneville) when
Mrs. Manneville requested to the King’s Bench for a writ of habeas corpus after her husband
took their eight-month-old daughter from her and threatened that she would never see her
43
child again. The law at that time claimed that the custody of a child, whatever age, belongs to
the father and supported the husband in fulfilling his threat (Wright, 1999). In 1818, the term
‘poisoning the child’s mind’ was referred to in the case of the Marchioness of Westmeat. In
Ball v. Ball (1827), what is now called PA was described as ‘alienation of the affections of
the child’ and in 1887 in the American case (Guillot v. Guillot) it was referred to as
‘vilification of the mother’s character’ (Rand 2013; p.292-293).
During the 1970s, an initial description of the patterns seen in some parents involved
in child custody disputes and high conflict divorce started to appear. Alliances between a
preferred parent and their children to undermine contact or visitation with the other parent, or
how parents use their children as weapons during parental conflict were common themes
reported by scholars (Gardner, 1970; Wallerstein & Kelly, 1976; Westman, Cline, Swift &
Kramer, 1970). Some concepts such as ‘programming’ and ‘brainwashing’ were introduced
in the literature by the American Bar Association (Rand, 2013) as well as ‘pathological
alignment’ (Wallerstein & Kelly, 1976) and ‘unambivalent preferences’ (Levy, 1978).
During the 1980s, studies describing the alliances of children of divorce with one
parent rejecting the other parent increased. Different authors (Benedek & Schetky, 1985;
Johnston, Campbell, & Mayes, 1985; Rivlin, 1985; Wallerstein & Blakeslee, 1989;
Wallerstein & Kelly, 1980) provided observations of their studies that ultimately led to the
description of the same phenomenon. In 1985, Richard Gardner introduced the term Parental
Alienation Syndrome (PAS) to describe what he had been observing during several years
working as a child and adolescent psychiatrist conducting custody evaluations. During this
time, the focus of the observations was on the child, however, a few years later, Wallerstein
and Blakeslee (1989) described the behaviours of some parents who were planting seeds of
doubt in their children against the other parent.

44
Since Gardner’s proposal of PAS, there has been constant controversy in the literature
criticising the phenomenon. Although there has been support in validating PAS as a diagnosis
(Baker & Darnall, 2007; Brody, 2006; Dunne & Hedrick, 1994; Kopetski, 1998a, 1998b;
Rand, 1997a, 1997b; Walsh & Bone, 1997), there are some authors who argue that having a
diagnosis of PA as a syndrome is not useful, is not valid clinically and does not meet the
criteria for a syndrome due to a lack of empirical evidence (Bruch, 2001;Emery, 2005;
Johnston & Kelly, 2004; Walker & Shapiro, 2010).
The literature during the 1990s continued to describe elements of parental
programming and strong alliances, this time in large samples of families involved in custody
or parenting disputes (Clawar & Rivlin, 1991; Johnston, 1993). Also, studies examining the
impact of divorce on non-custodial fathers who lost contact with their children, emerged.
These studies described the concepts of parental disengagement and paternal disengagement
(Kruk, 1992ab, 1994). Other authors (Bernet, 1995; Dunne & Hedrick, 1994; Nicholas, 1997)
dedicated their efforts to extend or confirm the existence of PAS. The studies published
during this era were grounded in the PAS concept, or on the addition of more information
about the phenomenon, such as the age of the children more likely to be alienated, gender of
the alienating parents or motivations of these parents (Clawar & Rivlin, 1991; Darnall, 1998;
Dunne & Hedrick, 1994; Johnston, 1993; Nicholas, 1997; Roseby & Johnston, 1998; Siegel
& Langford, 1998).
Research into the long-term consequences of PA on the child emerged during this
time (Waldron & Joanis, 1996) and the distinction between PA that occurs with
indoctrination (consistent with the Gardner definition of PAS) and PA without indoctrination
(which occurs when the child gravitates to one parent or the other to get out of the ‘war zone’
of parental conflicts) (Bernet, 1995) were described. Moreover, research about the behaviours
and characteristics of alienating parents was of interest (Darnall, 1998; Nicholas, 1997;
45
Roseby & Johnston, 1998; Siegel & Langford, 1998) and the characteristics of the targeted
parent were discussed (Nicholas, 1997).
Discussion during the 21st century appeared to be around three main topics: (1)
including the term PA into the Diagnostic Statistical Manual fifth edition, DSM-5 and the
International Classification of Diseases eleventh edition, ICD-11 (Bernet et al. 2010; Ellis,
2000); (2) proposing new theoretical frameworks such as the continuum of children’s
relationship with parents after separation (Kelly & Johnston, 2001); and (3) presenting
therapeutic interventions such as the Multi-Modal Family Intervention- MMFI (Johnston,
Walters, & Friedlander, 2001), its refinements (Friedlander & Walters, 2010) and the Family
Bridges Workshop (Warshak, 2010b).
A variety of studies contributing to the description of the main ‘players’ involved in
PA increased also during these years. For example, studying the characteristics and
behaviours of alienating parents (Baker, 2005bc; Baker & Darnall, 2006; Burril, 2001;
Gordon, Stoffey, & Botinelli, 2008), the characteristics and consequences of PA on children
(Baker, 2007; Bernet, Baker, & Verrocchio, 2015; Johnston, 2005) and targeted parents’
experiences of PA (Balmer et al., 2017; Poustie et al. 2018; Vassiliou & Cartwright, 2001).
Also, studies opposing PA begin to appear. Authors like Joan Meier (2009), Kelly and
Johnson (2001) and Friedlander and Walters (2010) as deniers of PA, argue that PA it is a
form of denial of abuse and often targeted parents are the ones who contributes to the
alienation by the way they behave.
During this period, a consensus in differentiating PA from estrangement (Johnston,
2005) and in differentiating alienated children from non-alienated children (Baker, Burkhard,
& Albertson-Kelly, 2012) occurred. Also, studies exploring gender differences in PA began
to appear. For example, Gardner (2002a) declared that PAS can be indoctrinated by both
mothers and fathers; while the study of Balmer et al. (2017) found that targeted mothers were
46
exposed to significantly higher severity of exposure to PA than targeted fathers. Additionally,
Harman, Biringen, Ratajack, Outland and Kraus (2016) found gender biases in the perception
of acceptability of parental alienating behaviours, with the alienating behaviours of mothers
considered more acceptable than the alienating behaviours of fathers.
Recently, PA has been described as a form of family violence, with the behaviours of
alienating parents being compared to the behaviours of perpetrators of other forms of family
violence and child maltreatment (Harman, Bernet, & Harman, 2019; Harman, Kruk, & Hines,
2018; Harman & Matthewson, 2020; Lee-Maturana, Matthewson, & Dwan, 2020b; Poustie et
al., 2018) and some efforts to create instruments to identify PA are also emerging (Bernet,
Gregory, Reay, & Rohner, 2018).
In addition, some famous cases of PA have been identified in the literature. For
example, Albert Einstein was alienated from his children by his wife Maleva Malic (Isaacson,
2007); the poet Percy Bysshe Shelly, married for a second time to Mary Shelley, who lost
custody of his children and became a targeted parent by his children’s maternal grandparents
in 1817 (Volokh, 2006); the Irish musician Sir Bob Geldof who waged his battles to get his
children back in England (Anderson & O’Sullivan, 2009) and the Hollywood celebrities Alec
Baldwin, Kate and Oliver Hudson and Jason Patric also were targets of PA (Harman &
Biringen, 2016).
In an effort to synthesize and understand how the phenomenon of PA has evolved
over time, Table 2.2 presents a summary of the greatest contributions to the academic
literature of different authors. It should be noted that perhaps not all contributions have been
included, although the author has tried to be as comprehensive and exhaustive as possible.
47
Table 2.2
Historical Timeline of Contributions to the Literature on PA
Year Authors Contribution to the literature regarding

parental alienation
1970 The American Bar Association, ABA (in Introduced the concepts of brainwashing and
Rand, 2013) programming as a theoretical framework.
1970 California Children of Divorce Project (in Provided normative responses on children of
Rand, 2013) divorce.
1970 Jack C. Westman, David W. Cline, William Provided a description of a pattern in which a
J. Swift and Douglas A. Kramer parent teams up with their children to
undermine the other parent.
1970 Richard A. Gardner Explained in ‘The boys’ and girls’ book about
divorce’ how parents sometimes use their
children as weapons.
1976 Judith Wallerstein and Joan B. Kelly Identified the ‘pathological alignment’
occurring sometimes in the divorced families
of their study.
1978 Alan Levy Proposed four types of preferences made by

children involved in custody disputes, the
fourth equivalent to the PA definition: (1)
child who will not take sides; (2) child with an
ambivalent preference; (3) child with a
realistically unambivalent preference; and (4)
child who is pathologically unambivalent in
rejecting a parent or refusing to visit,
seemingly brainwashed by the preferred
parent.
1980 Judith Wallerstein and Joan B. Kelly Identified alliances between a narcissistic
parent and a vulnerable older child in an effort
to hurt and punish the other parent.
Frequently, the child turned on the parent they
had loved and been very close to prior to the
marital separation.
1985 Janet R. Johnston, Linda E.G. Campbell Identified six primary responses in 44 children
and Sharon S. Mayes of post-separation and divorce disputes over
their custody and care. The responses were:
strong alliance, alignment, loyalty conflict,
shifting alliance, acceptance of both with
avoidance of preferences and rejection of both.
1985 Elissa P. Benedek and Diane H. Schetky Described how some children took sides in the
divorce in the presence of one parent, feeling
48
guilty about visiting the other parent. In some

extreme cases brainwashing was employed.
1985 Richard A. Gardner Introduced the term Parental Alienation

Syndrome (PAS) after several observations
conducting child custody evaluations. Also, he
defined the eight behaviours or symptoms of
PAS in a child.
1985 Brynne Rivlin Identified a tendency for children involved in

custody disputes to strongly align with one
parent. She explained that if the alliance was
encouraged by the preferred parent, the other
parent could feel as he or she was treated as
the enemy.
1989 Judith Wallerstein and Sandra Blakeslee Described how court-ordered visitation can be
‘entangled with Medea-like rage’. The authors
explained how some parents can engage in
techniques to turn children against the other
parent.
1991 Stanley S. Clawar and Brynne V. Rivlin Reported that in about 80% of the 700
counselling cases of their research, there were
some elements of parental programming.
Parental programming consisted of one parent
implanting false and negative ideas about the
other parent in an effort to turn the child
against them.
1992a Edward Kruk Conducted a cross-national study (Canada and

Scotland) on the impact of divorce on
noncustodial fathers. The author suggests that
the disengagement of the fathers from their
children’s lives is due to: a combination of
structural constraints, the fathers’ own
psychological response to the threatened or
actual loss of their children and the pre-
divorce father-child relationship. He also
suggests that divorce constitutes a situation
where fathers are judicially and legislatively
disadvantaged on the basis of gender and
represents a loss, depriving them of an
attachment figure and a role or identity.
1992b Edward Kruk The author examined the issue of 80 non-

custodial fathers' loss of contact with their
children and families after divorce, reporting a
striking discontinuity between father-child
relationships before and after divorce. He also
found that fathers who were more involved
with and attached to their children during the
marriage were most likely to lose contact after
divorce; and those fathers relatively less
49
involved and attached were more likely to

remain in contact.
In addition, the consequences of divorce and
the adaptation to it are likely to be more
problematic when the relationship father-child
before divorce was intense.
1993 Janet R. Johnston Identified strong alliances in her two studies

involving 140 divorcing parents and 175
children disputing custody visitations.
1994 John Dunne and Marsha Hedrick Concluded after studying 16 cases of severe
PAS that: (1) PAS can occur independently of
the length of the relationship prior to
separation, or immediately after separation, or
many years after divorce; (2) the age of the
alienated children can vary from very young to
teenagers; (3) PAS can involve all the children
of a family or only one; (4) the alienating
parent often is the mother, but alienation also
occurred by the father who usually is the non-
custodial parent; and (5) motivations of the
alienating parent were often unconscious or
coloured in socially acceptable ways.
1995 William Bernet Distinguished PA through indoctrination,

which is consistent with Gardner’s PAS, from
PA without indoctrination which occurs when
the child gravitates to one parent or the other
to get out of the ‘war zone’ of parental battles.
1996 Kenneth H. Waldron and David E. Joanis Described PAS as a family dynamic
identifying long-term detrimental effects on
the child, who learns that hostile and
manipulative behaviours are acceptable and
normal in relationships.
1997 Larry Nicholas Identified attitudes and behaviours in the

alienating parent, the targeted parent and the
targeted child, reporting that: (1) Parental
alienating behaviours highly correlated with
children’s alienations’ symptoms; (2) There
were no significant correlations between the
child’s symptoms and eight of ten targeted
parents characteristics; and (3) two of those
ten characteristics of targeted parents
correlated with the child’s symptoms:
temporarily giving up on the child and
becoming irritated and angry with the child for
exhibiting the alienating behaviours.
1998 Vivienne Roseby and Janet R. Johnston Explained how PA appeared as a phenomenon
in high-conflict divorce and custody disputes.
50
They introduced the term narcissistic

vulnerabilities of the divorcing parties.
1998 Douglas Darnall Described the causes of PA for the adults’

behaviours and processes. He proposed a
classification that distinguishes between naïve,
active and obsessed alienators. Also, he
created a 49-item questionnaire to determine
the presence of behaviours that induces PA.
1998 Jeffrey C. Siegel and Joseph S. Langford Studied the Minnesota Multiphasic Personality
Inventory (MMPI-2) responses of 16 PAS
mothers in the course of child custody
evaluation. The conclusion was that parents
who engage in alienating behaviours are more
likely than other parents to use the
psychological defences of denial and
projection.
2000 Elizabeth M. Ellis Stated that the definitions for PAS have been
unclear due to a confusion made by clinicians
with the child’s symptoms, the parents’
behaviours and the quality of the relationship
between the child and the alienating parent. In
addition, the author proposed a DSM-style
criterion to diagnose PAS, based on 12
behaviours manifested by the child.
2001 Joan B. Kelly and Janet R. Johnston Proposed the term ‘alienated child’ instead of
PA or PAS. They also proposed a new
framework that is a continuum of children’s
relationships with parents after separation and
divorce that goes from a positive relationship
with both parents, affinity with one parent,
alliance with one parent estranged from one
parent (realistic estrangement) to alienated
from one parent (pathological alienation). The
authors claimed that PA is not necessarily
caused by the alienating parent.
2001 Janet R. Johnston, Marjorie G. Walters and Proposed the Multi-Modal Family
Steven Friedlander Intervention (MMFI) which describes goals
and strategies to be considered in family-
focused counselling and therapy when PA
occurs. They included strategies to work with
the alienated child, the alienating parent and
the rejected parent.
2001 Despina Vassiliou and Glenn Cartwright Described the alienation experiences of five
targeted fathers and one targeted mother in a
qualitative study. They found that denigration
toward the targeted parent was a tactic used by
51
the alienating parent and children acted as

alienators too. In addition, the authors stated
that there are several possible attributes that
may be precursors or indicators of PAS.
2001 Janelle Burrill Classified parents and children, based on their

PAS symptoms, into categories of mild,
moderate and severe. The author found a
correlation between the parent’s and the
children’s symptoms; and a correlation
between the alienating parent’s behaviours and
the child’s negative behaviours against the
alienated parent.
2001 Richard A. Warshak Defined three components that must be present

in the identification of PA: (1) persistent, not
occasional rejection or denigration of a parent
that reaches the level of a campaign, (2) an
unjustified or irrational rejection by the child
and (3) rejection by a child that is a partial
result of the alienating parents’ influence.
2002a Richard A. Gardner Reported a gender shift regarding PAS

alienators. The author recognised that starting
in the late 90’s fathers were as likely as
mothers to indoctrinate children into PAS.
2005 Janet R. Johnston Differentiated alienated children who

persistently refused visitation and expressed
unrealistic negative views and feelings against
the other parent, from those children who
refused contact with a parent after separation
for expectable reasons (normal developmental
preferences for one parent, alignments that are
reactions to specific circumstances of divorces
or estrangement from a parent who has been
neglectful or abusive).
2005b Amy J.L. Baker Identified similarities between alienating

parents and cult leaders. The description of the
alienating parents made by adults who were
alienated from a parent as a child was:
narcissistic parents who required excessive
devotion and loyalty, especially at the expense
of the targeted parent. She also stated that
alienating parents used the same emotional
manipulation and persuasion techniques that
cult leaders used to heighten dependency on
their followers: excessive control, power and
adulation. The outcomes of the victims of cult
groups and victims of PA were also similar,
showing low self-esteem, guilt, depression and
lack of trust in themselves and others.
52
2006 Amy J.L. Baker and Douglas Darnall Identified the most common alienating
strategies reported by a sample of targeted
parents. Some of these strategies overlapped
with those identified in other study using a
sample of adults who as children were
alienated from the other parent.
2007 Amy J.L. Baker and Douglas Darnall Discovered that even the most alienated child
will present some ‘crack in the armour’, which
can be a hope to targeted parents as an
opportunity for countering the alienation.
2007 Amy J.L. Baker Confirmed the negative lifelong consequences

of PA in children.
2007 Kathleen M. Reay Confirmed the scientific validity of Gardner’s

PAS in a sample from Canada. She found that
as the level of PAS increases, so does the
measurable level of psychological distress. In
addition, she concluded that there are lifetime
issues of mental health for PAS victims.
2008 Robert Gordon, Ronald Stoffey and Reported the results of the Minnesota
Jennifer Botinelli Multiphasic Personality Inventory-2 (MMPI-
2) in families involved in custody disputes.
The results showed that alienating parents
(mother and fathers) had higher scores in the
clinical range indicating primitive defences
(splitting and projective identification) than
parents of the control group. Also, the score of
targeted parents were mostly similar to the
scores of the control group.
2010 Steven Friedlander and Marjorie G. Walters Presented a description of the dynamics,
differential assessments and interventions for
families involved in PA, based on the
refinements and modification of the MMFI
previously proposed by Johnston et al. (2001).
They also presented the typology of cases in
which a child resists or refuses contact with a
parent, proposed previously by Kelly and
Johnston (2001).
2010b Richard A. Warshak Presented the Family Bridges: A workshop for

troubled and alienated parent-child
relationshipsTM, an innovative educational and
experiential program to help severely and
unreasonably alienated children and
adolescents adjust to court orders that place
them with a parent they claim to hate or fear.
Dr. Warshak acknowledges the contributions
53
of Dr. Randy Rand, Dr. Deidre Rand, Dr.

Sandra Warshak, Dr. Marc Otis and Dr. John
Zervopoulos for the creation and development
of the Program.
2010 William Bernet, Wilfrid von Boch-Galhau, Presented a bibliographic review in their effort
Amy J.L. Baker and Stephen L. Morrison to justify the inclusion of the diagnosis of PA
in the Diagnostic Statistical Manual of Mental
Disorders, fifth edition (DSM-5) and in the
International Classification of Diseases,
eleventh edition (ICD-11), stating that when
the phenomenon is correctly recognised, it can
be prevented and treated in many cases.
2010 Edward Kruk Examined the history and experiences of 14

Canadian women who had lost custody of
their children within a legal divorce process.
Some of themes found in their stories were:
attachment and loss associated with
involuntary child absence, legal abuse within
the adversarial system, and judgment based on
nonconformity to a motherhood ideal; physical
violence and emotional abuse in the family
system; access denial and parental alienation;
stigma and lack of support services; and
serious financial losses.
2012 Amy J.L. Baker, Barbara Burkhard and Presented the first empirical effort in
Jane Albertson-Kelly conducting a differential diagnosis through a
28-item paper-pencil questionnaire to
differentiate between alienated and non-
alienated children.
2015 Richard A. Warshak Published the examination of ten mistaken

assumptions about PA that can compromise
decisions in court and in therapy.
2015 William Bernet, Amy J.L. Baker and Maria Confirmed the negative long-term impact of
C. Verrocchio PA on adults exposed to alienating behaviours
as children, such as psychological problems in
their adult lives. They also confirmed that a
sample of Italian adults who reported
experiencing alienating behaviours as a child
endorsed the same behaviours as previous
samples in United Sates.
2015 Kate Templer, Mandy Matthewson, Janet Published the first systematic review of the
Haines and Georgina Cox literature highlighting evidence-based
practices for PA. They suggested that changes
in custodial or residential arrangements in
favour of the targeted parent are effective in
ameliorating PA and specialized family
therapy addressing the alienation is effective
54
in restoring family relationships and family

functioning. Also, they proposed that a
coordinated approach from therapists and legal
practitioners is important in resolving PA.
2016 Jennifer J. Harman, Sadie Leder-Elder and Presented the first known representative poll
Zeynep Biringen of adults determining the prevalence of PA in
North Carolina. The results showed that 13.4%
of parents have been alienated from one or
more of their children.
2016 Amy J.L. Baker and Amy Eichler Introduced the PA Theory, which asserts that
children who are exposed to certain parental
behaviours might come to unjustifiably reject
the other parent. Also, these children exhibit
specific behavioural markers that differentiate
them from children who reject a parent based
on the abuse or neglect, or seriously deficient
parenting on the part of the parent being
rejected.
2016 Jennifer J. Harman, Zeynep Biringen, Ellen Reported gender biases in the perception of
M. Ratajack, Pearl L. Outland and Allyson acceptability of parental alienating behaviours,
Kraus resulting in these behaviours as more
acceptable if exhibited by a mother than a
father.
2017 Sian Balmer, Mandy Matthewson and Janet Reported differences in the severity of
Haines exposure to PA tactics, targeted mothers were
more exposed to significantly higher severity
of exposure to PA than targeted fathers on an
international sample of targeted parents.
2018 Clare Poustie, Mandy Matthewson and Sian Investigated targeted parents’ experiences of
Balmer PA and alienating behaviours. They found that
targeted parents experienced physical and
emotional distance separating them from their
children, emotional and financial costs
associated with their engagement with
‘systems’ (legal and child protection system)
and poor mental health and concerns for their
children’s psychological well-being. The
authors suggested that alienating behaviours
are a form of family violence.
2018 William Bernet, Nilgun Gregory, Kathleen Assessed the usefulness of the Parental
M. Reay and Ronald P. Rohner Acceptance-Rejection Questionnaire (PARQ)
to identify and quantify the degree of splitting,
which may diagnose PA. They stated that
severely alienated children engaged in a high
level of splitting by perceiving the preferred
55
parent in extremely positive terms and the

rejected parent in extremely negative terms.
2018 Saulyn Lee-Maturana, Mandy Matthewson, Published the first known systematic literature
Corinna Dwan and Kimberley Norris review on the characteristics and experiences
of targeted parents of PA. The results showed
that only 11% of the articles pertaining to PA
focused directly on targeted parents; and more
specifically, only 3.6% of the articles
described the characteristics and experiences
of targeted parents from their own perspective.
Moreover, most of the articles had small
sample sizes with data mostly from the United
States, United Kingdom and Canada.
2018 Jennifer J. Harman, Edward Kruk and Presented parental alienating behaviours as a
Denise A. Hines form of family violence with serious
consequences for children and families. The
authors highlighted that PA has been denied
just like other form of abuse has been denied
historically, socially and politically.
2018 Edward Kruk Revealed that alienation is far more common

and debilitating for children and parents than
was previously reported. The author stated that
PA is a form of child abuse identifying two
core elements: PA as a significant form of
harm to children that is attributable to human
action. He also suggested that child abuse as a
form of individual abuse, PA calls for a child
protection response and child abuse as a form
of collective abuse, PA warrants fundamental
reform of the family law system in the
direction of shared parenting as the foundation
of family law.
2020 Janet Haines, Mandy Matthewson and Presented the first Australian book on
Marcus Turnbull understanding and managing PA for
practitioners, researchers and people
experiencing PA.
56
2.4. The alienating parent.
The alienating parent, also known as the preferred parent or the alienator parent, is
one who uses strategies consciously or unconsciously to alienate the child from the other
parent. There are three types of alienating parents (Darnall, 1998):
(1) Naïve: these alienators are passive about the relationship with the other parent and
occasionally say or do something to alienate or reinforce the alienation.
(2) Active: these alienators know that what they are doing is wrong but, in an effort to
cope with the hurt and anger, they alienate the child as a result of emotional
vulnerability or poor impulse control.
(3) Obsessed: these parents feel their desires to hurt the targeted parent and destroy the
child’s relationship with that parent is justified. Rarely, they show self-control or
insight.
Most alienating parents described in the literature present with pathologies;
personality disorders such as borderline, narcissistic, histrionic, paranoid or anti-
social/psychopathic; and psychological disturbances or characteristics such as paranoia,
psychosis, suicidal behaviours and substance abuse (Friedman, 2004; Harman & Biringen,
2016; Johnston, 1993; Johnston, Walter, & Olsen, 2005; Rand, 1997a, 1997b; Siegel &
Langford, 1998; Turkat, 1999; Warshak, 2010c). Additionally, it has been reported that some
alienating parents tend to use primitive defences against psychological pain including
externalisation, denial and projection (Johnston & Campbell, 1988; Kopetski, 1998b); others,
have presented a need for control and domination (Baker, 2005b; Clawar & Rivlin, 1991;
Rand, 1997a; Warshak, 2010a); they also can present with an enmeshed relationship with the
child (Harman & Biringen, 2016); they can have abnormal grieving processes; have a family
57
history of unresolved grief, lack of awareness of normal ambivalence, lack of empathy and
sometimes, they were the favourite child or were overly indulged or idealised as children
(Kopetski, 1998b).
Research appears inconclusive as to whether alienating parents are equally mothers
and fathers (Balmer et al., 2017; Harman, Leder-Elder, & Biringen, 2016). However, gender
differences arise in the use of types of alienating behaviours, in the severity of the alienation
and in the perception of acceptability of who perpetuates the alienation. For example,
mothers may use more indirect forms of aggression than fathers (López, Iglesias, & García,
2014), mothers experience more severe alienating tactics than fathers (Balmer et al., 2017)
and people perceive alienating behaviours less negatively when they are enacted by mothers
than by fathers (Harman et al., 2016).
Some authors (Harman & Biringen, 2016; Warshak, 2000) have reported that
alienating parents tend to have an inability to cope with loss and they tend to be unable to
accept that their relationship or marriage to the other parent has ended, even if they ended it;
consequently, they might maintain an emotional attachment toward the targeted parent, being
unaware of their fantasies of reconciliation. Moreover, some alienating parents tend to lack
insight into how their behaviours are contributing to the problem (Harman & Biringen, 2016)
and tend to blame the other parent for their own state of misery (Darnall, 1998). According to
Kelly and Johnston (2001), many alienating parents come to believe that the other parent is
dangerous and abusive.
Clawar and Rivlin (1991) suggested that alienating parents sometimes alienate the
child from the other parent to cover or change the undesirable scrutiny of their personal
problems, such as alcohol, drugs, neglectful parenting, physical and sexual abuse, criminal
involvement or a socially unacceptable life-style. Baker (2005b) believes that alienating

58
parents manipulate the thoughts and feelings of children to obtain psychological benefits and
to promote a sense of dependency and loyalty through:
(a) Relentless badmouthing of the character of the other parent to reduce their importance
and value.
(b) Creating the impression that the targeted parent is dangerous and planned to hurt the
child to create rejection and fear.
(c) Misleading children about targeted parent’s feeling for them to create hurt, resentment
and psychological distance.
(d) Withdrawing love if the child manifests affection or positive regard for the targeted
parent to increase the need to please the alienating parent, and
(e) Erasing the other parent from the life and mind of the child through minimising actual
and symbolic contact.
In 2006, Baker and Darnall identified 1,300 actions made by alienating parents
described by 97 targeted parents participating in their study. These actions were coded and
classified into eight groups of strategies describing 66 types of specific behaviours. Table 2.3
shows the summary of those strategies with some examples of the behaviours used by
alienating parents to alienate their children from the targeted parent.

59
Table 2.3
Alienating Strategies proposed by Baker and Darnall (2006)
Strategy Examples
Badmouthing Saying to the child that the targeted parent is
dangerous, mean, abandoning or does not love the
child; referring to the targeted parent in front of the
child by the first name; confiding in the child about
the marriage, court orders or child support issues;
belittling targeted parents’ values, hobbies, etc.
Limiting/interfering with parenting time Moving away or hiding the child; arranging fun
activities during the targeted parent’s parenting time;
not letting the child see the targeted parent at
targeted parent’s extended family’s home; calling or
visiting during the targeted parent’s parenting time;
early pick-ups and late drop-offs, etc.
Limiting/interfering with mail or phone contact Blocking number or turning off phone; intercepting
calls and messages; monitoring calls and e-mails;
throwing out letters.
Limiting/interfering with symbolic contact Limiting mention and photographs of targeted
parent; not allowing the child to bring items from the
targeted parent’s home; throwing out gifts for the
child from targeted parent; having the child call
someone else “dad” or “mom”, etc.
Interfering with information Not providing targeted parent with school, medical,
activity information; not providing targeted parent’s
contact information to others, etc.
Emotional manipulation Withdrawing love if the child is positive about the
targeted parent; making the child feel guilty about
the relationship with the targeted parent;
interrogating the child after visit with the targeted
parent, etc.
Unhealthy alliance Cultivating child’s dependence; having the child spy
on targeted parent; having the child keep secrets
from the targeted parent, etc.
Miscellaneous Beating the targeted parent in front of the child;
telling the child that the targeted parent doesn’t love
him/her; making it appear as if the targeted parent
were rejecting the child; creating conflict between
child and targeted parent; badmouthing targeted
parent to friends, teachers, doctors, etc.
Similar results were provided by Poustie et al. (2018) in their study with 126 targeted
parents, which described and classified the alienating behaviours into six groups: (1)
emotional manipulation; (2) encouraging defiance alliance; (3) disrupting targeted parent-
child time; (4) withholding information; (5) defamation; and (6) erasing the targeted parent.
60
2.5. The child.
The child, also known as the alienated child, is the one who rejects or refuses the
targeted parent or a relationship with him/her under the influence of the alienating parent.
Several authors (Baker, 2005ab; Cartwright, 1993; Kelly & Johnston, 2001; Kopetski, 1998b;
Rand, 1997b; Warshak, 2000) have focused on examining the child’s behaviours and the
short and long-term consequences of the alienation on them. Furthermore, children of PA are
being considered victims of child abuse (Kruk, 2018). Kruk (2018), described these children
as suffering depression, poor self-esteem and self-hatred, showing disrupted social-emotional
development: withdrawal, isolation and social anxiety; with low self-sufficiency, lacking of
autonomy and depending on a parent; manifesting poor academic achievement and poor
impulse control; and struggling with mental health, addictions and self-harm.
Children of PA also manifest certain characteristic behaviours when they are involved
in the dynamics of PA. According to Stahl (2003), the child often develops a fusion of
thinking with the alienating parent, using the terms ‘us’ or ‘we’ when defining attitudes or
beliefs; they tend to make superficial and exaggerated complaints about the targeted parent
with little or no substance; they show inconsistent and contradictory statements and
behaviours, especially in the presence of the alienating parent; they manifest a strong
tendency to become over-involved in adults issues; they provide vague reasons when they are
asked why they are rejecting a parent; they tend to use the same phrases or expressions as the
alienating parent; usually, they are used as spies by the alienating parent and they have a
tendency to see the world in a rigid and all or nothing manner.
Some other behaviours have been seen in children of PA, for example, they tend to
deny having ever experienced any good times with the targeted parent when that is clearly
not the case; some of them appear as ‘responsible’ or ‘adult-like’, while others may appear
being vulnerable and dependents; they tend to idealise the alienating parent and devaluate the
61
targeted parent; they can be rude and disrespectful, even violent with the targeted parent
without guilt; the reaction of hatred or disdain against the targeted parent is unjustified and
disproportionate to the deed, often, these reactions are also against the extended family and
friends of the targeted parent (Fidler & Bala, 2010).
The literature has also shown the consequences to the child of PA. These
consequences are serious and can last until their adulthood, including: mental illness, low
self-esteem, self-hatred, low self-worth, depression and anxiety, sleep disturbances,
relationship difficulties, lack of trust regarding self and others, social isolation, and drug and
alcohol misuse (Baker, 2005bc, 2010a; Ben-Ami & Baker, 2012; Cartwright, 1993;
Friedlander & Walters, 2010; Godbout & Parent, 2012; Johnston, Walters, & Olesen, 2005;
Kopetski, 1998b).
2.6. The targeted parent.
The targeted parent, also known as the alienated parent or the rejected parent, is the
one who the child rejects without a justifiable reason, most of the time under the influence of
the alienating parent. When there is a reason for the rejection, such as abusive behaviours,
aggressive behaviours or neglect, it is not a case of PA, it is estrangement (Garber, 2011;
Harman et al., 2016; Johnston, 2005).
Targeted parents have been presented in the literature (Johnston, Walters, &
Friedlander, 2001) as parents with a range of problems with their parental skills, blaming the
problems entirely on the other parent and acting as bewildered, angry and innocent victims.
Kelly and Johnston (2001) and Johnston (2003) stated that targeted parents, or rejected
parents as they refer to them, have contributed to the alienation in one or more significant
ways. They identified them as parents who: withdraw when facing high conflicts; can
62
counter-reject their children; have harsh and rigid parenting style; are self-centred and
immature; have critical and demanding traits; and lack of empathy toward their children.
It is important to consider why targeted parents might present in this way (Haines, et
al., 2020). For example, targeted parents who withdraw from their children lives, may have
given up because they might realise there is little they can do to meet the alienating parent’s
demands or because they might be unable to subject themselves to repeated maltreatment.
Targeted parents may be seen as passives and avoidant because they do not want to ‘rock the
boat’. They might think that if they ‘annoy’ the alienating parent by trying to fight for
visitation, it might cost them the contact with their children. When targeted parents are seen
to withdraw from high conflict, they may actually be withdrawing from the fight with the
alienating parent because they feel they have exhausted all avenues for resolution of the
problem and have no more coping strategies to use to defend themselves. This also can be
misinterpreted by others as targeted parents lacking empathy, being self-centred, immature or
absent.
Other authors (Baker, 2010a; Baker & Andre, 2008; Baker & Darnall, 2006; Balmer
et al., 2017; Giancarlo & Rottmann, 2015; Kopetski, 1998b; Poustie et al., 2018; Vassiliou &
Cartwright, 2001) have suggested that targeted parents are people who have not only suffered
the loss of their children (either as a loss of emotional connection, as a loss of physical
contact or both) but, they have also suffered the consequences of being rejected by their
children in terms of physical, psychological, financial and/or emotional afflictions due to
their exposure to PA tactics. In addition, the literature has described targeted parents as
survivors of family violence perpetrated by the alienating parent (Harman, Kruk, & Hines,
2018; Poustie, et al., 2018) and being victims of false accusations of mental, physical and
sexual abuse (Summers & Summers, 2006; Tong, 2002; Vassiliou, 1998).
63
This Chapter has shown that although there are different definitions that have
different nuances to describe the same phenomenon of PA, all of these definitions had the
focus of attention either on the child or on the alienating parent’s behaviours. It was not
possible to find a definition which illustrates PA from the targeted parent’s perspective.
Hence, the concept of PA in the literature has been addressed in two specific ways: (1)
referring to the alienating parent’s actions, and (2) referring to the effect of those actions on
the child.
In this section, also a brief history of PA was provided, as well as a brief description
of the main ‘players’ involved in it: the alienating parent, the child and the targeted parent.
The following Chapter presents the methodology and the methods chosen for this thesis.
64
Chapter III
Methodology and Methods
65
3. Methodology and Methods
The research conducted for this thesis consisted of three related studies. The first
study was a systematic literature review which is reported in Chapter IV. This study aimed to
identify gaps in the literature regarding the characteristics and experiences of PA from the
targeted parents’ perspective, helping to inform the research questions of the following
studies in this thesis. Study Two (in Chapter V) and Study Three (in Chapter VI) aimed to
explore targeted parents’ experiences using a qualitative description approach (Sandelowski,
2000, 2010). This approach was chosen because it allowed the researchers to summarise
specifics events experienced by people (Lambert & Lambert, 2012) and obtain an accurate
description of the phenomenon from the participants’ perspective (Sandelowski, 2000). Study
Two and Study Three received ethical approval from the Tasmanian Social Science Human
Research Ethics Committee (Ethics Reference No.: H0015333, in Appendix D).
In this Chapter, aspects of the methodology and methods, in particular those regarding
to the research design, sample, data collection, data analysis and trustworthiness of the three
studies are presented.
3.1. Research questions and aims
This thesis explored, identified and described targeted parents’ experiences of PA, the
consequences of the alienation on them and their coping mechanisms. These were explored
from the perspective of targeted parents. This thesis developed a greater understanding of
targeted parents’ experiences and their needs, which might assist in the development of future
appropriate professional support and intervention programs for targeted parents. There were
three research questions with associated aims that constituted this thesis (See Table 3.1).
66
Table 3.1
Research Questions and Aims
Research Question Aim
What is known in the existing academic Identify and synthesise all relevant
Study One literature about the characteristics and information about targeted parents’
(Chapter IV) experiences of targeted parents of PA from characteristics and experiences from
their own perspective? their own perspective in the existing
academic literature.
Study Two How do self-referred targeted parents To describe targeted parents’

(Chapter V) alienated from their children experience the experiences of being alienated from
alienation? their child/ren from their own point
of view.
How have self-referred targeted parents been Describe the consequences of PA in

Study Three affected by the alienation and how have they targeted parents and identify the
(Chapter VI) coped with the alienation? coping strategies used by them to
deal with the alienation.
3.2. Research Design
The systematic literature review (Study One, in Chapter IV) provided a critical and
synthesised analysis of published studies on the characteristics and experiences of targeted
parents of PA. The systematic review identified, evaluated and summarised all relevant
individual studies on PA from the perspective of targeted parents in order to (1) make this
evidence available and accessible to decision-makers (Centre for Reviews and Dissemination,
2009); (2) demonstrate where knowledge was lacking (Petticrew, 2003; Petticrew & Roberts,
2006); and (3) guide the research questions of Study Two and Three (Brown et al., 2006;
Shamseer et al. 2015). One of the advantages of conducting the systematic review was to
easily identify available literature for review and efficiently distinguishing relevant
information for inclusion from irrelevant information (Higgins & Green, 2011).
The risk of bias present in systematic reviews was minimised using transparent and
replicable methods following an a priori planning, which was a strict protocol for systematic
reviews, the PRISMA-P (Moher et al., 2015; Shamseer et al., 2015). Using this systematic
review protocol allowed the researcher to avoid making arbitrary decisions regarding
67
inclusion criteria and data extraction (Shamseer et al., 2015). To avoid duplication, the
review was registered with PROSPERO (Booth, Clarke, Ghersi, Moher, Petticrew, &
Stewart, 2011).
PRISMA-P (Moher et al., 2015; Shamseer et al., 2015) was chosen because it
provides evidence-based guidance, including a checklist and a flow diagram, when
conducting systematic reviews and metanalysis. The PRISMA-P is an update of PRISMA
(Moher et al., 2009; Liberati et al, 2009) previously named QUOROM (Moher et al., 1999)
and it was developed by an international steering committee, comprising members from
different disciplines with wide ranging experience in systematic reviews. The PRISMA-P
consists of a 17-item checklist that facilitates the preparation and reporting of a robust
protocol for systematic reviews. In addition to this, Study One covered the following eleven
key steps and characteristics (Centre for Reviews and Dissemination, 2009; Higgins &
Green, 2008):
- An included background.
- Presentation of a clear research question and objective.
- Creation of pre-defined eligibility criteria for studies.
- Review of the research question, objectives and inclusion criteria.
- Inclusion of a definition of inclusion and exclusion criteria.
- Explicit and reproducible methodology that involved a systematic search to identify
all studies that would meet the eligibility criteria.
- Inclusion of a selection of studies.
- Inclusion of a data extraction protocol.
- A quality assessment of the validity of the findings of the included studies.
- Synthesis of the data.
- Dissemination of the findings.

68
Study Two (in Chapter V) and Study Three (in Chapter VI) employed a qualitative
descriptive research design (Sandelowski, 2000). Qualitative descriptive design was chosen
because it was found to be the best fit methodology for describing targeted parents’
experiences of PA from their own perspective with no interpretation made by the researcher
(Sullivan-Bolyai, Bova, & Harper, 2005). The information gathered from the perspective of
the participants needed to be reported just the way the participants described it, and from
there, summaries of the frequencies of that information is presented to provide an accurate
general picture of the phenomenon that is understudied (Lee-Maturana et al., 2018).
Qualitative description research is a comprehensive summarisation, in everyday
terms, of specific events experienced by individuals or groups of individuals (Lambert &
Lambert, 2012). Qualitative description is useful when researchers seek to know the who,
what and where of events (Bradshaw, Atkinson, & Doody, 2017). Qualitative descriptive
research enables an in-depth analysis of literal descriptions from participants (Sandelowski,
2010) of a human phenomenon. The language used in qualitative description is considered a
vehicle of communication, rather than an interpretative structure (Sandelowski, 2000).
Qualitative description differs from the other qualitative research designs, because it
does not focus on the lived experience of the participants nor does it provide interpretative
meanings of those experiences as phenomenology does. It does not focus on culture or in
providing a thick description as does ethnography. Qualitative description does not aim to
build theory as does grounded theory (Bradshaw et al., 2017; Caelli et al., 2003; Merriam,
1998; Sullivan-Bolyai et al., 2005). Although qualitative descriptive studies are different
from other qualitative designs, they might have some hues, tones or textures seen in these
other approaches (Lambert & Lambert, 2012; Sandelowski, 2000, 2010).
In Study Two and Study Three, attention was placed on the words and phrases
participants used to describe the moments of their experiences instead of describing the
69
essence of the phenomenon as lived by them. This means, Study Two and Study Three did
not aim to recognise a complex, multilayered or meaningful reality reflecting corporeal,
temporal, spatial or relational dimensions of living to understand the lived experience of the
participants (Willis, Sullivan-Bolyai, Knafl, & Cohen, 2016). These two studies were focused
on describing targeted parents’ experiences of PA from their own perspective and in their
own words, seeking for similarities in their experiences.
3.3. Sample Strategy and Recruitment Process
The sample strategy used to select participants was criterion sampling (Liamputtong,
2017; Patton, 1990, 2002). This strategy involved the identification and selection of a group
of targeted parents who had experienced the phenomenon of PA (Bernard, 2002; Creswell &
Plano Clark, 2011) and were able to communicate their experiences in order to assist with the
research (Etikan, Musa, & Alkassim, 2016).
The selection criteria were: (1) each participant had to identify themselves as targeted
parents alienated from their child/ren; (2) each participant agreed to voluntarily participate in
the research; and (3) a PA screening tool developed by the researchers was used to confirm
eligibility to participate (see Appendix C). The screening tool involved participants indicating
if they had been exposed to 13 alienating tactics that were identified in the literature (e.g.,
Balmer et al, 2017). The screening tool has two components of the rating scale: yes/no with
follow-up 5 points rating scale. The yes/no component of the screening tool has been used to
determine eligibility for interviews. An example item includes: has the other parent of your
child(ren) vilified you? (for example, has the other parent alleged that you are dangerous in
some way without any evidence to support these allegations). Participants who agreed to at
least 5 out of 13 items were considered eligible to participate in the study.

70
The recruitment process was conducted through advertisements in the media, online
support groups and psychology and legal practices who agreed to advertise the study on
behalf of the researcher. Participants recruited were the same for Study Two and Study
Three, however, the focus of analysis was different. The number of targeted parents
participating in the research was determined by data saturation (Liamputtong, 2017). Data
saturation occurred when little or no new data were generated (Liamputtong, 2017; White,
2015) and the existing data fitted efficiently and effectively into the emerging themes
covering all aspects of the phenomenon under study (Carpenter & Suto, 2008; Morse, Barret,
Mayan, Olson, & Spiers, 2002). The final sample consisted of 54 self-referred targeted
parents, all of them alienated from their child/ren. In addition, all participants were informed
of the purpose, duration and nature of the study. If parents agreed to participate in the study, a
consent form (see Appendix B) was signed by them.
3.4. Data collection
The data for Study One was collected according to the Preferred Reporting Items for
Systematic review and Meta-Analysis Protocols, PRISMA-P checklist (Shamseer et al.,
2015). The systematic search was conducted using the following selected academic online
databases: Web of Science, PsycINFO, PubMED, EMBASE-ELSEVIER and The Cochrane
Central Register of Controlled Trials and conference abstracts, using the following search
terms: [(parental alienation) AND (targeted parent OR alienated parent)].
All the findings were directly exported to Endnote from the databases. Duplicates
were removed. The titles and abstracts of each article were screened against the inclusion
criteria (by SLM) and double screened (by MM). Full-text articles were screened by SLM
and double screened by MM. Included articles had to be peer reviewed journal articles, book
chapters or books of qualitative, quantitative or mixed method studies. Included articles or
books needed to report on the characteristics and experiences of targeted parents from their
71
own perspective. Any article describing the targeted parent experience from the perspective
of another such as children of PA, practitioners or hypothetical case examples were excluded
from the review. There were no restrictions on date of publication or language the articles
were published in.
In addition, a quality assessment on the selected articles was performed through the
Mixed Methods Appraisal Tool, MMAT (Pluye et al., 2011). The MMAT included sections
to assess qualitative, quantitative randomised controlled trials, quantitative non-randomised,
quantitative descriptive and mixed methods studies. Each item of each section was scored 1 if
the criterion was satisfied or 0 if it was not, then the overall score was calculated by
expressing the number of criteria as a percentage of the number of relevant criteria for each
study (Liamputtong, 2017; Pluye, Gagnon, Griffiths, & Johnson-Lafleur, 2009). The authors
of included studies were contacted when further information was required for full assessment
of the studies, as recommended by Pluye et al. (2009).
The data in Studies Two and Three were collected through in-depth semi-structured
interviews and a sociodemographic survey.
The socio-demographics survey. This survey was developed by the researcher and it
was used to obtain specific information about the participants and the context in which PA
occurred. Such information included: gender, country of birth, age, marital/relationship
status, time alienated from the child/ren and time separated from the alienating parent. Table
3.2 shows a summary of the participants’ sociodemographic information.

72
Table 3.2
Participants Sociodemographic Information
Sociodemographic Variable % TP
Gender Female 48%
Male 52%
Country of birth Australia 70%

New Zealand 9%
United Kingdom 6%
Canada 4%
United States 4%
Europe 4%
Middle East 2%
South America 2%
Age 31-40 years old 13%

41-50 years old 54%
51-60 years old 24%
60+ years old 9%
Marital Status Re-partnered 43%

Single 35%
Divorced to AP 13%
Separated but still married to AP 9%
Time alienated from TC Less 6 months 6%

6-11 months 9%
1-3 years 35%
4-5 years 19%
+5 years 31%
Time separated from AP Less 6 months 0%

6-11 months 3%
1-3 years 17%
4-5 years 19%
+5 years 61%
The interview. A semi-structured in-depth interview was chosen as an appropriate
method to collect the data because it allowed a deep exploration of the social and personal
matters of the participants (DiCicco-Bloom & Crabtree, 2006), capturing their thoughts,
perceptions, feelings and experiences from their own voice (Taylor, 2005). Semi-structured
interviews (Patton, 2002) were conducted because they enabled the researcher to explore,
probe and ask questions about PA that elucidated particular experiences of the participants
73
(Patton, 2002). The questions used were open-ended and organised around a pre-determined
guide (DiCicco-Bloom & Crabtree, 2006) shown in Table 3.3. Semi-structured interviews
also allowed for the exploration of new topics of importance that might emerge from the
participants’ narratives that were not listed explicitly in the guide and it would not normally
be explored with each individual person interviewed (Patton, 2002).
The in-depth semi-structured interviews were conducted individually at the
Psychology Research Centre at the University of Tasmania in person, via Skype or via
telephone (Hanna, 2012; Holt, 2010), according to the participants’ availability. Each
interview lasted approximately one hour and consisted of two sections: demographic
questions and PA open-ended questions (See table 3.3). The interviews were audio recorded
for data accuracy purposes and were transcribed verbatim. A copy of the transcripts was
offered to each participant, to give them the opportunity to modify or confirm the information
provided.
Table 3.3
Interview Guide
Section Questions
Gender, country of birth, age, marital/relationship

Demographic status, time alienated from the child/ren and time
separated from the alienating parent.
- What can you tell me about your experience as a

targeted parent of PA?
Parental alienation - What do you think triggered the alienation? What
makes you think that?
- What sorts of tactics has the alienating parent used
to alienate you from your child?
- How have you coped with PA?
- Is there any other information you think is
important to share about your experience?
74
3.5. Data Analysis
The data in Study One were analysed using Guidance on the Conduct of Narrative
Synthesis in Systematic Reviews (Popay et al., 2006). This approach aims to improve the
quality of narrative approaches to evidence synthesis. Narrative synthesis is useful when it is
not possible to use statistical meta-analysis or another specialist form of synthesis; which is
expected for Study One because the inclusion criteria included a mixture of qualitative and
quantitative approaches with a scarcity of randomized controlled trials (Garg, Hackam, &
Tonelli, 2008).
Narrative synthesis was chosen because it integrates the findings of the review,
relying on the use of words and text to summarise and explain the findings of the synthesis
(Popay et al., 2006). The narrative synthesis was undertaken instead of a specialist synthesis
approach because the included studies differed from each other and had different research
designs producing qualitative and quantitative findings (NHS Centre for Reviews and
Dissemination, 2001).
The starting point in synthetising the data in Study One was a textual description of
each included article in order to become familiar with the data and to begin comparing and
contrasting the findings across each article. Then, the articles were clustered in groups by
study design, gender of participants and the country or context where the studies took place.
The data of each article were organised in tabular form, to present a visual description of it.
The tabulation included: author and year, study design, sample, research objective, data
collection and findings (see Table 4.2 in Chapter IV).
On the other hand, the data of Study Two and Study Three were analysed thematically
and inductively. Thematic analysis involves identifying, analysing and reporting themes
within the data (Braun & Clarke, 2006). It involves searching for an identifying common
thread that extend across an entire interview or set of interviews (DeSantis & Noel Ugarriza,
75
2000). It is also an appropriate method for analysis data collective in qualitative descriptive
research (Bradshaw et al., 2017). In addition, inductive thematic analysis was chosen because
it allows to link the themes to the data as they emerge from the participant’s narratives, and
enables the analysis of data when little or no predetermined theory, structure or framework of
the topic is available. The data itself is used to derive the structure of analysis (Boyatzis,
1998; Braun & Clarke, 2006).
Some advantages of thematic analysis are: it summarises key features of a large body
of data and/or offers a ‘thick description’ of the data set; it highlights similarities and
differences across the data set; generates unanticipated insights; it allows for social as well as
psychological interpretations of data; and it can be useful for producing qualitative analyses
suited to informing policy development (Braun & Clarke, 2006). Another advantage of
thematic analysis is the possibility of drawing a thematic map which is a visual presentation
of themes and their relationships (Ryan & Bernard, 2000).
The thematic analysis in Study Two and Study Three followed the six phases
proposed by Braun and Clarke (2006). This approach was chosen because it seems to be the
most influential approach in the social sciences, offering a clear and operational framework
for conducting thematic analysis (Maguire & Delahunt, 2017). It also emphasizes the
production of rigorous and high-quality analysis and it has in-built quality procedures such as
a two-stage review process whereby themes are reviewed against the coded data and the
entire data-set (Braun & Clarke, 2006, 2012, 2013).
The six phases of thematic analysis were:
(1) Familiarization with the data: The data were transcribed by the researcher and every
transcription was read and re-read several times. Notes were taken of initial ideas and
initial potential themes.

76
(2) Generation of initial codes: The data were coded using NVivo-11 (QSR International,
2015). A Code allowed to identify a feature of the data (semantic content or latent)
that appeared interesting to the researcher.
(3) Searching for themes: The codes were organised into potential themes and gathered
all the data relevant to each potential theme.
(4) Reviewing themes: The potential themes were checked in relation to the coded
extracts and the entire data set. A thematic map of the analysis was generated (See
Figure 5.2 in Chapter V and Figure 6.3 in Chapter VI).
(5) Defining and naming themes: Definitions and names for each theme were generated.
In addition, once the themes were defined, a description of the frequencies and the
explanation of the themes and subthemes was made.
(6) Producing the report: A final analysis was conducted on the selected extracts,
weaving together the narrative and data extracts, and contextualising the analysis to
existing literature.
3.6. Trustworthiness of the studies
Trustworthiness is the foundation of good research and of good decision making in
evidence-based practice (Eldridge, 2017). The strategies to ensure trustworthiness of Study
One, as it was a systematic literature review, were the use of the Preferred Reporting Items
for Systematic Review and Meta-analysis Protocol, PRISMA-P checklist (Shamseer et al.,
2015) and the quality assessment of each of the studies included in the review using the
MMAT (Pluye, et al., 2011) described in section 3.4. Data collection (page 70). In addition,
titles and abstract as well as full texts were double screened by the author and the first
supervisor (MM) independently of each other; and the data were analysed using Guidance on
77
the Conduct of Narrative Synthesis in Systematic Reviews (Popay et al., 2006), described in
section 3.5 Data analysis (page 74).
The strategies to ensure trustworthiness for Study Two and Study Three followed the
parallel or methodological criteria (Lincoln, 1995; Lincoln & Guba, 1985), in an effort to
establish that the findings of both studies were credible, transferable, confirmable and
dependable. Table 3.4 shows the four concepts of the parallel criteria proposed by Lincoln
and Guba (1985) along with their respective strategies used to judge trustworthiness in Study
Two and Study Three of this thesis. All of them are explained below.
Table 3.4
Criteria and strategies for judging trustworthiness in Study Two and Study Three
Parallel or Methodological criteria Strategies used in this thesis
(Lincoln & Guba, 1985)
Credibility Peer debriefing and member checking.
Transferability Purposive sampling.
Dependability Audit trial, peer examination and code-recode

procedure.
Confirmability Audit trial and reflexivity.
Adapted from Lincoln (1995) and Lincoln and Guba (1985)
Credibility is the confidence in the truth of the findings, or when participants involved
in the study find the results of the study credible. A qualitative study is credible when it
presents descriptions or interpretations of the experiences that people who also have shared
those experiences would recognize the descriptions (Sandelowski, 1986). Credibility was
addressed through seeking support from other professional members of the academic staff of
the University of Tasmania (supervisors included), who provided scholarly guidance to
improve the quality of the inquiry findings. The drafts of the studies and final reports were
presented to them to receive their comments, perceptions and suggestions in developing the
78
conclusion of both studies; and the findings were presented to and discussed with experts in
the field at an international conference (peer debriefing). In Addition, the data were sent back
to the participants for them to evaluate and suggest any changes if they were unhappy with it
or they had been misreported before producing the final report (members check).
Transferability shows that the findings have the applicability in other contexts or are
transferable to other similar settings. Transferability was addressed through using purposive
sampling because it helped to focus on key informants who were particularly knowledgeable
of the issues under study (Schutt, 2014) and it provided greater in-depth findings than other
(non) probability samplings methods (Cohen, Manion, & Morrison, 2011).
Dependability is the process of selecting, justifying and applying research strategies,
procedures and methods clearly explained and its effectiveness is evaluated by the research
and confirmed by an auditor, showing that the findings are consistent and could be repeated.
To ensure dependability, documents were kept for cross-checking the research process such
as raw data, interview and observations notes and transcriptions of the interviews (audit trial),
in addition to the establishment of an audit trail of the data using a spreadsheet and NVivo.
Also, the data were coded three times with two and then six weeks of gestation period
between each coding; and the results were compared until there was an agreement in the
codes and themes to enhance a greater understanding of the patterns and improvement of the
presentation of the narratives of the participants (code-recode procedure). Furthermore, the
findings and the research process were discussed all the time with the primary supervisor
(MM) and with another doctoral student who had experience conducting qualitative research
to contribute in a deeper reflexive analysis with another perspective (peer examination).
Confirmability is achieved when the findings of the study are reflected from the
participants’ reports and the data speaks for itself, not based on biases and assumptions of the
researcher. Confirmability was established using a reflexive journal to assess any influence of
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the researcher’s background, perceptions, interests and personal history in relation to the
study (reflexivity) in addition to the audit trail mentioned above.
In this chapter, the methodology and methods that led the three studies of this thesis
were presented. In Study One, an explanation of what a systematic literature review is, its
advantages and disadvantages, how the process of selecting the articles was performed and
how the findings were analysed using narrative synthesis was provided. For Study Two and
Study Three, an explanation of what a qualitative descriptive design is and why it was chosen
was provided. It also presented the sampling process focusing on the purposive sample by
criterion, how the data were collected through the surveys and in-depth semi-structured
interviews, and how thematically the data were analysed. Finally, the strategies used to
ensure the quality of this thesis were presented.
The next chapter provides information about the systematic literature review which
aimed to identify and synthetise all relevant information published in the academic literature
about targeted parents’ characteristics and experiences from their own perspective.
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Chapter IV
Study One
A Systematic Literature Review
81
In the following section, a systematic literature review is presented in order to answer
the first research question of this thesis: What is known in the existing academic literature
about the characteristics and experiences of targeted parents of PA?
This chapter is based on the article ‘Characteristics and experiences of targeted
parents of parental alienation from their own perspective: a systematic literature review’
published in 2018 in the Australian Journal of Psychology (see Publications in page XIX).
4.1. Introduction
Parental alienation (PA) is a phenomenon that occurs during and after family
separation. It can be defined as the outcome of one parent influencing their child to turn
against their other parent (Bernet, von Boch-Galhau, Baker, & Morrison, 2010; Garber, 2011)
without legitimate justification (Bernet & Baker, 2013). The child is encouraged to refuse or
resist a relationship with the other parent (targeted parent) and align themselves with the
alienating parent (Garber, 2011). Some authors have suggested that PA is a form of child
abuse or family violence (Baker & Ben-Ami, 2011; Poustie, Matthewson, & Balmer, 2018;
Reay, 2015). It is important to note that a child rejecting a parent on reasonable grounds, such
as in response to abuse or neglect is estrangement (Garber, 2011), not PA (Gardner, 2001;
Reay, 2015). PA can occur even if the relationship between the child and targeted parent was
once a very positive one for the child (Darnall, 2011).
Parental alienation has been seen in legal and therapeutic contexts, especially in child
custody disputes. However, the term has not been formally recognised as a result of
controversy surrounding the notion of PA as a syndrome. Gardner (2002a) considered PA as
a syndrome (PAS) diagnosed in the child. Gardner argued that this diagnosis is made on the
basis of a cluster of eight symptoms.

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The eight symptoms of PAS included: (a) ongoing denigration of the targeted parent;
(b) weak, poor, or unrealistic rationalisations for rejecting the targeted parent; (c) an inability
to display ambivalence toward the targeted parent; (d) claiming their resistance against the
targeted parent derives from their own thinking (“independent-thinker phenomenon”); (e)
aligning with the alienating parent during conflict; (f ) a lack of guilt regarding their
treatment of the targeted parent; (g) existence of false and/or distorted accounts of events
involving the targeted parent (borrowed scenarios); and (h) attempts to influence the views of
others about the targeted parent (Gardner, 2002a). These symptoms usually appear together
in almost all cases of moderate to severe PA. In mild cases of PA, the child may display some
alienating behaviours, but is able to maintain contact with the targeted parent. In moderate
cases, the child displays a variety of alienating behaviours and struggles with the transition
from the alienating parent's care to the care of the targeted parent. Once they have made the
transition, however, the child quickly settles and bonds with the targeted parent. In severe
cases, the child is emphatic in their rejection of the targeted parent and refuses all contact
(Gardner, 1998). Several authors suggest there is insufficient evidence to support the
validation of PAS as a construct (Ellis, 2008; Kelly & Johnston, 2001; Walker & Shapiro,
2010), and does not have a pathological basis (Kelly & Johnston, 2001). Nevertheless, the
consensus in the literature is that PA exists.
Although the targeted parent has been described as experiencing depression and
anxiety during and after alienation (Kopetski, 1998b), fear, post-traumatic stress disorder,
insomnia (Giancarlo & Rottmann, 2015), frustration, powerlessness, helplessness, and anger
due to constant interference from the alienating parent (Baker, 2010b; Baker & Andre, 2008;
Baker & Darnall, 2006), many of these descriptions appear to be based on the perception of
other informants such as the alienated adult child and practitioners. These descriptions do not
provide a clear view of who targeted parents are and what their experience of alienating
83
behaviours has been like for them. It is important to know what has been published about
targeted parents from their own perspective in order to fully appreciate their needs as they
respond and react to alienating behaviours. Hence, this study aims to identify and synthesise
all relevant information about targeted parents’ characteristics and experiences from their
own perspective in the existing academic literature. From this review, recommendations on
how targeted parents can be better supported in psychological and legal interventions will be
made along with recommendations for future research.
4.2. Materials and methods
4.2.1. Design
The literature review search protocol followed the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses Protocol (PRISMA-P: Shamseer et al, 2015). The
review was registered in PROSPERO (ID= CRD42017062533).
4.2.2. Procedure and Search Strategy
The academic databases searched from their inception until May 2018 were: Web of
Science, PsycINFO, PubMED, and EMBASE-ELSEVIER, using the following search terms:
(parental alienation AND [targeted parent OR alienated parent]). The Cochrane Central
Register of Controlled Trials and conference abstracts were also searched.
Article titles were screened, and duplicates removed by one of the researchers.
Relevant studies were exported to Endnote. Abstracts were screened for relevance and double
screened by another member of the research team. Two of the researchers reviewed the full
text of these articles against the inclusion criteria.

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4.2.3. Inclusion and Exclusion criteria
Included articles had to meet the following inclusion criteria: qualitative, quantitative,
or mixed method studies from peer- reviewed journals articles, book chapters or books. The
articles or books needed to report on the characteristics and experiences of targeted parents
from their own perspective. Any article describing the targeted parent experience from the
perspective of another such as children, practitioners or hypothetical case examples were
excluded from this review. There were no restrictions on date of publication or language the
articles were published in.
4.2.4. Data analysis
The data were analysed using guidance on the conduct of narrative synthesis in
systematic reviews (Popay et al., 2006). Guidance is recommended when articles likely to
include mixed methodologies are included (Garg, Hackam, & Tonelli, 2008). To ensure study
quality and avoid bias, the Mixed Methods Appraisal Tool (MMAT) was used (Pluye et al.,
2011) appraising methodological quality for quantitative, qualitative and mixed methods
studies included in a review. Data were extracted by the following variables: author and year,
study design, sample, research objectives, data collection, and findings.
4.3. Results
As shown in Figure 4.1, the number of articles identified from searching the
electronic databases were 894 and a further 315 articles were identified from hand searches.
After removing duplicates, 1,180 articles remained and the titles and abstract of these were
reviewed for relevance. A total of 91 articles were identified. The full text of the 91 articles
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Table 4.1
Reasons of articles excluded
Reason of exclusion % of articles
Perspective of adult targeted children. 10%
Perspective of alienating parents or practitioners. 6.2%
Pertaining to PAS or PA as a phenomenon. 25%
Focused on the targeted child. 11%
Focused on the alienating parent. 5%
Pertaining to legal issues. 7.5%
Pertaining to family intervention. 7.5%
Book reviews. 6.2%
Chapter books. 1%
Autobiographies. 5%
Letters to editors. 1%
Commentary. 1%
Articles on topics other than parental alienation. 13.7%
Eight of the 11 included articles met 100% of the quality criteria using MMAT (Pluye
et al., 2011). This means these articles met four criteria for each of the four domains: (a)
research question, (b) methodology, (c) data analysis, and (d) responses rate. Three articles
did not meet 100% of the quality criteria. Where possible, authors of these articles were
contacted to obtain further information about the studies’ methodologies. Only one author,
Dr. Despina Vassiliou, provided further information and this study met inclusion criteria. The
remaining two articles were excluded from the analyses, because without the additional
information eligibility for inclusion could not be confirmed. Thus, the final data analysis was
conducted on nine articles.
As shown in Table 4.2, six of the studies included more males than females in the
sample. One article (Finzi-Dottan, Goldblatt, & Cohen-Masica, 2012) included only females
as a result of purposive sampling, and two other studies (Balmer et al., 2017; Poustie et al.,
2018) had more females than males participating in the research. The studies were conducted
mostly in the United States (six articles), two in Australia and one in Israel. However, the
87
countries of residence of participants throughout the studies included United States, Canada,
Israel, Australia, United Kingdom, New Zealand, India, Belgium, and Ireland.
Table 4.2
Demographic Synthesis
Participants’
Age of Sex of No. children Legal custody
Article Marital status country of
participant participants with AP status
residence
Divorced/separated:
M=46.6 Male: 55.4% 86.5% Joint legal: USA
Baker, 2010b Not provided
SD=7.3 Female: 44.6% Never married: 50% Can
13.5%
Divorced/separated: Joint legal:

1: 26.8%
Baker and M= 42.4 Male: 61.9% 83.5% 23.7%
2: 51.5% USA
Darnall, 2006 SD= 7.8 Female: 38.1% Never married: Non-custodial:
3+: 21.6%
11.3% 41.2%
Joint legal:
Baker and M=44 Male: 55.9% 36.7%
Not provided. Not provided USA
Darnall, 2007 SD= 7.0 Female: 44.1% Non-custodial:
26%
Joint legal:
USA 48%
Divorced/separated: 17.3%
Aus 36.4%
45.3% 1: 40.9% Non-custodial:
Balmer et al., M= 40.7 Male: 46.7% Can 7.6%
Never married: 20% 2: 32.9% 27.1%
2017 SD=7.70 Female: 53.3% UK 4.4%
Married/defacto: 3+: 17.7% Non-custodial
NZ 2.2%
34.7% with visitation:
Ire 0.9%
22.7%
Divorced: 90%
Finzi-Dottan et M=39 Female: 100%
In process of divorce: Not provided Not provided Israel
al. 2012 SD= 6.3 (n=10)
10%
Gordon et al., Male: 81.6%

Not provided Not provided Not provided Not provided USA
2008 Female: 18.4%
Harman et al. M=44.5 Male: 54.5%

Not provided. Not provided. Not provided. USA
2016. SD= 17.85 Female: 45.5%
Aus (n=44)
Belg (n=1)
Male: 46.8% Divorced/separated: Can (n=12)
Poustie et al., M= 46 5 Not provided Not provided
45.3% India (n=1)
2018
Female: 53.2% Never married: 20% Ire(n=2)
Married/defacto: NZ (n=3)
34.7% UK (n=3)
USA (n= 60)
Vassiliou and Male= 83.3% 1: 66.6% USA

Cartwright, Not provided. Female= 16.6% Divorced: 100% 2: 16.6% Not provided. Canada
2001 3+: 16.6%
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Table 4.3 shows a synthesis of the nine articles included in this review, six followed a
quantitative descriptive design and three followed a qualitative design. For all the studies, the
sample included targeted parents and the date of publication ranged from 1997 to 2018. The
methods used in the studies to collect the data were through surveys (Baker, 2010; Baker &
Darnall, 2006, 2007; Balmer et al., 2017; Harman et al., 2016; Poustie et al., 2018), in depth
interviews (Finzi-Dottan et al., 2012; Vassiliou & Cartwright, 2001) and the administration of
the Minnesota Multiphasic Personality Inventory 2 (MMPI-2) and psychological assessment
(Gordon et al., 2008).

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Table 4.3
Articles Synthesis
Author (year Study design Sample Research objective Data collection Findings
publication)
Baker (2010b) Survey study. 76 self-reported Examine targeted A 62 items survey Responses of targeted parents revealed
targeted parents. parents’ perceptions including: negative views of attorneys with high levels
of their attorneys Background characteristics of dissatisfaction in regards to caring,
regarding legal and respondents’ understanding, engagement and
disputes, child experience with attorneys. communication.
custody, access,
visitation or
parenting time.
Baker and Survey study, 97 self-reported Identify the range A 14 questions survey via Eight categories were identified by the
Darnall retrospective targeted parents. of strategies utilised email, included: targeted parent as strategies used by the
(2006) design. by alienating demographic information, alienating parent, within each category
parents, from the alienation process and containing between four and 11 specific
perspective of the strategies used by the alienating behaviours. There was no-relation
targeted parents. alienating parent. associated to the gender of targeted parent
and type of alienating strategies and some
targeted child characteristics were
associated to the level of PAS.
Baker and Survey study. 68 adults self- Empirically 33 questions divided in 2 Results revealed that targeted parents
Darnall reported targeted examine the sections: demographic experienced from their children:
(2007) parents. relationship information and denigration, weak or absurd rationale for the
between PAS and behaviours of the targeted alienation, lack of ambivalence, lack of
the eight symptoms. child. guilt, borrowed scenarios, independent
thinker phenomenon, taking the alienating
parent’s side in the conflict, and spread of
alienation to the extended family of the
targeted parent.
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Balmer, Online survey 225 targeted parents Determine targeted An online survey Severity of exposure to alienating tactics
Matthewson study. (105 fathers and 120 parents’ containing: Demographic was high. Targeted mothers reported higher
and Haines mothers). experiences of PA information, Recall of the severity of exposure to PA than targeted
(2017). post separation exposure to PA tactics, fathers. Severity of exposure to PA tactics
from the alienating The Stress Appraisal predicted increases in the appraisal of the
parent, and to measure, The Depression, PA situation as threatening.
investigate common Anxiety, and Stress Scale,
targeted parents’ The Parenting Sense of
characteristics. Competence Scale and The
Parent-Child Relationship
Inventory.
Finzi-Dottan Qualitative- 10 self-reported To explore the Demographic One main theme emerged: “Merging v/s
et al. (2012). phenomenological targeted mothers. motherhood questionnaire and semi- Detachment”, consisting of 4 subthemes:
perspective. experience of structured interviews. (1) Marriage as an illusion of salvation from
alienated mothers an abusive home.
whose children (2) Giving birth to a child as compensation
refuse any contact for chaotic childhood experiences.
with them. (3) Husband exploiting and abusing their
sense of failing motherhood.
(4) The husband and mother-in-law
expelling the mother.
Gordon et al. Quantitative. 158 MMPI-2 cases. To test the MMPI-2 profiles from Mothers and fathers who were alienators
(2008). involvement of parents who were court had higher (clinical range) scores indicating
primitive defences ordered to be evaluated for primitive defences (splitting and projective
in PAS. child custody were used. identification) than the control sample
The cases were father- (normal range scores) in both indices.
mother pairs. Targeted parents MMPI profiles were
mostly similar to the control parents.
Harman, Mixed methods. A poll of 610 North To conduct the first Computer assisted The results suggest that tens of millions of
Leder-Elder Carolina adults known telephone interviews. adults and their children may be impacted
and Biringen representative poll by PA and evidence is presented about PA
(2016). of adults to existing across all socio-economic and
determine demographic indicators.
prevalence of PA in
U.S.
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Poustie et al. Online survey 126 targeted parents To explore the lived Qualitative data provided Six themes were identified indicating the
(2018). study. (67 mothers and 59 experiences of a at the end of an online hallmarks of the targeted parent perspective:
fathers). large international survey about the targeted (1) Specific alienating behaviours;
sample of targeted parent experience of PA (2) physical distance separating the targeted
parents and alienating behaviours. parent from their child, (3) dissatisfaction
postseparation from with legal or mental health services and
the alienating child support agencies; (4) numerous
parents in order to psychological implications or specific
better understand psychological disorders; (5) Family violence
the perspective of and (6) specific coping activities.
this under-
researched
population.
Vassiliou and Qualitative 6 targeted parents (5 Examine targeted Semi-structured open- Four common themes in the alienation
Cartwright father and one parents’ perceptions ended, telephone interview process were found:
(2001). mother). of PAS. questionnaires. 1.The children as secondary alienators.
2.targeted parents feeling powerless due to
the alienation.
3.Dissatisfaction with legal and mental
system.
4.Alienating parents’ feelings and desires as
a cause of the alienation.
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4.4. Discussions
A systematic literature review was conducted to identify and synthesise all relevant
information available in the academic literature reporting targeted parents’ characteristics and
experiences from their own perspective. From nine articles meeting the inclusion criteria,
only four of these specifically focused on the targeted parents’ characteristics and
experiences (Balmer et al., 2017; Finzi-Dottan et al., 2012; Poustie et al., 2018; Vassiliou &
Cartwright, 2001). Moreover, only three of these studies were qualitative in design, two of
them had small participant numbers (Finzi-Dottan et al., 2012; Vassiliou & Cartwright, 2001)
and were predominantly females (11 females vs. 5 males). However, despite the number of
articles found and their features, it was still possible to obtain valuable information about the
characteristics and experiences of targeted parents from their own voice.
4.4.1. Characteristics of targeted parents
According to the evidence provided by Gordon et al. (2008), targeted parents were not
responsible for being rejected by their child. Further, they did not present with any
psychopathology. However, the alienating parents presented with psychopathology consistent
with personality disorder. Similarly, Johnston and Campbell (1998) described alienating
parents as experiencing narcissistic injury with unresolved anger that may be a trigger for the
alienation.
There is conflicting evidence in the literature regarding the parenting role of targeted
parents. Balmer et al. (2017) found targeted parents generally perceived themselves adequate
and confident in their parental skills and their ability to discipline their children. They were
motivated to be involved in their child’s life, considered themselves able to set healthy
boundaries with their children and encourage them to be autonomous (Balmer et al., 2017).
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The same authors found some gender differences, with mothers feeling more satisfied with
being a parent than did fathers. Fathers reported being more involved with their children’s
activities than did mothers. Despite these gender differences, a general positive attitude
toward their parental ability was experienced. In contrast, Vassiliou and Cartwright (2001)
described the targeted parents who participated in their study as experiencing a loss of their
parental role and power due to PA. The reasons for this variance are unclear and cannot be
elucidated in this review due to the differences in the design, recruitment and location of the
studies.
It is unclear from the literature whether mothers or fathers are more likely to become
targeted parents. For decades, fathers have reportedly been more likely to be alienated from
their children than mothers (Ellis & Boyan, 2010; Gardner, 1989, 2002a; Johnston, 2003;
Rand, 1997a, 1997b; Vassiliou & Cartwright, 2001). Even Turkat (1995) proposed the
“divorce related malicious mother’s syndrome” emphasising mothers as alienating parents.
This is consistent with Gardner’s (2001, 2002a) assumptions that females are more
commonly the alienating parent. However, three reasons can be provided to postulate why
these gender assumptions may not be completely true.
First, some authors found more mothers participated in their research than was
expected (Baker & Darnall, 2006; Balmer et al., 2017; Poustie et al., 2018), which would
suggest that perhaps in previous studies the voluntary participation rate of fathers was higher.
Second, past recruitment processes may have influenced the gender recruited. Third, in the
past it was more common for mothers to obtain custody of their children, increasing the
probabilities of positioning her as the alienating parent (Gardner, 2002a, 2002b).
The relationship between the severity of alienation and gender is also not entirely
clear. Balmer et al. (2017) found that mothers experienced significantly greater severity of
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exposure to PA tactics compared to fathers. Specifically, targeted mothers reported
experiencing significantly higher severity of exposure to denigration tactics at the hand of the
alienating parent than did fathers. Harman et al. (2016) reported no differences in the severity
of the alienation between mothers and fathers.
There is not enough evidence to establish the mean age of the participants as a
characteristic either. Although it was found that the mean age of the participants of the
articles included was 42.8 years, no data were found regarding to the age of the participants
when they first experienced alienating behaviours. This lack of clarity seems to be a
consequence of the lack of information or the scarce number of studies examining these
variables. Further, only three of the included studies reported on the age of the child at the
time of data collection (Baker & Darnall, 2006, 2007; Balmer et al., 2017). From these
studies, the common age range for children was 11–15 years of age. This is consistent with
previous research indicating that older children are more susceptible to PA (Johnston, 2003)
because by adolescents they are physically able to stay with the parent they have aligned
with. Moreover, children over the age of 12 are more likely than younger children to be asked
by the Court during custody proceedings about their preferences regarding custody (Barnett
& Wilson, 2004). No study reported on the age of the child when the alienation commenced,
therefore no conclusions can be drawn in relation to the most common age targeted parents
may see changes in their children as a consequence of alienating behaviours.
4.4.2. Targeted parents’ experiences and its impact
Targeted parents considered hate, anger, revenge or a combination of these as the
trigger for the alienating parent’s behaviour; feeling that their relationship with their children
had been sabotaged by the alienating parent (Vassiliou & Cartwright, 2001). Targeted parents
reported having experienced a variety of tactics by the alienating parent that contributed to
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the alienation including emotional manipulation, encouraging defiance and alliance,
interrupting the time destined to spend with the child, denying the targeted parent information
about the child, defamation, and erasing the targeted parent from the child’s life (Poustie et
al., 2018). Similar findings were reported by Baker and Darnall (2006) and Baker and Fine
(2014).
Targeted parents also reported their relationship with the alienating parent was
strained after the onset of PA; describing their alienating behaviours as severe (Baker &
Darnall, 2006; Harman et al., 2016) and often involving a third party as an alienator such as a
family member (Balmer et al., 2017), the child (Vassiliou & Cartwright, 2001) or their
mother-in-law (Finzi-Dottan et al., 2012). When considered together, these findings show
that targeted parents feel isolated, despair, and frustrated (Balmer et al., 2017; Finzi-Dottan et
al., 2012; Poustie et al., 2018; Vassiliou & Cartwright, 2001) and they perceive themselves as
victims of a series of strategies used by the alienating parent and their allies to turn the child
against them.
Targeted parents reported negative consequences of being exposed to alienating
behaviour, such as dissatisfaction with the legal and mental health systems (Baker, 2010;
Balmer et al., 2017; Poustie et al., 2018; Vassiliou & Cartwright, 2001), emotional and
financial implications (Poustie et al., 2018; Vassiliou & Cartwright, 2001), and psychological
distress (Baker, 2010; Balmer et al., 2017; Poustie et al., 2018). Targeted parents described
their experiences with the legal system as slow, ineffective, uncaring, and contributing to the
alienation (Poustie et al., 2018). This was also shown in Baker (2010b), who reported the
duration of legal disputes ranged from one to 10 years and during this period, targeted parents
reported having their case heard by several judges, hindering procedural continuity. They
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also reported encountering attorneys and judges who do not appear to understand PA and the
relevant concerns in such cases.
The lack of understanding of PA by those involved in the legal and mental health
systems may be contributing to increased feelings of anxiety and depression in targeted
parents (Baker, 2010b; Balmer et al., 2017). It cannot be ascertained if the psychological
outcomes experienced by targeted parents were indeed a consequence of PA or one of a
series of precipitating factors of the alienation. Only one study (Balmer et al., 2017) used a
validated instrument to measure these clinical variables, which confirms the need to further
assess the impact of PA on the targeted parent.
As part of the experiences of the alienation, targeted parents have reported some
coping strategies they have used to endure the process. These strategies include self-
education, educating others, finding social support and being stoic (Poustie et al., 2018). This
finding indicates that many targeted parents are resilient and seek out active coping
strategies.
4.4.3. Cultural concerns
There is a narrow picture of PA and who targeted parents are around the world. Most
studies included in this review were conducted in the United States (six articles). Only one
study used an international sample (Balmer et al., 2017) and one small study of six targeted
parents was conducted in Israel (Finzi-Dottan et al., 2012). See Table 4.2 for demographic
variables.
According to the findings of this review, targeted mothers in Israel experienced abuse,
discord, rejection, isolation, and detachment from significant figures in their lives, including
parents, husband, extended family, husband’s family, and their own children (Finzi-Dottan et
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al., 2012). Similar perceptions were reported by targeted parents from English- speaking
countries (Baker & Darnall, 2006; Balmer et al., 2017; Harman et al., 2016; Vassiliou &
Cartwright, 2001). It is important to expand this picture of PA in order to create a better
understanding of the targeted parent and the PA phenomenon cross-culturally.
4.4.4. Recommendations for practitioners
Based on the findings of this study, it is recommended that practitioners need to be
aware that mothers and fathers can be alienated from their children. This is important because
a prevailing misconception is that targeted parents tend to be fathers. It is important that
practitioners working in family law and family mental health become aware of PA and its
consequences. Further, practitioners need to be aware that targeted parents can experience
symptoms of depression and anxiety and their symptomatology must be factored into any
intervention strategies developed by practitioners.
4.4.5. Limitations of this study and recommendations for research
The following limitations were identified in this review. Firstly, the scarce number of
articles meeting inclusion criteria and the methodological nature of the studies restricted any
possibility to compare the findings or conduct a meta- analysis. Secondly, the review was
limited to published peer-reviewed research excluding grey literature. Finally, the findings of
this review may not be generalisable as most of the studies were conducted in the United
States and therefore lacking information across cultures.
In addition, caution is needed when drawing conclusions from the results presented in
this review. For example, full diagnostic interviews or psychological assessments would be
more accurate to confirm that targeted parents suffered anxiety, depression, and stress during
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the process of PA; the interviews and surveys of the studies included did not report the time
the alienation occurred or the age of the targeted parents experiencing the alienation.
One important outcome of this systematic literature review was that there is a gap in
the literature about targeted parents and their experience of being alienated from their
children. The present literature review has identified many questions that need further
investigation such as, who is more likely to become a targeted parent? What is the impact of
PA on the emotional and physical well- being of the targeted parent? How do targeted parents
cope with the alienation and what can practitioners do to help? How are these issues similar
or different cross-culturally and between mothers and fathers?
Future studies investigating personality profiles of alienating and targeted parents
may help elucidate whether there are any common characteristics shared by targeted parents
and alienating parents. It is also necessary to develop valid and reliable instruments to
measure PA and assess risk of becoming a targeted parent. In general, more qualitative
studies are needed to understand the experience of targeted parents from their perspective and
more quantitative studies are required to elaborate a profile of the targeted parent.
Understanding how individuals experience PA and identifying the common characteristics
might be the first step to assist in the development of appropriate interventions.
4.5. Conclusion
The present study has provided valuable insights into the characteristics and
experiences of targeted parents of PA from their own perspective, despite the scarce number
of studies found in the academic literature. However, more information about PA is needed
with more studies about targeted parents in order to further understand their needs.
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The importance of this study lies in being the starting point for future research. We
have identified gaps in the literature that will serve to initiate a new line of research that will
help mental health and legal professionals in their work with targeted parents. If families,
parents, mental health and legal professionals understand what PA is and how targeted and
alienating parents behave, then perhaps the cases of alienation might decrease.
This chapter has presented the original manuscript published, which covered the
search on the databases until May 2018. A second search for the purposes of updating the
information was conducted on May 2019. The results of this second search were not reported
in this chapter because during May of 2018 and May of 2019 only 4 articles were published
on PA, yet, none of them met the inclusion criteria. Hence, this systematic literature review
has shown that there is a lack of studies focusing on targeted parents, especially studies from
their own perspective. This study has identified some gaps in the literature regarding the
experiences of targeted parents and their coping mechanisms used to deal with the alienation;
gaps that have helped to inform the research questions of the following studies. The next
chapter reports Study Two of this thesis “A qualitative description of targeted parents’
experiences.”
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Chapter V
Study Two
A Qualitative Description of Targeted
Parents’ Experiences
101
Research about targeted parents’ experiences is still limited, especially research
seeking to describe and inform their experiences from their own perspective. This chapter
presents Study Two of this thesis which aimed to add qualitative evidence to the literature
about how targeted parents perceive and experience the phenomenon of PA in order to
answer the second research question: How do self-referred targeted parents alienated from
their children experience the alienation?
In this chapter, the question about how targeted parents have experienced the
alienation is addressed. Results and theoretical discussion supported are also presented. This
study has been submitted to the American Journal of Family Therapy and it has been
accepted.
5.1. Introduction
Parental alienation (PA) is a phenomenon that occurs among families, during or after
separation, when one parent (the alienating parent) encourages or influences his/her child to
reject or refuse any relationship with the other parent without legitimate justification (Bernet,
2010; Bernet & Baker, 2013; Bernet, von Boch-Galhau, Baker, & Morrison, 2010; Garber,
2011). The rejected parent is commonly referred to as the ‘targeted parent’.
Targeted parents have been described in the literature as people suffering from
physical, psychological and/or emotional conditions due to being alienated from their
child/ren; such as anxiety, depression (Balmer, Matthewson, & Haines, 2017; Kopetski,
1998b), posttraumatic stress disorder, fear, insomnia (Giancarlo & Rottmann, 2015),
frustration, powerlessness, helplessness and anger (Baker, 2010b; Baker & Andre, 2008;
Baker & Darnall, 2006; Vassiliou & Cartwright, 2001). Kopetski (1998b) concluded after
analyzing 600 cases during 20 years that targeted parents have a history of passivity,
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emotional constriction and overaccommodation; they have a tendency to avoid self-assertion;
and they have a potential for presenting with psychological distress in response to the
alienating tactics.
Some authors have reported that targeted parents can be the victims of false
accusations of emotional, physical and sexual abuse (Summers & Summers, 2006; Tong,
2002; Vassiliou, 1998). Most recently, targeted parents have been described as parents
suffering emotional and financial costs, having poor mental health (Poustie, Matthewson, &
Balmer, 2018) and feeling that their well-being has been significantly threatened by their
exposure to PA tactics (Balmer et al., 2017). They have also been described as survivors of
family violence perpetrated by the alienating parent (Harman, Kruk, & Hines, 2018; Poustie,
et al., 2018). However, more research is needed in relation to understanding the processes
involved in PA as a form of family violence.
Research on targeted parents’ experience of PA is growing but it is still limited. Lee-
Maturana, Matthewson, Dwan and Norris (2018) identified and synthesized all relevant
information about targeted parents in the existing peer-reviewed academic literature. They
found only 11% of the articles pertaining to PA focused directly on targeted parents; and
more specifically, only 3.6% of the articles described the characteristics and experiences of
targeted parents from their own perspective. Moreover, most of the articles had small sample
sizes with data mostly from the United States, United Kingdom and Canada.
Further information is needed to understand targeted parent’s experience of being
alienated from their child/ren from their own perspective, in order to generate more
knowledge and awareness of their experience. In turn, this information will assist in the
development of appropriate support services and intervention programs to those people who
are suffering psychological and physical distress due to a phenomenon in which there is a
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little understanding, and without appropriate interventions can lead in catastrophic
consequences in that population.
In order to answer the following research question: How do self-referred targeted
parents alienated from their child/ren experience the alienation? The aim of this qualitative
descriptive study was to identify, synthetise and describe targeted parents’ experiences of
being alienated from their child/ren from their own point of view to address the gap in the
literature and the need for more research in this field (Balmer et al., 2017; Finzi-Dottan,
Goldblatt, & Cohen-Masica, 2012; Harman, Leder-Elder, & Biringen, 2016; Lee-Maturana et
al., 2018; Poustie et al., 2018; Vassiliou & Cartwright, 2001; Whitcombe, 2017).
5.2. Methods
5.2.1. Participants
A total of 54 self-referred targeted parents, all of them alienated from their child/ren,
participated in semi-structured interviews. The number of participants was determined by
data saturation (Liamputtong, 2017). Fifty-two percent were fathers and 48% were mothers.
The age range of the participants was between 41-50 years old (54%), 51-60 years old (24%),
31-40 years old (13%) and more than 60 years old (9%). See Table 5.1 for details regarding
participants’ age and gender.
Table 5.1
No. of Participant According to Range of Age and Gender
31-40 41-50 51-60 60+
years old years old years old years old
Targeted Mothers 5 14 5 2
Targeted Fathers 2 15 8 3
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5.2.2. Procedure and materials
Ethics approval was obtained from the University of Tasmania’s Social Sciences
Human Research Ethics Committee (Ethics Ref No: H0015333). Participants were recruited
from advertisements in the media, online support groups and psychology and legal practices
who agreed to advertise the study on behalf of the researchers. Interested individuals
contacted the researchers via an email address provided in the advertisements.
The interviews were conducted by the first and second author who are practitioners in
psychology and one research assistant who was a trainee psychologist at the time of the
interviews. The second author provided qualitative interview techniques training to the first
author and research assistant to ensure standardized interviewing procedures were used. The
interviews were conducted individually at the Psychology Research Centre at the University
of Tasmania in person, via Skype or via telephone (Hanna, 2012; Holt, 2010). Prior to the
interviews, participants were informed of the purpose, duration and nature of the study. They
were asked to complete a screening tool developed by the researchers which involved
participants indicating whether they had been exposed to13 alienating tactics by indicating
yes or no to each item. An example item includes: has the other parent of your child(ren)
vilified you? (for example, has the other parent alleged that you are dangerous in some way
without any evidence to support these allegations). This screening tool was used to determine
eligibility for interview. Participants who agreed to at least 5 out of 13 items were considered
eligible to participate in the study. These parents were then asked to sign a consent form
before interviews were conducted.
The interviews were semi-structured and contained open-ended questions. Interviews
lasted approximately one hour and consisted of two sections: demographics questions
(gender, age, place of birth and residence, relation status, time alienated and time separated
from the alienating parent) and questions about the parents’ experiences of being alienated
105
from their child (e.g., What can you tell me about your experience of being alienated from
your child(ren)? Is there any other information you think is important for us to know about
your experience?). Participants had the opportunity to talk spontaneously about their
experiences according to their own interests and priorities. The interviews were audio
recorded for data accuracy purposes and transcribed verbatim. Each participant was provided
with a copy of their transcript to give them the opportunity to modify or confirm the
information provided (member checking).
5.2.3. Design
This study followed a qualitative descriptive design (Sandelowski, 2000), which
transforms the rich description of themes directly from the participants’ voice (Sullivan-
Bolyai, Bova, & Harper, 2005). This design allows for a rich naturalistic description of an
understudied topic (Bradshaw, Atkinson, & Doody, 2017) without the data analysis being
driven by preconceived ideas about the topic. Qualitative description aims to describe a range
of responses about a phenomenon or life event and code the descriptions by look for
commonalities and differences across the transcripts (Willis, Sullivan-Bolyai, Knafl, &
Cohen, 2016). Qualitative description follows the principles of qualitative research but differs
from the other qualitative research designs, because it does not focus on the lived experience
of the participants or in providing interpretative meanings of those experiences as
phenomenology does; it does not focus on culture or in providing a thick description as does
ethnography; or does it aim to build theory as does grounded theory (Bradshaw et al., 2017;
Caelli, Ray, & Mill, 2003; Merriam, 1998; Sullivan-Bolyai et al., 2005). Qualitative
description uses low inference interpretation to present the facts, staying close to the
participants’ data. This means that the responses are directly extracted from the participants,
reducing potential bias or any personal motivation or opinions of the researchers.

106
The data were analysed thematically and inductively following the six phases
proposed by Braun and Clarke (2006): familiarization with the data, generation of codes
using NVivo-11 (QSR International, 2015), searching for potential themes, reviewing the
themes, defining and naming the themes and weaving together the narrative and data extracts
contextualizing the analysis to existing literature. Inductive thematic analysis was chosen
because it is a method that permits identifying, analyzing, and interpreting patterned themes
in qualitative data (Braun, Clarke, & Terry, 2014).
The coding process was performed by the first and second authors of this article.
Once themes were identified and defined, a description of the frequencies and the explanation
of the themes and subthemes were made. To ensure the scientific rigor of the study, the Four
Dimensions Criteria described in Forero et al. (2018) were used. Credibility was established
through the development of a rigorous interview protocol, training interviewers in that
protocol and piloting it with peers. Further, the authors of this study have knowledge and
experience in qualitative research methods and analyses. Members of the research team met
regularly to review all aspects of the project. Dependability was ensured by establishing an
audit trail of the data using a spreadsheet and NVivo. The first and second authors
independently coded the first five transcripts to ensure inter-coder reliability. The first and
second author immersed themselves in the data by reading and re-reading transcripts until
themes emerged. Initial themes were presented to peers and themes were revised according
to peer feedback. Obtaining feedback from peers established confirmability. Confirmability
was also ensured through regular reflective meetings between the first and second authors as
well as meetings between all three authors. Themes were triangulated by comparing them to
individual transcripts, researcher reflections and previous literature on PA. Transferability
was ensured through data saturation and purposeful sampling.

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5.3. Results
5.3.1. Demographic Information of Targeted Parents
The majority of targeted parents were from Australia (70%). The remaining
participants were from New Zealand (9%), United Kingdom (6%), Canada (4%), United
States (4%), Europe (4%), Middle East (2%) and South America (2%). The majority of the
targeted parents (mothers and fathers) were aged between 41-50 years old (Table 5.1). Some
participants reported to be re-partnered (43%); the rest were single (35%), divorced (13%) or
separated but still legally married to the alienating parent (9%).
Table 5.2
Time of Alienation and Time Separated from Alienating Parent according to Gender of Targeted Parent
Less 6 6-11 1-3 years 4-5 years +5 years N total
months months
Time T. fathers 2 4 10 6 6 28
Alienated T. mothers 1 1 9 4 11 26
Time T. fathers 0 2 6 6 14 28
Separated T. mothers 0 0 3 4 19 26
Table 5.2 shows that most of the targeted parents were alienated from their child/ren
between one to three years and they were separated from the alienating parent for more than
five years. Targeted mothers were alienated from their child/ren for longer than were targeted
fathers in this sample.

109
interviews. As this is a qualitative descriptive study, and the data were gathered from
interviews with open-ended questions, the percentages provided represent the percentage of
targeted parents who talked about or mentioned the theme in their narratives spontaneously in
proportion to the total sample. Hence, the remaining percentages do not represent necessarily
the opposite of the topic. For example, if 90% of the participants reported being victims of an
episode of family violence, it doesn’t mean that a 10% were not victims; on the contrary, it
means that that 10% didn’t report, or talk or mention anything related to being victims of
family violence.
5.3.2.1. Targeted Parents Experiencing Family Violence Before the Alienation
Table 5.3
Description of the Theme Family Violence Experienced by Targeted Parents before the Alienation
Subtheme % of TP from the Type of family violence % of TP Gender
total sample (WHO, 2002) reporting FV
(n=54) (n=49)
Male Female
Physical 20% 16% 4%

Family 90% Sexual --- --- ---
Violence Psychological 67% 27% 40%
Deprivation or neglect 13% --- 13%
Total 100% 43% 57%
Ninety percent of the participants reported having been victims of at least one episode
of family violence in the form of physical, psychological (including control, threats, and
deceit) and deprivation or neglect perpetrated by the alienating parent (see Table 5.3). Before
the alienation occurred, alienating parents reportedly showed controlling behaviors towards
targeted parents. Thirty-one percent of targeted parents (see Table 5.4) referred to the
alienating parent wanting to be in control or the alienating parent being controlling and
dominant.
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Targeted parents reported being controlled emotionally, financially and socially by
the alienating parent. They reported that the alienating parent acted in ways that resulted in
targeted parents becoming isolated from their family and friends. Specifically, they
reportedly controlled the targeted parent’s day-to-day activities, their future goals, mail, e-
mails accounts, social media accounts, money, phone calls and the access to their children.
Mine was definitely a lot of - a lot of control issues. He’d open my mail; he’d check
my phone. A lot of gaslighting. And I think that was the start of it… (Participant
no.33).
The threats made by the alienating parent were in response to the possibility of the
targeted parent ending the relationship or leaving the alienating parent. The types of threats
reported by 24% of the participants (see Table 5.4) included threatening to physically assault
or murder the targeted parent, take the children away or make the child hate the targeted
parent.
When I went for the divorce I was threatened with: ‘You'll never see your daughter or
your grandchildren’. I was threatened with that. He put a lot of fear in me, I was
afraid of him (Participant no. 18).
Twelve percent of targeted parents (see Table 5.4) reported that the alienating parent
deceived them throughout their relationship. Deceit took the form of blatant lies or
concealing information.
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We actually moved down to [X] at one stage, because he told me that he had been
promoted to be state manager. So, we packed up our life in [Y] and moved down there
[to X], and that was all a lie [the promotion]. But gradually, through our marriage,
he used to hide things from me (Participant no. 22).
The episodes of domestic violence in the form of physical, deprivation or neglect were
reported by 33% of targeted parents.
I was pregnant... and we got into an argument and he pinned me down to the ground
and put his knee in my stomach… (Participant no. 24).
I had 3 years of domestic violence counselling before leaving her, and that’s why I left,
domestic violence. More emotional than physical, there were three issues of physical
violence but mainly it was emotional and that’s why I left (Participant no. 32).
In terms of gender differences, it was found that 57% of targeted mothers reported
they had been victims of family violence perpetrated by the alienating parent, whilst 43% had
been targeted fathers (see Table 5.3). In addition, it seems that alienating fathers tend to be
more psychological aggressive against targeted mothers, and alienating mothers tend to be
more physically aggressive against targeted fathers.
Further, the findings suggest that alienating fathers are the ones who use control and
threats against targeted mothers, and alienating mothers are the ones who use deceits as a
form of aggression toward targeted fathers (see Table 5.4).

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Table 5.4
Elements of Psychological Violence reported by Targeted Parents by Gender
Gender
Type of
violence Males Females Total
Control 9% 22% 31%
Threats 10% 14% 24%
Deceits 8% 4% 12%
Total 27% 40% 67%
5.3.2.2. Targeted Parents Experiencing the Alienation
This theme contains the experience of being alienated from a child from the targeted
parents’ perspective. Four sub-themes emerged in their narratives: what the targeted parent
believed was the cause of the alienation, mentioned 73 times by 87% of the targeted parents;
what they did, mentioned 72 times by 65% of the targeted parents; what they knew,
mentioned 20 times by 30% of the targeted parents; and the others who are the extended
family and the children’s school, being mentioned 104 times by 87% of the participants (see
Table 5.5).
Table 5.5
Description of the Theme Targeted Parents Experiencing the Alienation
Subtheme % Targeted No. of times
Parents mentioned
What the targeted parent believed was the cause of the 87% 73
alienation
What the targeted parent did 65% 72
What the targeted parent knew 30% 20
The Others (extended family and children’s school) 87% 104

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What the targeted parent believed was the cause of the alienation. This subtheme
summarises the reasons targeted parent believed were the cause of the alienation: revenge and
alienating parents’ mental health issues. These causes reported by the targeted parents were
coded exactly as described by them and independently of any psychological process assumed
by the researchers.
Revenge. Revenge, as a reason for the alienation, was described by 31% of targeted
parents. Some targeted parents described the alienation process and alienating behaviors as
punishment for either: leaving the relationship, having an affair or because they took legal
action against the alienating parent.
But he absolutely, from the word go, his whole aim was to punish me for leaving
(Participant no.39).
More specifically, 30% of targeted parents believed that the alienation started as
revenge at the moment of family separation or divorce.
I think that the trigger for the hostility was my application for a divorce (Participant
no. 3).
Another 30% of targeted parents attributed the revenge through financial gain for
having greater care of the children. These financial gains were in the form of child support and
a greater portion of assets from financial settlements.

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She said: I told you, I’m not going to pay child support. And I realized she’s made up
all these lies so that our son would want to live with her and she wouldn’t have to pay
child support payments (Participant no. 40).
And a 6% of targeted parents believed that the cause of the alienation was revenge for
having a new partner after separation or divorce.
Everything was fine for probably a month period and then everything changed when
I got a girlfriend and then she just completely changed, decided that she's going to
remove the kids out of my life and I would never see them again. So, yeah, that’s
pretty much where it started (Participant no. 54).
She just left… but she never told me she wasn’t coming back… She just went and I
never saw her again (Participant no. 30).
Mental health. Twenty-six percent of targeted parents believed that the cause of the
alienation was triggered by the alienating parent mental health issues, seen as concerns of the
alienating parent that impacted on their ability to make rational decisions that were in the best
interest of the child. Some targeted parents referred to the behaviors of the alienating parent as
being consistent with their understanding of particular personality disorders.
The psychological evaluation, it did say that my ex was a very- had a very high sense
of self, very... narcissistic tendencies (Participant no.54).

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What targeted parents did. Targeted parents described several actions that show
they were active in maintaining a relationship with their children during the alienation, such
as keeping communication and contact with their children, being available for them, looking
after themselves, making attempts to reconnect with their child when all else failed or just
changing the focus of attention away from the alienation.
Keeping communication and contact. Targeted parents tried to communicate with
their children whenever they could, either by writing emails or letters (24%), sending text
messages (9%), calling directly to their mobile phones (6%) or sending gifts for Christmas or
birthdays (20%). Targeted parents have travelled to other cities or countries just to see their
children or they have bought airplane tickets to encourage their children to visit them (7%);
they have gone to their children’s homes and waited outside or knocked on the doors (7%);
they have attended their children’s events such as graduations or sport games (4%); been
involved in school activities such as canteen or classroom volunteering (4%); or they have
attended their children’s school to wait at the gate or to speak to school staff (4%). None of
these attempts had a positive response from their children.
I contact her, probably, on average, about once every two weeks via email, or a text
or a card, and I send presents at birthdays, and Christmas and the odd. If I go away,
I’ll send something that I’ve brought back. So, I keep up contact as best I can with
her, and I never hear anything back (Participant no. 26).
Being available for the kids. Targeted parents reported maintaining the same address,
same mobile-phone number in case their children wanted to come back, quitting jobs to have
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more flexible time (6%) or keeping a spare room for them even if they don’t have any contact
(4%).
I've still got a spare room but nobody's slept in it. So, I'm going to keep having a room
for him and I've still got his stuff (Participant no. 19).
Looking after themselves. Some targeted parents tried to look after themselves by
seeking help from telephone counselling services or other face-to-face counselling services
(6%). Some targeted parents (6%) blocked their children from social media or took
themselves off it because they realized it was too painful being exposed to their children’s
comments or messages. Two percent of targeted parents said they have flown to another city
seeking professional help from someone who understands what PA is.
I’d be calling organizations like Mensline and Lifeline. My distress would just be-
because they can’t help me (Participant no.33).
When all else failed. Targeted parents described engaging in various desperate
attempts to maintain some contact with their children when all other reasonable attempts had
failed. They described constantly checking Facebook or Instagram to see pictures of their
children (7%); keeping records of almost everything they did as evidence to prove to their
children in the future what they did for them, that they always cared about them and they did
not abandon them. Some targeted parents said they had spoken to the media (4%) to make
their cases public; opened a bank account for their children to deposit money equivalent to
birthday and Christmas presents after learning that their children were not receiving their
gifts (2%); hired a private investigator to find out where their children were (2%); put their
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children on a watch list at airports to avoid the alienating parent taking the children out of the
city (2%); and made a piece of jewelry with the child’s name to remember on it (2%).
I searched them out on Instagram and Facebook. They’ve blocked me so many times,
so I created another email, trying to just get a few pictures here and there
(Participant no. 21).
Changing the focus of attention away from the alienation. Twenty-two percent of
participants decided to focus on something else other than the alienation, explaining they
‘tried everything’ they could. Another group of targeted parents reported they ‘gave up’
because they did not want to add more stress to the children by continuing court proceedings
(17%); they could not cope with the process anymore (11%); they needed to look after
themselves (9%); they could not afford the amount of money needed for lawyers or to keep
up with the alienating parent’s demands; or their children are almost adults (6%).
I did nothing but try every legal possible way to try and see them. I went to the school,
I did everything that I could possibly do, and nothing was working. And I just got to a
stage where I thought this is going to consume me totally, and I just- You just can’t do
that. So, I just had to accept what it was, and try and get on with my life, which is
what I’m trying to do (Participant no.4).
What targeted parents knew. Thirty percent of targeted parents reported not
knowing what PA was until they had experienced it themselves. They said they regret not
knowing about it because if they did, they may have acted differently in the face of it.
Targeted parents also described that now they know, there is still not a lot they can do
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because the legal system and many mental health practitioners have insufficient knowledge
of PA and underestimate the impact of alienating behaviors.
I only found out about parental alienation recently and reading a lot of the sites and
blogs from other people I realized I’m not alone. At the time I thought I was very
alone. The hardest part is that there seems to be nothing that the authorities can do to
prevent this (Participant no. 40).
The others. This sub-theme includes targeted parents’ experiences with extended
family (described by 91% of targeted parents) and their experiences with their children’s
school (reported by 49% of the participants). Targeted parents reported that either their
extended family or the alienating parent’s extended family were somehow involved in the
alienation. Sixty-nine percent of targeted parents mentioned extended family, such as
grandparents, uncles, aunts, siblings, cousins, etc., were alienated from the child also.
Twenty-two percent reported that extended family (their own or the alienating parent’s) was
the alienator or was contributing to the alienation.
The girls have been isolated from everyone on my side of the family (Participant
no.54).
Targeted parents described that their children’s school was either supportive of them
or aligned with the alienating parent. Forty-three percent of the targeted parents reported that
the school (the principal, teachers, counsellors and administration staff) aligned themselves
with the alienating parent and worked together to maintain and exacerbate the alienation. Six
percent of the participants reported receiving support and help from their children’s school, in
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terms of providing times to see the children, or sending reports home or having meetings to
inform them of their child’s progress at school.
But Miss B. has been fantastic, the first time ever, and again, it seems to me that the
only ones that actually will support you, are the ones that have actually been through
it, or their partners have actually been through it. And this principal herself has lost a
child and also been a single parent at some stage as well, so she knows what it’s like
(Participant no.7).
5.4. Discussion
Demographic information provided some information about the characteristics of the
targeted parents participating in this study. In terms of gender, this information supports the
notion that PA does not discriminate on the basis of gender (Balmer et al., 2017; Kopetski,
1998b). There were just as many targeted mothers as targeted fathers participating in this
study who experienced the rejection of their children. Similar results were found in Balmer et
al. (2017) and in Harman, Leder-Elder and Biringen (2016).
This demographic information shows that PA is not bound by geographical borders,
supporting Lorandos, Bernet and Sauber (2013) who stated that PA has been identified in the
professional literature of at least thirty countries on six continents, transcending politics,
culture and religion. Despite PA being discussed around the world, studies about how culture
can affect the way PA is experienced or addressed by the targeted parent have not been
conducted. Similar suggestions are made by Finzi-Dottan et al. (2012) who recommend
expanding studies around wider samples from different social and religious backgrounds.
Identifying elements of family violence in the targeted parents’ narratives is one of
the most important findings of this study because it supports recently published literature
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concluding that alienating behaviors used by alienating parents is a form of family violence
(Harman, Kruk, & Hines, 2018; Kruk, 2018, 2019; Poustie et al., 2018). Almost all of the
participants involved in this study reported having experienced at least one episode of
violence in the form of intimate partner violence (IPV) perpetuated by the alienating parent
before the alienation took place. This violence included psychological aggression, physical
aggression and legal and administrative aggression (Breiding, Basile, Smith, Black, &
Mahendra, 2015).
According to Harman et al. (2018), psychological aggression is the most common
type of IPV. Alienating parents reportedly engage in behavior that constitute control and
coercion over the targeted parent and child damaging the targeted parent’s and child’s sense
of self (Baker, 2007; Williams, Richardson, Hammock, & Janit, 2012). The narratives of the
targeted parents who participated in this study revealed that they have survived four types of
psychological aggression including coercive control, threat of physical violence, exploitation
of victims’ vulnerabilities and gas lightning (Breiding et al. 2015).
Moreover, it was found that most of the targeted mothers in this study were more
often victims of IPV perpetrated by the alienating parent than were fathers. This finding is
consistent with the literature on family violence which suggests that females are more likely
to be survivors of family violence than are males (Archer, 2000; Australian Institute of
Health and Welfare, 2019; Norlander & Eckhardt, 2005; Pence & Paymar, 1993); however, it
was also found that a noteworthy proportion of targeted fathers in this study described being
victims of IPV as well. Many scholars cited in a meta-analysis (Langhinrichsen-Rohling,
Selwyn, & Rohling, 2012) consider gender asymmetry regarding IPV may be due to men
under-reporting their experience of IPV or it may be due to biases or differences in sampling
strategies in the research (Johnson, 2006).

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In this study, gender differences were also found regarding the type of aggression
perpetrated by alienating parents. More targeted mothers than fathers reported being victims
of psychological aggression and described being controlled and threated by the alienating
father. Targeted fathers more so than mothers reported being victims of physical aggression
perpetrated by alienating mothers. They also considered deceit as a form aggression toward
them. These findings are supported by previous literature which suggest that women, as
victims of IPV, are more likely to experience fearful coercive control than men (Coker et al.,
2002), whilst women, as perpetrators of IPV, commit equal or higher rates of physical
aggression toward partners as compared to men (Archer, 2000; Katz, Kuffel, & Coblentz,
2002; Magdol, Moffitt, Caspi, Newman, Fagan, & Silva, 1997). Further, deceit can be
considered a form of emotional abuse because it creates a false perception of reality as a
means of control (Hollins, 2019).
Given the seriousness of the consequences of family violence on survivors, it is
important to recognise these elements of aggression and abuse as part of the alienation
process and develop appropriate and timely interventions in legal and psychological areas.
For example, interventions may require a legal and therapeutic component where the ongoing
safety of the child and targeted parent is secured and prioritised (Templer, Matthewson,
Haines, & Cox, 2017). If, indeed, alienating parents are perpetrators of family violence, the
consequences of leaving alienated children in the care of alienating parents needs to be
carefully reviewed.
According to the participants’ view of the beginning of the alienation, targeted parents
believe they were being punished either because they left the relationship, had a new
relationship or an affair, or because they involved the alienating parent in court or police
matters. This finding is consistent with findings reported by Vassiliou and Cartwright (2001)
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attributing the alienating parent’s behaviors as being motivated by hate and anger, revenge, or
some combination of these.
Some of these findings have been previously studied in the literature. For example,
Warshak (2000) explained that the targeted parent having a new partner can result in
alienation because of maladaptive coping mechanisms of the alienating parent. The alienating
parent might feel jealousy and experience narcissistic injury due to a residual emotional
attachment toward the targeted parent or because the alienating parent is unaware of
harboring fantasies of reconciliation.
The alienating parent’s mental health has been recognized previously as a trigger of
the alienation. Poustie et al. (2018) found that targeted parents attributed the personality and
psycho-social issues of the alienating parent as a behavioral manifestation of the alienation.
Indeed, disordered personality traits and delusional beliefs have been identified as being
associated with the alienating parent’s need to damage the relationship between the targeted
parent and child (Kopetski, 1998b; Rand, 1997b).
Targeted parents had been active in their fight to have a relationship with their
children. They reported doing everything they could to keep contact with their children and
maintain a loving relationship with them, even when these attempts were hindered by the
alienating parent or their allies. There was a group of targeted parents who stopped fighting
the battle because they could no longer afford the cost of the battle, they needed to look after
their own health and had concerns about the impact of the battle on their children’s
wellbeing. Similar findings were reported by Bala, Hunt and McCarney (2010) and Harman
and Biringen (2016).
The findings showing targeted parents as active and capable parents are noteworthy
because they contradict observations of some authors who have described targeted parents as
passive (Kelly & Johnston, 2001; Kopetski, 1998b), overly accommodating, emotionally
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repressed (Kopetski, 1998b), inept, lacking in empathy towards their children (Johnston &
Campbell, 1988; Johnston & Roseby, 1997) and avoidant in the face of high conflict (Kelly
& Johnston, 2001). The inconsistency in the findings may be related to differences in
research design and methodology. Studies describing targeted parents as displaying
problematic behaviors are based on researcher and/or clinician interpretations of the
observations they have made. The current study, however, is based on the perspective of the
targeted parent themselves. It may be that targeted parents are active in their fight to remain
in their children’s lives but are overly accommodating of the alienating parent’s demands as a
means of avoiding further conflict and further harm to the children. Targeted parents may
also appear to an observer as lacking in empathy when their behavior is a reflection of a
parent struggling to come to terms with their child’s rejection rather than an actual deficit in
child-centeredness (Haines, Matthewson, & Turnbull, 2020). It is important to note that no
parent interviewed in this study expressed hatred towards the alienating parent.
It is also interesting to note the importance of third-party involvement in the process
of the alienation. Very few studies in the literature have described the role of third-party
involvement in PA (e.g., Golly, 2016; Sauber, 2006; Warshak, 2000). The narratives in this
study show that not only members of the wider family system play an active role in the
alienation process (both the alienating parent’s family and the targeted parents’ family), other
systems such as schools can play a significant role in the maintenance or aggravation of PA.
Targeted parents have experienced the alienation actively, like fighting a battle to
save their child/ren against the other parent’s behaviour. They have been fighting this battle
with, at times, limited knowledge and resources. Sometimes they are not only fighting the
other parent, they also find themselves fighting against their own family, their family-in-law,
their friends and their children’s school. Some of them have stopped focusing on the fight for
good reasons, for their children’s well-being or for their own, or due to a lack of financial
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resources. These parents have been victims of family violence and they have suffered the
significant loss of their children.
5.5. Limitations of this Study and Recommendations for Research
It is known, within qualitative research, that every story is different and unique to
each individual. One of the limitations of this qualitative descriptive study is that finding
commonalities via themes was favored over exploring unique individual experiences. Future
research might consider exploring the lived experience of targeted parents from a more
traditional qualitative perspective (e.g., phenomenology) to capture the deep meaning of the
phenomenon. Also, a limitation of having a self-referred sample may add biases in the
responses. The narratives of participants have been treated as true in this study; however, it
cannot be guaranteed that all participants were indeed targeted parents. Future research into
the experience of PA can avoid this limitation by exploring the experiences of each member
of the alienated family.
Another limitation of this study may be considering the dataset as a whole rather than
differentiating the data by gender. Although there was a differentiation by gender regarding
family violence experiences, targeted mothers who are alienated from their children may
have different PA experiences than targeted fathers. The aim of this study was not to consider
gender differences; however, future research should explore similarities and differences in
the experiences of targeted mothers and fathers. Further, an inherent limitation of thematic
analysis is researcher bias. Although every attempt was made to conduct the research within a
purely inductive, data-driven manner, researcher bias may have influenced the results. Future
research could employ both qualitative and quantitative research methods to address this.
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5.6. Conclusion
This qualitative descriptive study has shown that PA is a phenomenon that appears in
almost the same manner in different individuals from different parts of the world. The current
study adds valuable information to be used by practitioners working with targeted parents in
order to understand their experiences and the process of alienation from their perspective, not
from the perspective of lawyers, counsellors, or children.
In conclusion, to understand the experiences of targeted parents of PA, it is important
to understand that although they are active in their attempts to get their children back, they
appear to be survivors of family violence perpetuated by the alienating parent and their allies.
The extended family and the alienated children’s school play an important role in the alienation
process. They can act as actor of the alienation. Finally, there are specific events that can trigger
the alienation. Early identification of these triggers may help to prevent PA.
This chapter has presented the experiences of targeted parents of being alienated from
their children from their own perspective, with particular attention on what happened before
and during the alienation. This study contributes new topics to the research field of PA such
as the identification of specific triggers, identification of family violence as part of the
alienation, school and extended family as alienators and the behaviours of targeted parents
during the alienation. The following chapter presents Study Three of this thesis, which
reports the experiences of targeted parents focused on the consequences and coping
mechanisms they have used to deal with the alienation.

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Chapter VI
Study Three
A qualitative description of the
consequences of the alienation on
targeted parents and their coping
strategies
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In this chapter, Study Three of this thesis is presented, seeking to answer the third
research question: How have self-referred targeted parents been affected by the alienation
and how have they coped with the alienation? In addition, from the findings, suggestions and
direction to be taken into account when working with targeted parents in PA matters is
provided.
This study has been published under the name ‘Targeted parents surviving parental
alienation: a qualitative description of the consequences and coping strategies’ in the Journal
of Child and Family Studies (see Publications in page XIX)
6.1. Introduction
Parental alienation (PA) is a phenomenon in which a parent, the targeted parent, is
rejected by his or her child without legitimate justification. The child refuses to have contact
or any relationship with the targeted parent as a result of a series of alienating behaviours
made by the other parent, the alienating parent (Bernet & Baker, 2013; Garber, 2011). PA can
occur prior to, during or after separation, especially when the custody of children is in
dispute. PA has been seen in divorced families, intact families and unmarried families from
all around the world (Baker & Verrocchio, 2015; Balmer et al., 2017; Hands & Warshak,
2011; Harman & Biringen, 2016; Lorandos, Bernet, & Sauber, 2013). It is important to note
that children rejecting a parent for legitimate reasons and for reasons not duly influenced by
another parent is not PA. These circumstances can be considered estrangement (Garber,
2011; Tjaden & Thoennes, 2000).
The consequences to targeted parents of being alienated from their children are
devastating. Baker and Sauber (2013) explained that being a targeted parent is one of the
most painful experiences a parent can face, often without the support and understanding of
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family and friends. Targeted parents experience pain and loss (Baker & Andre, 2008; Reay,
2011), and suffer immense grief for their children who are alive yet lost to them (Gardner,
2001).
As a consequence of being alienated from a child, targeted parents suffer depression,
anxiety, posttraumatic stress disorder, sleeping problems, loss of self-esteem and engage in
self-blame (Baker, 2010b; Baker & Andre, 2008; Baker & Darnall, 2006; Baker & Fine,
2014; Balmer et al., 2017; Giancarlo & Rottmann, 2015; Goldberg & Goldberg, 2013;
Kopetski, 1998b; Vassiliou & Cartwright, 2001). The literature also reports targeted parents’
feeling maltreated by the alienating parent (Goldberg & Goldberg, 2013), and feeling
shocked desperate, confused, alone (Baker & Fine, 2014) frustrated, angry and fearful
(Baker, 2010b; Baker & Andre, 2008; Baker & Darnall, 2006; Vassiliou & Cartwright, 2001)
in response to the alienation. Some authors have reported that targeted parents suffer
emotional and financial costs jeopardizing their well-being (Balmer et al., 2017; Poustie et
al., 2018). Moreover, targeted parents have been described as survivors of family violence
perpetrated by the alienating parent (Harman et al., 2018; Poustie et al., 2018). These
descriptions of targeted parents are an important development in the literature because earlier
studies regarding PA have focused on conceptualizing PA or have focused on alienated
children (Baker, 2005abc, 2007; Baker et al., 2012; Baker & Darnall, 2006, 2007; Bernet et
al., 2015; Darnall, 1998; Garber, 2013; Gardner, 1992, 1998; Johnston, 2005; Johnston et al.,
1985; Kelly & Johnston, 2001). Much of the academic literature on PA has been from the
United States and Canada. Research about targeted parents has been extracted from
informants other than targeted parents, such as alienated children and practitioners (Lee-
Maturana et al., 2018). Further, the literature includes commentary on clinical experience and
observation that are sometimes published in textbooks as well as self-help book formats
(Baker & Fine, 2013, 2014; Baker & Sauber, 2013; Warshak, 2010a; Woodall & Woodall,
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2017). The current academic literature focusing on targeted parents is growing and brings
valuable information to the research field.
More research is needed from a global perspective to strengthen the existing
knowledge of targeted parents. Reporting the consequences of the alienation on targeted
parents and their coping mechanisms may contribute to decision-making processes for
psychological and legal interventions. Additionally, it will contribute to a better
understanding of the phenomenon within the scholarly literature. Hence, this study aims to
describe the consequences of PA on targeted parents from their perspective by identifying the
coping strategies used by them to deal with the alienation. This study also offers suggestions
for working with targeted parents in clinical practice.
The findings reported in this study are part of a larger research project. This article
focuses on the consequences and coping strategies used by the targeted parents who have
experienced PA.
6.2. Methods
6.2.1. Participants
A total of 54 self-referred targeted parents participated voluntarily in a semi-
structured interview. The inclusion criterion for the study was being a parent alienated from
at least one child. This sample consisted of 28 targeted fathers (52%) and 26 targeted mothers
(48%). Most of the sample were from Australia (70%), whilst the remaining participants were
from New Zealand (9%), United Kingdom (6%), Canada (4%), United States (4%), Europe
(4%), Middle East (2%), and South America (2%). The majority of the targeted parents were
aged between 41 and 50 years old (54%); some of the participants had re-partnered (43%). In
addition, most of the targeted parents were alienated from their child/ren between 1 and 3
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years and they were separated from the alienating parent for more than 5 years. Targeted
mothers were alienated from their child/ren for longer than were targeted fathers in this
sample.
6.2.2. Design and Procedure
A qualitative descriptive design was chosen (Sandelowski, 2000). Qualitative
description allows researchers to describe a phenomenon, often of an understudied topic,
directly from the participant’s voice (Bradshaw et al., 2017; Sullivan- Bolyai et al., 2005). It
also allows researchers to code participants’ responses into themes looking for commonalities
and differences across the transcripts (Willis et al., 2016). This results in rich description of
those themes into the development of pragmatic educational, therapeutic or behavioural
interventions (Sullivan-Bolyai et al., 2005).
Ethics approval was obtained from the University of Tasmania’s Social Sciences
Human Research Ethics Committee (Ethics Ref No: H0015333). Participants were recruited
from advertisements in the media, online support groups and psychology and legal practices.
The interviews lasted for approximately one hour, were semi-structured and contained
open-ended questions regarding how the targeted parents have experienced the alienation and
how they have coped with it. Also, participants were asked to provide further information
that they thought was important for the research. Prior to the interviews, participants were
presented with information about the nature of the study and were asked to respond to a
parental alienation screening tool developed by the researchers to ascertain eligibility for the
interview. This screening tool consisted on a 5-point Likert scale, which involves participants
rating their level of exposure to 13 alienating tactics identified in the literature, to confirm if
they were indeed targeted parents; if they were eligible, they were asked to sign a consent
form. Participants also completed a demographics survey based on gender, age, place of
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birth, relation status, time alienated, and time separated from the alienating parent. All
interviews were audio recorded and then transcribed. The transcripts were double checked by
participants for data accuracy purposes.
The transcripts were thematically and inductively analysed (Braun & Clarke, 2006;
Braun et al., 2014) and clustered by codes using NVivo-11 (QSR International, 2015). Based
on qualitative descriptive methods (Sandelowski, 2000), a description of the codes and an
analysis of the frequencies of the themes and sub-themes were made. Rigorous criteria to
judge trustworthiness were adopted based on: credibility, using member check and peer
debriefing; transferability, through purposive sampling; dependability, utilizing inquiry audit,
peer examination and code-recoding; and confirmability, through audit trail and reflexibility
(Guba, 1981; Lincoln & Guba, 1985).
The Appraisal Theory of Emotions (Roseman, 1996, 2011, 2013; Roseman &
Edvokas, 2004; Roseman et al., 1990; Roseman et al., 1994) and Beck’s Cognitive Model
(Beck, 1976; Burns, 1999; Knapp & Beck, 2008) was used to analyse the element ‘emotions
displayed by targeted parents due to alienation’ in the subtheme Emotional Consequences
and the thoughts of targeted parents reported in the subtheme Cognitive Consequences
respectively. This allowed for the data to be analysed within a theoretical framework
facilitating the understanding of targeted parents’ experience and how they have been
affected by the alienation.
6.3. Results
Two themes have emerged from the participants’ narratives: (1) consequences of PA
on targeted parents and (2) coping strategies used by targeted parents to deal with the
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It is important to note that the findings are shown in percentages. The percentages of
the themes were calculated according to the total sample (n = 54); and the percentages
reporting the subthemes and elements of the subtheme were calculated according to the total
number of participants commenting on the theme.
6.3.1. Consequences of the alienation in targeted parents
Consequences of the alienation refers to any negative issue targeted parents
experienced as a direct result of being alienated from their children. The data were organised
around six sub-themes that represent six types of consequences: emotional, behavioural,
finances/work, cognitive, physical and social (See Table 6.1).
Table 6.1
Consequences of the Alienation in Targeted Parents
Subtheme % TP mentioning the elements No. of references*
of the subtheme
Emotional 89% 179
Behavioural 74% 58
Finances / work 59% 71
Cognitive 57% 48
Physical 33% 28
Social 22% 13
*Number of times the consequence was mentioned.
6.3.1.1. Emotional. Eighty-nine percent of the total sample of targeted parents
reported being affected emotionally by the alienation. Emotions described by the participants
were classified in terms of psychological difficulties, emotions they have shown while
experiencing the alienation and a description of how they feel about the alienation.
Psychological difficulties. Depression (33%), stress (23%), anxiety disorders (21%),
and posttraumatic stress disorder (15%) were reported by targeted parents as consequences of
the alienation. Targeted parents also mentioned having been affected by an adjustment
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disorder (4%), panic attacks (2%), low self-esteem (2%), lack of confidence (2%), and loss of
identity (2%). It is important to note that some of these psychological difficulties were
mentioned as clinical diagnoses by targeted parents during the interviews. Some of them said
they had been diagnosed by a medical or mental health professional; however, it is unclear if
they all were diagnosed or if they were self-diagnosed. For example, Participant no. 24 stated
that their doctor made the diagnosis: ‘My doctor ended up having to put me on a medication
to help me with my anxiety and my depression.’; whilst Participant no.25 did not specify
where their diagnosis came from: ‘I’ve got issues with anxiety and—well, particularly
posttraumatic stress disorder with depression and an adjustment disorder.’ It is important for
future research to make this distinction. The internet provides individuals access to an
abundance of resources including medical information. This can lead to self-diagnosis. Self-
diagnosis can be dangerous because it can increase anxiety (Ahmed & Stephen, 2017; White
& Horvitz, 2009) and it has the potential to escalate medical concerns (White & Horvitz,
2009). In addition, self-diagnosis can give rise to inaccurate diagnostic labels (Pillay, 2010);
can create a self- perception of abnormality and morbidity; increase physical and emotional
distress (Ahmed & Stephen, 2017); and prevent access to appropriate treatments or
interventions (White & Horvitz, 2009).
Emotions that targeted parents have experienced. In their own words, targeted parents
described experiencing several negative emotions due to being alienated from their children,
such as feeling frustrated, upset, sad or overwhelmed. They no longer felt joy or pleasure in
life, they felt rejected, embarrassed, drained, guilty, confused, broken, angry, isolated and
disempowered. Other words mentioned by the participants to describe how they felt were
exhausted, ganged up on, embarrassed, hurt, insecure, daunted, pressured and powerless.
Also, they felt powerful emotions, sorry for themselves, in so much pain and on a mountain
of emotions. Some targeted parents reported trying to avoid their emotional responses. Table
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6.2 shows the terms targeted parents used to describe their emotions in their own words, the
percentage of them mentioning the term and a quotation extracted from their narratives as an
example.
Table 6.2
Terms Describing the Emotions Displayed by Targeted Parents while Experiencing the Alienation in their
own words
Terms % of TP Participants quotations

Frustration 13% ‘Frustration is probably the biggest emotion that I display, it comes
out as anger but its frustration that dealing with somebody that
won’t communicate honestly.’ (Participant no.31)
Upset 10% ‘It’s really upsetting because it’s my kids, and it’s all for no
reason.’ (Participant no.41)
‘I get very upset about it but I know that I haven’t done anything
wrong and I know that I can’t never change what anyone thinks of
me you know.’ (Participant no.30)
Sadness 8% ‘I’m definitely a very mellow person and you know I feel sadness
always, always, always in my heart and, umm, it’s very shallow and
it’s on the surface and the slightest thing can set me off.’
(Participant no.49)
Overwhelmed 8% ‘I got so overwhelmed and then all I did was sit there and cry for
30 minutes to an hour all by myself and then once I got all that out
you know, I was able to go back to doing what, you know, my daily
routine...’ (Participant no.24)
No joy-pleasure in life 8% ‘I can’t feel any pleasure. I don’t enjoy anything, anything at all. I
don’t remember being happy in the last 3 years ever.’ (Participant
no.48)
Rejection 6% ‘It feels like rejection. Complete rejection from one of the most
important relationships that you have. And it feels incredibly
unjust, because it’s rejection on grounds that you know to be
spurious and wrong.’ (Participant no.26)
Draining 6% ‘It’s been very draining. There are times when I’ve had to just put it
out of my mind.’ (Participant no.36)
Guilty 6% ‘And the guilt, that’s the horrible thing, the guilt I feel for even
smiling, in a conversation or halfway through a laugh, actually my
mind will click on then, and say why? straight away, there’s this
voice that says why are you laughing? Your kids aren’t here and it
will stop me from laughing and it doesn’t matter how funny it is or
what the situation is or how light hearted whatever is happening is,
I still have that guilt.’ (Participant no.49)
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Confused 4% ‘Yeah, so just completely... confused... and that went on …’

(Participant no.26)
Broken 4% ‘You can’t image how broken I am at the moment I lost my son’
(Participant no.27)
Anger 4% ‘I just feel anger... and lots of crying’ (Participant no.31)
Isolated 4% ‘I felt very isolated. None of my family was over there. I couldn’t
keep my job at the private school, because I couldn’t be a mother
and a good teacher. I just couldn’t do it all.’ (Participant no.21)
Blocking emotions 4% ‘I’ve blocked emotions, negative emotions, to stop myself from
overtly hurting.’ (Participant no.48)
Disempowered 4% ‘There’s been times where I’ve been bedridden for months, because
of the impact that it’s had on me. I just feel totally disempowered.’
(Participant no.33)
‘And also, one last thing, I suppose, is that as a parent, you become
completely disempowered. You lose your ability to parent. You
cannot discipline, you cannot say anything, because if the child is
upset in any fashion, way, or state … fashion or whatever, you get a
negative report.’ (Participant no.7)
Powerful emotions 2% ‘I’ve had a horrendous shock, and it creates all sorts of very
powerful emotions in me.’ (Participant no.26)
Exhausted 2% ‘It’s been very hard on me and exhausting.’ (Participant no.53)
Ganged up on 2% ‘I felt like I was ganged up on in some ways and it was all
orchestrated, and helped, with obviously my ex-husband
orchestrating it all.’ (Participant no.51)
Embarrassed 2% ‘I couldn't even go into the local shopping centre without feeling so
embarrassed with moms that I knew from netball and I used to
coach the kids' netball teams and stuff....’ (Participant no.20)
Hurt 2% ‘And it reaches the point where there’s nothing that you do,
nothing, yeah, it does hurt. Yeah, emotionally it does hurt.’
(Participant no.14)
Insecurities 2% ‘Yes, exceptionally so. Dark thoughts... and insecurities, yeah.’

(Participant no.42)
Feeling sorry for 2% ‘I just went right down into a big hole. I was in this hole and feeling
themselves sorry for myself.’ (Participant no.44)
Daunted 2% ‘It was quite daunting for me, because it’s really hard to accept
that my children could do that to me.’ (Participant no.45)
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Pressured 2% ‘I’ve had enormous pressure put on me; financially, physical,

sickness, and defending me from her for years.’ (Participant no.50)
Mountain of emotions 2% ‘There's been a mountain of emotional issues, I suppose, in the

sense that I suppose I try to keep busy all the time as I suppose as a
defence mechanism, as a compensatory approach to keep busy so
that … because there's little triggers that can trigger off.’
(Participant no.51)
So much pain 2% ‘Almost like, when people ask you when they meet you, “Oh, do you
have children” and you almost feel like saying, well, do I? You
start to question do I have a child, and of course I've got a child
that I love very much but it's so … there's so much pain.’
(Participant no.51)
Powerless 2% ‘First word that comes to my mind is powerless. There's nothing

you can do about it.’ (Participant no.54)
All of the terms describing the emotions displayed by the participants were classified
as synonyms or as the meaning they gave to the situation according to a negative emotion
extracted from Roseman’s Emotion System (Roseman, 1996, 2011, 2013; Roseman &
Edvokas, 2004; Roseman et al., 1990). According to Roseman (2013), emotions are guided
by appraisal of people’s response to crisis situations and opportunities. Emotions can be
understood as a coherent, integrated systems of general-purpose coping strategies. Roseman’s
model identifies twelve negative emotions and offers a functional explanation for the
presence of particular emotions in the emotion repertoire, and their elicitation by appraisal
combinations. The twelve emotions include fear, sadness, distress, frustration, disgust,
dislike, anger, contempt, regret, guilt, shame, and surprise. Surprise can be considered
negative or positive depending of the person’s appraisal.
When considering Roseman’s Emotion System model, targeted parents feel sadness,
distress, frustration, anger, guilt and shame as a consequence of the alienation. These
emotions are elicited by the interaction of seven appraisal determinants: unexpectedness (not
unexpected-unexpected), situational state (motive inconsistent-motive consistent),

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motivational state (aversive-appetitive), probability (uncertain-certain), agency
(circumstances-other person-self), control potential (low- high), and potential type
(instrumental-intrinsic).
All of these negative emotions are motive inconsistent (situational state) and not
unexpected (unexpectedness), which means that the event, in this case the alienation, is
unwanted by the targeted parent and their emotions are expected according to the situation.
Sadness, frustration, anger, and guilt are emotions related to an absence of reward
(motivational state) and are considered an instrumental problem (potential type); whilst
distress and shame are emotions related to the presence of punishment (motivational state)
and are considered an intrinsic problem (potential type). When sadness and distress are
elicited in targeted parents, the occurrence of the alienation aspects are definite and certain
(probability); eliciting frustration, anger, guilt, and shame (see Table 6.3).
These negative emotions are related to the appraisal of what or who caused the event
(agency); in this context, the emotions relate to what or who caused the alienation. Feeling
sadness, distress, or frustration is related to circumstantial causes; feeling angry is related to
causes external to the person, Roseman (2011) called it ‘other cause’; and feeling guilty and
shame is related to self- caused. In addition, the appraisal of high or low control regarding the
event (control potential) can be interpreted from these negative emotions as well. Hence,
targeted parents feeling sadness and distress might think there is nothing they can do about
their situation (low control). On the contrary, those who feel frustration, anger, guilt, or
shame might think they can do something about their situation to change it (high control).
According to Roseman (2011), these emotions form strategies (contacting, distancing,
rejection, and attack) for coping with a particular situation when various responses,
characteristic of a particular emotion, are interrelated. These may be helpful in understanding

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targeted parents’ feelings and how these feelings interact in response to the alienation. For
example, when people feel sadness and distress, they tend to distance themselves from the
stimuli by reducing contact with it as a way of coping with the situation (distancing strategy).
People feeling frustration, anger or guilt tend to move against the objects and events in
general, against other people, or against the self (attack strategy). When people feel shame,
they tend to move the stimuli away from them (rejection strategy).
Table 6.3
Negative Emotions displayed by Targeted Parents experiencing the alienation using Roseman’s Emotion
System
NEGATIVE EMOTIONS
Motive Inconsistent
Circumstance/ Cause Appetitive (absent) Aversive (present) Control/Potential
Unexpected Surprise Low
Not unexpected / Fear Low

Uncertain
Certain Sadness Distress Low

Exhausted, sad, Hurt, overwhelmed,
broken, no feeling drained, rejected, insecure,
pleasure in life ganged, daunting, in so
much pain, feeling
powerful emotion or in a
mountain of emotions
Uncertain / Certain Frustration Disgust High

Frustrated, confused,
disempowered,
powerless
Other cause Dislike Low

Uncertain / Certain
Uncertain / Certain Anger Contempt High

Upset, angry
Self-caused Regret Low

Uncertain / Certain
Uncertain / Certain Guilt Shame High

Guilty Embarrassed, isolated,
sorry for themselves
Instrumental Intrinsic problem

problem
Adapted from Roseman (2011; p.438)
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Description of how targeted parents feel about the alienation. PA is described by targeted
parents as the worst thing that ever happened to them. It was described as grieving a child
who is still alive. They described grieving with no help or understanding from others.
Targeted parents described experiencing disenfranchised grief. Disenfranchised grief is
where a person feels a loss, but they are unable to express that grief because it is not socially
acknowledged (Doka, 2008). Table 6.4 shows the exact terms used by targeted parents to
describe how they feel about PA.
Table 6.4
Terms Describing How Targeted Parents Feel About Parental Alienation in their Own Words
Terms % of TP Participants quotations

Disenfranchised grief 25% ‘It's like he's murdered my children... but the only thing is I can't
grieve. I can't go to a grave. I can't say anything that I want to
say.’ (Participant no.20)
‘The way I’d describe this situation, it’s like I’m mourning over
someone who has died, while knowing they’re still around.’
(Participant no.43)
Extremely/ too hard 15% ‘It was just too hard. I lived a few minutes from their school, and
it just haunted me so much that I ended up having to move up to
New South Wales because I just felt that it was just taking over
my whole life.’ (Participant no.4)
You are on your own / no 15% ‘So, there are no places you can go to try and get counselling,
help where people can help you through any of this. You're on your
own, trying to get through it.’ (Participant no.22)
Stuck in the 15% ‘Not having contact was… you know… completely in the dark,
bottom/dark/limbo/ no way totally missing my son.’ (Participant no.28)
out
‘But you feel like, limbo, I feel like I can’t move, does that make
sense?’ (Participant no.35)
Awful experience 13% ‘It’s a pretty awful experience, emotionally it has taken its toll.’
(Participant no.46)
No control over it 8% ‘I’ve got no control over it at all. It’s since the intervention order
took place.’ (Participant no.11)
Hell 6% ‘...Essentially the last 5 years has been a living hell.’ (Participant
no.47)
Battle 6% ‘From day one there’s been a battle.’ (Participant no.8)
Rollercoaster 6% ‘It’s this intense, emotional intense rollercoaster, you know,

you’re down one day and up the next and can’t explain some days
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when you’re down and you can’t explain some days why you’re
up...’ (Participant no.49)
Terrible thing 4% ‘It’s just… it is a really terrible thing.’ (Participant no.12)
Nightmare 4% ‘It was just a nightmare in every single regard.’ (Participant

no.16)
No words to describe it 4% ‘I don’t think there are any words to describe how it feels [the
alienation].’ (Participant no.37)
Life has been destroyed 4% ‘My life has been destroyed, he’s destroyed my life and that’s
what he set out to do.’ (Participant no.38)
Up hill 4% ‘It was still very much an uphill battle to force orders on the
mother when she just blatantly not followed the rules.’
(Participant no.54)
The worst thing of their lives 2% ‘It’s just been the worst thing I’ve ever been through in my life.
It’s, it is absolutely utterly.’ (Participant no.16)
Down hill 2% ‘I started to go downhill, I developed depression.’ (Participant

no.44)
6.3.1.2. Behavioural. Seventy-four percent of targeted parents described engaging in
different types of behaviours as a direct consequence of the alienation. The most common
behavioural problem affecting targeted parents were sleep disturbances (43%) and suicide
attempts (23%). Some participants said they had attempted suicide on multiple occasions.
Table 6.5 shows all the behaviours reported by the participants.

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Table 6.5
Behavioural Consequences due to Alienation reported by Targeted Parents
Behavioural consequence % of TP Participants quotation
Sleeping problems 43% ‘I wake up. I can't sleep at night. I'm lucky if I get
three hours sleep a night.’ (Participant no.6)
Ending up in hospital 23% ‘And every time I stepped into family court; I was
ending up at the hospital within hours of being
there.’ (Participant no.16)
‘I ended up in… hospital and they asked me

whether I wanted any additional help and I said
yes please and so they transferred me to ….
Psychiatric Ward …...’ (Participant no.25)
Suicide attempt 23% ‘I attempted suicide 3 times last year, I spent a

week in hospital essentially in a catatonic state.’
(Participant no.47)
Crying 21% ‘I cried and cried and cried and cried and cried.
It was awful. I didn’t go out very much, because I
just, you know, all of my friends had children the
same ages as mine with them, so, you know, that
would just remind me that I lost my child, sorry
[crying].’ (Participant no.1)
Not eating 13% ‘I wasn’t eating, my parents already put me into

the hospital because they were afraid that I was…
I was close to dying.’ (Participant no.53)
Taking antidepressants 10% ‘I took antidepressants... I just went right down

into a big hole.’ (Participant no.44)
Excess eating 7% ‘When it happened, I found solace in eating. I’d

never been overweight, but I put on 14kg. I found
food as a gratification.’ (Participant no. 45)
Forcing fatigue/keeping busy 7% ‘I suppose I try to keep myself busy all the time
as, I suppose, a defence mechanism, as a
compensatory approach to keep busy so that,
because there's little triggers that can trigger off.’
(Participant no.51)
Excess drinking 7% ‘Yes... excess drinking because of it [the

alienation].’ (Participant no.42)
Move to another city 3% ‘I lived a few minutes from their school, and it
just haunted me so much that I ended up having to
move up to New South Wales because I just felt
143
that it was just taking over my whole life’

(Participant no.4)
Grinding and cracked teeth 3% ‘I was grinding my teeth because the stress… I
was grinding my teeth so badly that I cracked
four teeth, yeah, just because of stress, you know,
I’ve never done this before.’ (Participant no.30)
6.3.1.3. Finances/work. Fifty-nine percent of the total sample of targeted parents
mentioned that PA had affected their finances and their capacity to work. Mainly, in their
own words, they referred to being destroyed financially because of the excessive amounts of
money spent on PA matters such as lawyers, court procedures or child support. They also
reported having lost their jobs either because of the stress of maintaining employment or
because of the time spent in court. In addition, targeted parents said they were unable to
afford solicitors, or counsellors or were unable to afford rent; some had lost their houses or
assets. Some of them had more than one job to cover the expenses because there is no
financial help for them. Table 6.6 shows in detail the consequences of the alienation in
targeted parents’ finances and work system.
Table 6.6
Finances/Work Consequences Experienced by Targeted Parents because of Parental Alienation
Finances/ Work % of TP Participants quotation
consequence
Excessive amount of money 50% ‘I still have $20,000 of debt to pay off from legal fees, even
spent in PA matters though I represented myself for the majority of the case. The debt
was over $50,000. It doesn’t take into consideration that it was
probably another $80,000 I already paid in cash at the time. It’s
crazy that I had to spend so much money to not see my children.’
(Participant no.43)
House or assets loss 41% ‘Look, I’ve lost two houses, a business, I’ve probably lost $120k
paying lawyers and court...’ (Participant no.42)
Loss of jobs 28% ‘I’ve lost a couple of jobs because of my, because of the impact of
the alienation on me.’ (Participant no.3)
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Financially destroyed 25% ‘Because they [Child Support Agency] take a percentage of your
gross income and not your net income, it basically financially
destroyed me. So basically, as I said, it’s financially destroying
me.’ (Participant no.5)
Couldn’t afford 22% ‘I couldn’t afford lawyers any longer, my legal bills over the first
solicitors/lawyers/counselling 5 or 6 years was in the vicinity of $50-$60k. I remember talking to
child support and they would say that custody and visitation is up
to the courts, not us. But that’s if you can afford it.’ (Participant
no.36)
Couldn’t afford rent 16% ‘I had to, I had to move out of the place I was living because I
couldn’t afford it anymore.’ (Participant no.8)
They paid for everything and 13% ‘Then the bill of the lawyers came, right? They are the winners of
still unable to see their kids all this... and the process just delay and delay, and my son didn’t
come... I pay 16 hundred dollars every month... right? And there
is no question about it to even change that, and still can’t see my
son’ (Participant no.27)
Career/studies destroyed 13% ‘It helped destroy my career, lost my home, became homeless, the
whole thing, no ramification whatsoever from that.’ (Participant
no.7)
Have more than one job 6% ‘It’s been very hard financially, so I work, I have one job I want
to get rid of… one I’ve kept and now, I’ve just picked up another
two, so that’s just to keep me afloat.’ (Participant no.13)
No financial help for them 6% ‘I’ve suffered a big financial cost too... there is no aid for
someone in the financial position that I am because I make just a
bit too much money to, for social assistance and in order to meet
to have access to social assistance I have to be a single mum and
now that I don’t have any kids with me full time, as per, you
know, as their definition, I’m considered a single person, so there
is not aid, there is not help for me, right? But I should have equal
rights, but I don’t.’ (Participant no.53)
AP took all the money 3% ‘I went to the family court a number of times, but after $148k, I
ran out of money. And I just couldn’t do anything anymore. I
didn’t have the finances left, and then once she moved away and I
had to pay child support, I had to pay nearly 2000 a month in
child support. This was a significant amount of my wage... it took
all my money’ (Participant no.40)
6.3.1.4. Cognitive. Fifty-seven percent of the total sample reported having problems
that can be organised as cognitive consequences. As is shown in Table 6.7, targeted parents
described overthinking, being unable to concentrate or articulate thoughts and having mental
stress. In addition, some targeted parents reported some thoughts emerging from their
145
experiences, which have been classified as negative automatic thoughts (NAT) such as: all or
nothing thinking, overgeneralization, mind reading, catastrophising, labelling and
personalization (Burns, 1999; Knapp & Beck, 2008).
Table 6.7
Cognitive Consequences of Parental Alienation reported by Targeted Parents
Cognitive consequences % of TP Participants quotation
Overthinking 45% ‘... and the worry and all that, that goes with it, the, over
thinking stuff, now I overthink everything, ok?, what's going
to happen if I do this, or do that, how do I keep this from
turning into a huge argument, rather than just being able to
speak my mind and say look, this is right, stop.’ (Participant
no.31)
Hard to concentrate 45% ‘I couldn't focus anything more than a half an hour and I
just needed my mind to stop, because as soon as I turned off
the TV my mind was 100%, million miles an hour going,
going, going.’ (Participant no.6)
They think people might 41% ‘The alienated parent does not talk about it because when
think they should have done you do, people may think “What did you do to your daughter
something very bad or wrong for her not to even talk to you?” But it comes to a point
to be rejected by their where, I didn't do anything to my daughter.’ (Participant
children. no.18)
(NAT: overgeneralization,
mind reading and
personalization)
They think people don’t 41% ‘And having to justify to this psychologist that I'm a normal
understand. person, I'm a loving mother. I care for my daughter, I felt
(NAT: all or nothing thinking, that I was constantly having to justify to people, that people
mind reading and labelling) wouldn’t understand, ‘oh, God, what has she done to her
daughter for her to not live with her, not to be with her; is
she some sort of abusive, horrible person’. (Participant
no.51)
Suicidal thoughts 27% ‘Sometimes I’d look at a car and feel like throwing myself
under it, just ending it all. And it’s only talk, you know,
sometimes if you’re hurting, that’s what goes through your
head, but that’s it.’ (Participant no.44)
Mental stress 22% ‘I just wanted to get help, but I was basically locked out and
I became very, very sick. I think it’s because of my mental
stress, you know.’ (Participant no.30)
They think there’s nothing 18% ‘I had absolutely nothing I could do. Once I found out what
they can do or they don’t it was, went and talked to my solicitor, and my solicitor said
know what to do. that there’s literally nothing she can do, because she can
146
(NAT: overgeneralization and only bring up in court things that are covered by the law.’
catastrophising) (Participant no.14)
They think they have lost 14% ‘The hardest thing for me has been the time I’ve lost.’
time being with their (Participant no.45)
children, time that never will
come back. ‘This is time with my kids that I’ll never ever, ever get back.’
(Participant no.16)
Unable to articulate thoughts 11% ‘I couldn’t articulate my thoughts; I couldn’t really speak.’
(Participant no.25)
They think people get tired of 9% ‘Umm, because I’m sure some people get sick of hearing my
hearing their story. story, new friends, old friends, they don’t really understand.’
(NAT: mind reading and (Participant no.13)
labelling)
They think people don’t 9% ‘People don't want to know. They don't believe you. They
believe what they are don't think it's possible.’ (Participant no.19)
experiencing.
(NAT: mind reading)
They think their kids 5% ‘I do think, at some point, my girls are going to seek me out.
someday will seek for them And they have to learn who their father is. This is the only
way they're going to.’ (Participant no.21)
They don’t know what their 5% ‘So, aside from the denial of contact, there’s not much I can
kids are told at home. say because I don't know what happens in that household. I
(NAT: mind reading) don't know what they tell her about me. I don't know whether
they’ve told her that I’m dead. They might have said ‘Oh
your father’s dead’ They might say that I hate, that I don’t
love her. They might say that I’m the nasty man. They might
say that I’m in jail. They can say whatever they like about
me, and I have no way of countering that.’ (Participant
no.3)
6.3.1.5. Physical. It was found that 33% of the participants mentioned being affected
physically by the alienation. The most common issues were physical health problems in
general, weight-loss, weight-gain and headaches (See Table 6.8). Some other physical or
health-related conditions were described by the participants as consequences of the
alienation. However, although they attributed them directly to the alienation, these conditions
or physical problems could have manifested with or without the presence of it. For example,
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chest pain, arrhythmia, tuberculosis, haemangioma, breast lumps, heart attack and
fibromyalgia.
Table 6.8
Physical Consequences reported by Targeted Parent as a Result of the Alienation
Physical consequence % of TP Participant quotation
Physical health issues in 39% ‘My physical health isn't great anymore.’ (Participant no.31)
general
‘My health has come crashing down something terrible.’
(Participant no.47)
Weight-loss 33% ‘When the court started, I was at 60kg and I went down to
48kg.’ (Participant no.52)
Weight-gain 22% ‘I put on a lot of weight, because It was extremely difficult

emotionally and financially.’ (Participant no.32)
Headaches 11% ‘I have not had a single day without a headache since my
daughter was taken.’ (Participant no.48)
Chest pain 6% ‘Yeah, about three or four months after the abuse allegations
were raised, I was getting like pains in the chest, and they got
bad enough that one night I went to Accident and Emergency
thinking that I wanted to make sure that I wasn’t having a
heart attack.’ (Participant no.12)
Arrhythmia 6% ‘...Probably about a month ago, I’d gone into arrhythmia just
because this shook me badly.’ (Participant no.11)
Tuberculosis 6% ‘I had tuberculosis and I thought that it was in my nervous

system. So, I was physically unwell.’ (Participant no.16)
Haemangioma 6% ‘I've also got a haemangioma, as well, which is benign, but

they cannot remove it. So that affects me with chronic pain. It
increases the pain... You sort of can't really go too far
forward.’ (Participant no.23)
Breast lumps 6% ‘I’ve been really sick, you know. I got two lumps in my breast
in the last three years and I think it’s because I was so, in so
much distress you know, and actually, I thought that because I
was so sad, I thought I’m making myself sick by being so sad,
if I don’t stop, you know, it’s going to be really bad.’
(Participant no.30)
Heart attack 6% ‘I had my heart attack and, I had it in March last year, and
the year building up to that was, it was a tough year, with
courts and this and that and hadn't seen my kids and going
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through the, you know, assault charges and all that.’

(Participant no.6)
Fibromyalgia 6% ‘I’ve got fibromyalgia in my legs and take medication for that,
but stress makes it ache even more.’ (Participant no.44)
6.3.1.6. Social. The social life of the 22% of targeted parents has been affected
directly by the alienation. Self-isolation was found to be the most common form of social
consequence. Targeted parents decided to be by themselves, rejecting friends and people
around them. Also, they reported having decided not to be involved in any kind of romantic
relationship. They want to be alone because people do not understand, or people have hurt
them in the past. PA has destroyed some of the targeted parents’ relationships and have
caused the loss of friendships (See Table 6.9).
Table 6.9
Social Consequences Reported by Targeted Parents as a Result of the Alienation
Social consequence % of TP Participants quotation
Self-isolation (reject social or 58% ‘It’s probably why I’m still single you know, because when
romantic life) you meet someone and talk about things, you get a bit more
open with each other, and then you know, and talk about
things. This has been a big factor in not having another
stable relationship, because there’s this baggage still there.’
(Participant no.28)
Relationship break-up 33% ‘I did meet someone a few years ago who I did hit it off very
well with, and wanted to spend my life with. Unfortunately,
everything that has occurred was obviously too much of a
burden for her, and she’s now run off and got married in
Europe.’ (Participant no.5)
Loss of friends 17% ‘After the separation I lost all my friends because she was
able to convince them that there must have been something
wrong with me otherwise the police wouldn't have got family
violence orders and all that sort of stuff.’ (Participant no.47)
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In summary, the findings show that PA has negatively and seriously impacted
targeted parents. They experience sadness, distress, frustration, anger, guilt and shame. PA
has affected their lives, their routines, the way they think, feel and behave. To endure this
experience, some targeted parents have found ways to survive the alienation. The following
section will provide the coping strategies used by some participants that were described
during the interviews.
6.3.2. Coping strategies used by targeted parents
Fifty-six percent of the total of participants in this study shared what they have been
doing to cope with the alienation. The data is organised around eight themes that include
descriptions of the activities they do to face the alienation: social, mental and physical
activities, seeking professional help, work or keep themselves busy, family support, finding
hobbies and faith (see Table 6.10). On the other hand, 44% of the total sample reported not
coping well or not coping at all.
Table 6.10
Coping Strategies used by Targeted Parents to Deal with the Alienation
Coping Strategies % TP commented on this No. of references*
Mental activities 35% 22
Social activities 33% 24
Professional help 33% 22
Being busy 30% 17
Family support 20% 13
Physical activities 13% 8
Hobbies 13% 8
Faith 9.3% 5
*Number of times the coping strategy was mentioned.
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6.3.2.1. Mental activities. Thirty-five percent of the participants mentioned engaging
in activities to keep their mind occupied. Some of those activities include: studying, either by
themselves or at universities; spending time researching about PA or another topic; spending
time reading; and writing a book about their experiences of PA.
I did a lot of research, trying to figure it out (Participant no.21).
I’ve started studying again to try and get some qualifications which I’ve never had
6.3.2.2. Social Activities. As part of seeking wellbeing, 33% of the targeted parents
found that being social helped them to feel better. The activities reported by the participants
were meeting with friends, talking and sharing their grief with others, seeking help in online
support groups and helping or volunteering.
Probably the friends more than anything. Being able to talk to your mates about
things and stuff, just have their support to hang in there, so, it was pretty good
Part of my coping mechanism is helping other people, it’s a big part of who I am. It
doesn’t matter who they are, I’m still happy to try and help any way I can. That’s my
biggest coping mechanism (Participant no.46).
6.3.2.3. Professional help. Seeking professional assistance is another way that 33% of
targeted parents cope with the alienation. Professional help included therapies or consultations
with psychologists, psychiatrists or going to counselling.

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I went along to see a psychologist, I went to see my GP first-off, because I was feeling
down a lot, and I said I might need some counselling here, so he organised that for
me. And I went to a psychologist who, she was very good, but she was limited in what
she was going to say or do (Participant no.8).
I went to see a psychologist to be able to help guide me through it, also be able to
advise me in terms of how best to deal with the children and their comments, and
specific comments that they come back and how best to react to that (Participant
no.17).
6.3.2.4. Being busy. Thirty percent of the participants mentioned that keeping
themselves busy was a good way to cope with the alienation. Targeted parents spend most of
their time working, focused on their careers, or just occupied or busy in any activity they can
be involved in.
I work. I work extremely long hours (Participant no.5).
Work saves me, I go to work, have a laugh, but that’s the thing that saved me
6.3.2.5. Family support. Twenty percent of the total sample of targeted parents stated
that their family’s emotional support was their way of coping with the alienation. Family
included their parents, either mothers or fathers; spouses or partners; and any children they
were not alienated from.

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And it’s quite funny, my 89-year-old dad has been my greatest supporter (Participant
no.13).
I've got a very close family, if I didn't have them, I’d be washed away (Participant
no.17).
6.3.2.6. Physical activities. Keeping a healthy exercise routine was the coping
mechanism described by 13% of the targeted parents. Physical activities such as running,
exercise in general, cycling, going to the gym, walking and rock climbing helped targeted
parents to feel better about themselves.
I’ve decided to start getting into exercise, and getting outdoors, and stuff like that, and
so, yeah, to make me feel a bit better about myself. And it was amazing like when I first,
you know, started exercising, I actually started feeling better (Participant no.2).
Getting out and going for a run, I found was probably helping a lot… (Participant
no.28).
6.3.2.7. Hobbies. Thirteen percent of targeted parents reported having a hobby as a
coping strategy to deal with the alienation. The hobbies were: having and posting on a blog,
painting and colouring, building, playing music, coaching a team and renovating or decorating
the house.
I have a blog that keeps me very occupied, and I investigate a particular cold case,
going back to 1948, sort of a cold war, espionage thing (Participant no.8).
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Colouring in with my littlest daughter, it became obsessive. I started painting, then
beading, then woodwork, but excessively. I’d stay up until 1am doing it. Anything to
occupy my mind (Participant no.45).
6.3.2.8. Faith. Nine percent of the participants referred to believing in something
superior, having faith, praying and attending church was the way to feel better and cope with
the alienation.
I'm a strong person, I'm a person of faith. I'm in my choir and I play bells at my
parish. I've been a person of faith since I've been a little child... I pray every day
because I believe it’s in God’s hands (Participant no.18).
I pray. Like I said, I'm a Christian. So, I pray a lot. And I get mad a lot at God, why
are you doing this? But I really do believe it’s a walk of faith, and there's a reason it’s
happening this way (Participant no.21).
6.3.2.9. Not coping well or not coping at all. Forty-four percent of participants found
they were coping in an inadequate way, with difficulties or not coping at all. For example,
smoking and drinking, hiding or blocking their emotions or isolating themselves.
How have I coped? Not very well [laughs], well look, to answer that, I don't know, I
don’t know how I’m still here really, to be honest (Participant no.3).
So, you cope with difficulties. You don’t live, you exist (Participant no.10).
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Coping with the alienation it has been hard for targeted parents, however, some of
them have found a way to deal with it. These findings support the need for support, guidance
and understanding for targeted parents.
6.4. Discussion
This study aimed to describe the consequences of PA on targeted parents, to identify
the coping strategies used by them to deal with the alienation and to make recommendations
for support programs for targeted parents. The findings of this study provide valuable
information from the voices of targeted parents. They describe in detail what it feels like
being alienated from their child, how they have been affected by the alienation and what they
have done to endure this experience.
Disenfranchised Grief, Ambiguous Loss and Psychological Sequalae
This study shows that targeted parents experience serious emotional consequences
from being alienated from their child but also from the experience of trying to maintain a
relationship with that child. Targeted parents appear to experience symptoms of depression,
anxiety, stress, posttraumatic stress and adjustment difficulties. Similar findings were
reported by Baker and Fine (2013), Harman and Biringen (2016) and Poustie et al. (2018). It
is important to note that some targeted parents reported having physical health symptoms that
they attributed to the alienation. Although it is beyond the scope of this study to determine
cause and effect, it should be noted that targeted parents appear to be under considerable
psychological distress. Research has shown that chronic stress, distress and psychological
illnesses, especially affective disorders are associated with immunosuppression in humans
(Khansari et al., 1990; Segerstrom & Miller, 2004). Furthermore, stress, immunity and
disease can affect each other in reciprocal ways (Morey et al., 2015).
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Targeted parents experience the loss of their child’s affection. The pain and heartache
they suffer, being unable to have contact or a relationship with their children, has been
compared to suffering the grief of a death of a child but with no support for this grief (Baker
& Fine, 2014; Gardner, 2001). When a loss is the result of an unclear situation and remains
unverified without resolution it is called ambiguous loss (Boss, 1999, 2007). Targeted parents
losing contact with their children may suffer physical ambiguous loss (Boss, 2016): their
children are physically absent yet psychologically present. Ambiguous loss is the most
stressful type of loss because it lacks resolution, there is no official verification of loss,
therefore, no finality with rituals of support (Boss, 2016). According to Boss (1999, 2006,
2007), people suffering ambiguous loss are criticized and left on their own to cope, isolated
and confined between hope and despair.
Ambiguous loss can lead to what has been defined as disenfranchised grief (Doka,
1989, 2002). People suffer disenfranchised grief when their loss is ignored, minimised, or
unacknowledged; their feelings in response to the loss are dismissed, criticised, or
misunderstood by others; they receive minimal or no support; their opportunities to grieve are
absent or discouraged; the reactions of others convey in disbelief, reproach, or condemnation;
and the loss and/or the individual’s reactions occur in a context of stigma (Knight &
Gitterman, 2019). The narratives of the targeted parents of this study regarding their feelings
are consistent with the characteristics of a disenfranchised grief.
The lack of resolution places targeted parents in limbo and unable to move forward
(Knight & Gitterman, 2019). Their feelings of hopelessness and helplessness may lead to
depression, guilt, anxiety or immobilisation (Boss, 2016). In addition, targeted parents
experiencing disenfranchised grief may experience an exacerbation of their natural emotional
reactions associated with grief, such as sadness, guilt, anger and loneliness (Doka, 2002)
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because their grief is not recognised and often repressed. In this context, targeted parents’
bereavement experience often follows without social support. This lack of support denies
them the opportunity to openly discuss their feelings and leaves them without expressions of
sympathy and support from others (Doka, 2002). This, in turn, prevents targeted parents from
engaging in the grieving process that is needed to facilitate coping and healing (Lenhardt,
1997).
In addition, targeted parents described experiencing sadness, distress, frustration,
anger, guilt and shame as a consequence of being alienated from their children. Using
Roseman’s Emotions Model (Roseman, 2011), we have been able to consider how targeted
parents may cope depending on their expressed emotions. For example, when targeted
parents self-isolate (coded as a social consequence and as not coping well or not coping at
all), it may be a manifestation of their sadness, distress and shame. They may be choosing to
distance themselves from the stimuli that triggers or perpetuates their distress. However,
some avoidance may indeed compound their distress.
Parental alienation is extremely hard for targeted parents. The lack of understanding
and scarcity of support for them result in serious costs including significant financial costs,
social, and relationship costs. Confusion, desolation, and isolation make targeted parents
vulnerable to poor mental health outcomes. They appear to be fighting a battle with limited
armoury. If the experience of targeted parents is considered a form of family violence
(Haines et al., 2020), the findings of this study suggest that targeted parents are suffering this
form of abuse and its sequalae silently. For some, their suffering is too great, and suicide is
considered an option to resolve their ordeal. This is consistent with Baker and Fine (2014),
Balmer et al. (2017) and Poustie et al. (2018). The finding that 23% of targeted parents in this
study have attempted suicide and 44% of the sample describe not coping well is alarming and
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of concern. This finding signals the urgency for the experience of targeted parents to be better
understood and the necessity for mental health and legal practitioners to be alert to the needs
of targeted parents.
Financial Burden
If the experience of being alienated from a child is considered purely from a financial
perspective, the financial costs to the individual are significant. This study illustrated that
some parents have spent hundreds of thousands of dollars alone just to maintain a
relationship with their children. If the cost to society is considered, the estimated cost of
parents being alienated from a child would also be substantial. Some targeted parents
described experiencing job loss, homelessness and challenges accessing mental health
services. Further, these financial losses appear to occur during mid-life, when most parents
hope to be able to enjoy the assets and financial security that are normally achieved by that
milestone. This is unrecoverable loss. When this is considered along with the public costs of
maintaining a family court system, the cost of parents being alienated from their children for
no justifiable reason would be vast. In this study, 59% of participants described being in
financial difficulty or crisis. This is a large number of people needing financial support.
When it is considered that the Australian population is over 25 million, this equates to over
15 million people needing financial support. If PA was better responded to in the legal and
mental health systems, this financial burden on individuals and society could be potentially
reduced.
Coping with Alienation and Recommendations for Supporting Targeted Parents Better
Coping with PA is not easy. The results of this study show that almost half of the
participants described coping with significant difficulties or not coping at all. Hence, mental
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health and legal practitioners need to be aware of the psychological distress targeted parents
experience. Their distress should not be ignored because to do so could increase some
targeted parents’ suicide risk. Practitioners who find themselves working with targeted
parents should be aware of suicide risk factors. These include expressions or displays of
psychological distress, feelings of worthlessness, sadness, grief, shame and social
withdrawal. All practitioners working with targeted parents should know how to ask clients
about suicidal thoughts and any plans to attempt suicide. This then necessities the need for
mental health and legal practitioners to work together (Haines et al., 2020).
Grief counselling for targeted parents’ disenfranchised grief experience must be taken
in account when working with targeted parents. Sometimes grief responses to ambiguous loss
are mistaken for mental health problems, such as posttraumatic stress, anxiety, or depression
(Leach et al., 2008; Malone et al., 2011; Mitchell, 2017), when not all antecedents are
included in a comprehensive and detailed evaluation.
Targeted parents experience a non-death loss, their children are both absent and
present at the same time, therefore closure is not possible (Duggleby et al., 2013).
Counselling should be focused on promoting resilience by helping targeted parents to tolerate
ambiguity rather than achieving closure (Boss, 2010). In addition, when grief is
disenfranchised, social support is absent (Meagher, 1989; Thornton et al., 1991) because the
society does not recognise the significance of the loss. Hence, a group modality type of
counselling may be beneficial when dealing with ambiguous losses (Cheung & Hocking,
2004; Duggleby et al., 2013; Hebert et al., 2013; Pillai-Friedman & Ashline, 2014) because it
can reduce isolation, stigma, and provide social acknowledgement.
This study also showed that targeted parents can experience distress as a genuine
response to their predicament. However, some distress may be perpetuated by targeted

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parents engaging in negative automatic thoughts. Targeted parents may benefit from
psychoeducation on the interrelation between thoughts, behaviour and feelings. Targeted
parents may benefit from learning cognitive restructuring techniques to help them to identify
unhelpful self-talk.
Some targeted parents in this study found a way to manage their distress. It seems that
being active either physically (doing exercises), mentally (studying or researching), or
socially (spending time with friends) works well for some targeted parents. To this end,
targeted parents may benefit from strategies such as behavioural activation or positive
activity scheduling because these techniques promote well-being in a range of the population
in both clinical and nonclinical settings (Mazzucchelli et al., 2010). Moreover, these
techniques encourage people to approach activities that they have been avoiding, help them
in analysing the function of cognitive processes such as rumination and assist them in
refocusing on their goals and valued directions in life (Veale, 2008).
6.5. Conclusion
This study comes to contribute to a systematization of information in first-person of
how the alienation is felt and how affects the targeted parents’ lives. This study provided
evidence that PA has a negative impact in targeted parents of PA. These parents have been
affected in several and different areas of their lives, suffering a constant emotional pain
displayed as different (psychosomatic) symptoms of an unresolved grief.
6.6. Limitations and recommendation for future research
An inherent limitation of thematic analysis is researcher bias. However, this study
was conducted within a purely inductive, data-driven manner and following the
trustworthiness criteria to avoid bias. Also, as a qualitative descriptive research design, this
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study lacks statistical generalizability. Yet, it allows for theoretical generalization that can be
compared and contrasted with other contexts and settings (Yin, 2003), contributing to the
knowledge base around targeted parents’ experiences of PA and giving them a voice to
express and share those experiences. The sample of this study experienced PA at different
times; some targeted parents were experiencing the alienation, whilst others already have lost
their children completely. It would be more appropriate to conduct prospective studies,
following targeted parents’ experiences in ‘real-time’, to avoid relying on memories.
From our findings, there is still a need for more research exploring targeted parents’
experiences from their perspective. In particular, studies exploring targeted parents’
experiencing the alienation of their children with a focus on their disenfranchised grief; on
how PA affects their well-being; and on how they address their feelings and their ability to
cope. Finally, future research should focus on the development, implementation and
evaluation of intervention programs for targeted parents in order to assist them in coping with
the alienation. Specially how Cognitive Behavioural Therapy techniques can contribute to
improve their well-being.
This chapter has shown how PA has a negative impact in targeted parents. It also
describes how they have coped with their own experience. Most importantly, the information
provided has come from their own perspective. This study demonstrates the extent of the
distress targeted parents experience as a result of being alienated from their children. It is
alarming that 23% of the sample have attempted suicide. Understanding the loss of a child
through a campaign of alienation is an ambiguous loss and the resulting experience for
targeted parents is disenfranchised grief. Study Three describes the common cognitive
distortions that can perpetuate targeted parents’ distress and the concerns practitioners need
to be aware of when working with a targeted parent.

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Additionally, Study Three highlighted the benefits of active (either mentally, socially,
physically or seeking support in family members, professionals or faith) while coping with
the loss of a child through alienation. Developing strategies based on Cognitive Behavioural
Therapy might be helpful to achieving these objectives.
The next chapter presents the general discussion and final conclusion of this thesis. A
special focus was given to the key findings of the three studies of this thesis; the contribution
of these key studies to the literature; the evaluation of the strengths and limitations of this
thesis; and suggestions for interventions with targeted parents along with recommendations
for future research.

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Chapter VII
Discussion and Final
Conclusions
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This thesis aimed to explore, identify and describe targeted parents’ experiences of
PA. This thesis also aimed to explore the consequences to the targeted parent and targeted
parent’s coping mechanisms. These aspects of PA were examined from the perspective of
targeted parents. The research in this thesis was conducted in order to develop a greater
understanding of targeted parents’ experiences and needs; and assist in the development of
future appropriate support services and intervention programs for them. Three related studies
were designed and conducted to accomplish this objective. The first study (in chapter IV),
was a systematic literature review, which provided important information about the extent of
the existing research examining targeted parents’ experience from their own perspective.
Study One and Chapter II provided identification of the gaps in the existing literature and
how to address them. The second study (in Chapter V), identified how targeted parents
experience the alienation, how the alienation started for them and what they did during the
alienation process. The third study (in Chapter VI), provided valuable information about the
consequences of the alienation and how targeted parents coped with it. This study provided
an evidence base for recommendations for practitioners working with targeted parents. A
summary of the three studies including the research questions, their answers and key findings
is shown in Table 7.1.
This final Chapter provides the key findings of this thesis and how this thesis
contributes to the literature. The clinical implications of the thesis are explored along with a
brief discussion of the legal response to PA in the context of therapeutic intervention and
recommendations for future research.

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Table 7.1
Research Questions, their Answers and Key Findings
Research Question Answer Key Findings
Study One What is known in the Information about TPs’ Eleven percent of the articles
(Chapter IV) existing academic characteristics and experiences pertaining to PA focused directly
literature about the from their own perspective in on TP, from those, only 3.6%
characteristics and the existing academic described the characteristics and
experiences of literature is limited. experiences of TP from their own
targeted parents of perspective.
PA from their own The studies were conducted in
perspective? USA (n=6), Australia (n=2) and
Israel (n=1).
Study Two How do self-referred Most of the TPs described TPs are mothers and fathers.
(Chapter V) targeted parents experiencing the alienation as PA is not bound by geographical
alienated from their survivors of family violence. borders.
children experience They identified specific Family violence is a key aspect of
the alienation? triggers of the alienation, the alienation.
making reference to the TPs describe extensive efforts to
behaviours of the alienating maintain a relationship with their
parent. TPs reported being children.
active in their attempts to Extended family, friends and
maintain a relationship with children’s school act as alienators.
their children.
Study Three How have self- TPs described being affected TPs suffer ambiguous loss and
(Chapter VI) referred targeted emotionally, behaviourally, disenfranchised grief manifested
parents been affected financially, cognitively, as psychological difficulties.
by the alienation and physically and socially. TPs experience sadness, distress,
how have they coped Coping strategies used by TPs frustration, anger, guilt and
with the alienation? include keeping active (doing shame.
mental, social or physical TPs reported experiencing
activities; or seeking support suicidal ideation. Some reported
from family or professionals; having attempted suicide.
having hobbies or faith). TPs tend to use negative
automatic thoughts.
Their social network has been
affected by the alienation.
Keeping themselves involved in
different types of activities can
work as coping strategies.
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7.1. Key findings and contribution to the literature
Three related studies formed the basis of this thesis. Each of these studies contributed
important findings to the literature on PA. The nine most important findings derived from this
thesis are described next.
Key Finding no.1: Studies about targeted parents remain limited. Therefore, there is a
need for more worldwide research on the targeted parent’s perspective.
Study One (Chapter IV) is the first known systematic literature review on targeted
parents’ characteristics and experiences of PA from their own perspective. This study
contributed to the existing literature by synthesising research that is currently known about
targeted parents from their own perspective. This study also identified gaps in the PA
literature. This study demonstrated that there is a paucity of peer reviewed studies examining
targeted parents’ reports of their own experience of being alienated from their children.
The articles extracted from the review consisted of different study designs, participant
recruitment, sample size and study location. This made it difficult to accurately compare the
data from included studies. Further, the data extracted from Study One were insufficient to
build a theory of targeted parents experience of being alienated from their children. However,
Study One provided valuable information about targeted parents in regards to gender
similitudes, parenting roles, severity of the alienation, alienating behaviours and
dissatisfaction with legal and mental health system.
Study One showed that there is a considerable body of literature published on PA.
Literature describing targeted parents or describing targeted parents’ experiences of PA is
scarce and tends to be based on other’s observations. These observations are from clinicians’
discussions, descriptions of case reports, descriptions of alienating parents’ report or
descriptions of alienated adult’s report. When considering the data from targeted parents’
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perspective, the information tends to be different to the literature describing them from the
perspective of others. For example, some authors described targeted parents as inept, lacking
in empathy towards their children (Johnston & Campbell, 1988; Johnston & Roseby, 1997)
and avoidant in the face of high conflict (Kelly & Johnston, 2001); whilst other authors
(Balmer et al., 2017; Poustie et al., 2018) described them as parents who perceive themselves
as adequate and confident in their parental skills.
Key finding no.2: PA is not new. There are several definitions of PA, none of them include
the targeted parent or the whole family system.
The phenomenon of PA has been described in the legal and clinical literature for the
last two centuries. Although the phenomenon has been given a variety of labels, it is evident
that the phenomenon has existed for centuries (Chapter II). Since the important contribution
of Richard Gardner, who described PAS (Gardner, 1985); there has been much controversy
among scholars. Scholars have debated the existence of the phenomenon as well as how the
phenomenon should be conceptualised and labelled. As such the literature has focused on the
presentation of alienated children (Baker, 2005a, 2007; Baker & Darnall, 2007; Gardner,
1998; Kelly & Johnston, 2001), describing alienating behaviours (Baker, 2005b; Baker &
Darnall, 2006); and attempts to validate or invalidate PA and/or PAS (Bernet, Von Boch-
Galhau, Baker, & Morrison, 2010; Kelly & Johnston, 2001; Reay, 2007).
The intention of this thesis was not to resolve the controversy around PAS or PA;
however, this thesis takes the stance that PA is a legitimate phenomenon that affects the
whole family system. The term PA was used throughout the thesis rather than PAS or any
other term because it is the most consistently used and identified term in the current
literature. Several definitions of PA were found during attempts to generate theoretical
background to this thesis and create the context for studying the experiences of targeted
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parents of PA. These definitions were directed towards: alienating behaviours used by
alienating parents, the damage caused to the children, or directed toward definitions of PAS.
Targeted parents’ experience, extended family and social networks surrounding affected
families have been ignored in definitions of PA.
The literature has demonstrated that there is a symptomatic and explicit manifestation
of PA in children due to the manipulation of an alienating parent (Baker & Darnall, 2007;
Gardner, 1992; Lorandos, Bernet, & Sauber, 2013). This manifestation in children might be
the 'tip of the iceberg' of a more complex problem. This thesis has shown that PA is more
than a syndrome diagnosed in children: PA is a form of family violence affecting targeted
parents (see Key Finding no.3 for larger discussion), children, extended family members and
the social systems in which alienated families are involved. PA is a complex phenomenon
that affects, breaks and decomposes the entire family and their related social systems such as
schools, friends, neighbours and the community in general. Definitions and the
conceptualisation of PA needs to be reconsidered to encompass this complexity.
Based on the findings of this research, PA can be defined in the following way:
Parental alienation is a phenomenon that takes the form of family violence
during and/or after separation when a parent, the targeted parent, is rejected by
his/her child/ren for no justifiable reason. This rejection is provoked by nothing more
than a campaign of alienating behaviours made by an alienating parent and his or
her allies such as extended family members, friends and members of the children’s
school community, to hinder the relationship between the targeted parent and his/her
child/ren. Parental alienation has a negative impact on all members of the family
affected by it and it occurs regardless of nationality, religion, or gender of the parents
and child. Also, it occurs when there was once a loving and caring relationship
between the targeted parent and their child/ren.

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Consequently, PA takes the form of family violence because alienating behaviours are
a form of psychological aggression (Baker, 2007, 2010a; Haines, Matthewson, & Turnbull,
2020; Harman, Kruk, & Hines, 2018; Harman & Matthewson, 2020; Verrocchio, Baker, &
Bernet, 2016). The alienating parent manipulates and creates scenarios of confrontation with
the aim of hurting the targeted parent and damaging the relationship they once had with their
child. Further, coercive control, exploitation of vulnerability and gaslighting (i.e., ‘mind
games’) were found in the participants’ narratives. These three tactics are considered
psychological aggression (Breiding, Basile, Smith, Black, & Mahendra, 2015).
When considering the narratives of the targeted parents who participated in this study,
it can be said that PA involves a set of alienating behaviours used by alienating parents, the
consequences of these behaviours on targeted parents and the actions targeted parents
perform to reverse this situation. It was identified that family members and former friends
who do not align with the alienating parent are also alienated from the child. PA includes and
affects all members of the family. Hence, PA should be considered a phenomenon affecting
the whole family system. Family systems theories, such as the McMaster model (Epstein,
Bishop, & Levin, 1978) states that all parts of the family are interrelated. This interrelation is
understood in the way: family members individually behave and interact with each other is
the way these interactions affect the family system as a whole. Therefore, interventions for
PA should be targeted at a family systems level (Haines et al., 2020).
The proposed definition in this thesis stated that ‘...the targeted parent, is rejected by
his/ her child/ren for no justifiable reason’. This sentence was included to highlight the
targeted parent’s perspective, creating a shift in the existing definitions found in the literature
that define PA either from the perspective of alienating behaviours or from the perspective of
the children’s symptomatology. The targeted parent is rejected with no justifiable reason
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because for PA to occur, neglect and abuse perpetrated by the rejected parent must not be
present (Baker, 2018).
The rejection is provoked by nothing more than a campaign of alienating behaviours.
For PA to occur, alienating behaviours used by the alienating parent must be present (Baker,
2018; Harman & Matthewson, 2020). The literature has shown that there might be several
reasons why a child rejects a parent, from abuse or neglect to natural alliances because of
sympathy, affinity, child development or mutual interests (Friedlander & Walters, 2010;
Kelly & Johnston, 2001). PA exists when there is a parent who wants to hurt the other parent
using the children to achieve that end point. In addition, this definition includes alienating
behaviours made by an alienating parent and his or her allies because the alienating parent
does not act by him/herself. According to the targeted parents’ narratives in this thesis, their
children, the extended family, friends of the alienating parents or former friends of the
targeted parents and members of their children’s school such as teachers or administrative
staff align with the alienating parent to hinder their contact or the relationship with their
children.
It was important to include that PA occurs regardless of nationality, religion, or
gender of the parents because the sample in this thesis came from different countries around
the world. The participants reported belonging to different religions and the sample consisted
almost of equal numbers of targeted mothers and fathers. PA occurs when there was once a
loving and caring relationship between the targeted parent and their child/ren because
almost all the participants in this study reported having a good relationship with their children
before the alienation took place.
This proposed definition of PA, based on the findings of this thesis and previous
academic literature, contributes to the literature by highlighting the systemic nature of the
problem and the perspectives of the key “players” in the alienation saga. Future research
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should consider this, and that PA is systemic in nature and is also a social problem. This
thesis has been limited to the experiences of targeted parents from a psychological
perspective, but further research should explore parental alienation from a sociological point
of view, given the importance of the topic. On the other hand, this definition proposes, among
others, that PA is a form of family violence affecting all family members. The following key
finding focuses on describing the reasons why this thesis considers PA a form of family
violence.
Key finding no.3: PA is a form of family violence.
Family violence, also known as domestic violence, is defined as any violent act
inflicted by one family member on another. It can occur between partners (as intimate partner
violence), by parents against children (as child abuse), by children against other children, by
children against parents and by adult children against elderly parents. Family violence can
appear in the following forms: physical, sexual, emotional, economic or neglect
(Organisation for Economic Cooperation and Development, 2013).
It has been suggested that PA is a form of family violence perpetuated by alienating
parents against their children (Baker, 2007, 2010a; Haines et al., 2020; Harman, Kruk, &
Hines, 2018; Verrocchio, Baker, & Bernet, 2016) and the targeted parents (Harman, Kruk, &
Hines, 2018). However, the focus of attention in this thesis is given to the findings that
targeted parents described experiencing alienation as family violence, specifically a form of
Intimate Partner Violence (IPV).
Intimate partner violence is a form of family violence involving physical violence,
sexual violence, stalking and psychological aggression (including coercive tactics) by a
current or former intimate partner such as spouse, boyfriend/girlfriend, dating partner, or
ongoing sexual partner (Breiding et al., 2015). The World Health Organization (2010) defines
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it as “behaviour within an intimate relationship that causes physical, sexual or psychological
harm, including acts of physical aggression, sexual coercion, psychological abuse and
controlling behaviours” (p. 11). Specifically, psychological aggression is the use of verbal
and non-verbal communication with intent to harm another person mentally or emotionally,
and/or exert control over another person (Breiding, Smith, Basile, Walters, Chen, & Merrick,
2011). One of the manifestations of psychological aggression are coercive control behaviours
(Breiding et al., 2015).
The majority of the targeted parents who participated in this study reported having
been survivors of at least one episode of family violence during their relationship with the
alienating parent and before the alienation took place. They described feeling controlled by
the alienating parent emotionally, financially and socially; they were threatened by the
alienating parent with physical assault, murder, taking the children away or making the
children hate them; and they felt isolated from friends and family during this time. They
reported the alienating parent interfered with their parenting time and withheld information
about their children. These are a manifestation of psychological aggression and they are
coercive control behaviours in the context of IPV, occurring before targeted parents realised,
they were involved in an alienating dynamic.
Other types of psychological aggression (Breiding et al., 2015) were reported by the
participants in this study, such as: exploitation of their vulnerabilities when the alienating
parent took advantage of targeted parents’ immigration status, sexual orientation or physical
and mental disability. Targeted parents described how the alienating parent used ‘mind
games’ that made them feel like they were crazy and lead them to question their own memory
of past events. This experience is consistent with gaslighting (Harman et al., 2018).
Two theoretical perspectives have been the most influential in understanding IPV:
feminist theory and the family violence theory (Archer, 2000; Johnson, 1995). Feminist
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theory considers IPV as rooted in patriarchal traditions of male dominance (Johnson &
Leone, 2005) over women, using violence to maintain power and control as a result of men’s
(social) privileges and their need to maintain it (Lawson, 2013). Feminist theory has been the
basis of intervention programs focusing on IPV as a pattern of coercive control and male
domination of women (Carlson & Jones, 2010; Young, Cook, Smith, Turteltaub, &
Hazelwood, 2007), such as the Duluth Domestic Abuse Intervention Project known as the
Duluth Model (Pence & Paymar, 1993).
The Duluth Model provides through its key tool: The Power and Control Wheel, a
visual representation of a range of abusive behaviours used by male IPV perpetrators as a
means of exerting power and control over their female partner. The abusive behaviours
include: intimidation; emotional abuse; isolation; minimizing the abuse; using children; male
privilege; economic abuse; coercion and threats; and physical and sexual violence (Pence &
Paymar, 1993). Although the Duluth Model considered only women as survivors of family
violence, nowadays it is known that survivors of family violence can be both men and
women. The power and control wheel can be used to further understand PA as a form of
psychological abuse (Harman & Matthewson, 2020) where the alienating parent exerts
control over the targeted parent.
Family violence theory states that IPV is an outcome of the conflict in couples and it
can occur in both heterosexual and same-sex relationships (Ali, Dhingra, & McGarry, 2016);
and women can also perpetrate violence against their male partners (Johnson, 2006; Straus,
2006). This perspective considers the gender biases inherent in feminist theory, as ‘not all
coercive control is rooted in patriarchal structures and attitudes, nor perpetrated exclusively
by men’ (Johnson, 2006; p.478).
Johnson’s typology of family violence (Johnson, 1995, 2008; Kelly & Johnson, 2008)
is one of the most comprehensive and influential classifications that can be used to better
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understand the phenomenon of IPV in different circumstances, situations and perspectives
(Ali, Dinghra, & MCgarry, 2016; Anderson, 2009; Langhinrichsen-Rohling, 2010). The
Coercive Controlling type of violence (CCV, Kelly & Johnson, 2008) formerly known as
Intimate Terrorism (Johnson, 2006) is defined as a pattern of emotionally abusive
intimidation, coercion, and control coupled with physical violence against partners (Kelly &
Johnson, 2008) and it has its roots in the Power and Control Wheel of the Duluth Model
(Pence & Paymar, 1993). More recently, Johnson (2008) has proposed the term “incipient”
CCV to describe cases in which there is a clear pattern of power and control in the absence of
physical violence. In this context, targeted parents may be considered survivors of incipient
CCV.
Coercion and control are central elements in family violence (Haines et al., 2020) just
as they are central elements in PA (Harman et al, 2018). Accordingly, the narratives of
targeted parents who participated in this study showed that alienating parents ensured power
and control through psychological, social, emotional and financial abuse during and after
their relationship with them. The violent acts described by targeted parents in this study can
be viewed as family violence as defined by the Family Law Act, 1975 in Australia. several
alienating behaviours reported by the participants of this study are identified as such (see
Table 7.2).
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Table 7.2
Family Violence identified in Targeted Parents’ Narratives
Family violence Examples from TPs narratives
(Family Law Act, 1975)
Stalking When alienating parents monitor and control targeted
parents’ social media, phone calls, mail, emails or use
their children as spies.
Repeated derogatory taunts When there is verbal abuse denigration, belittling and
mocking toward the targeted parent.
Denying financial authority and withholding When alienating parents control targeted parents
financial support finances pre-separation.
Preventing the family member from making or When targeted parents reported they were isolated from
keeping connections with his or her family, friends family and friends, or they were denied to keep contact
or culture with family overseas.
Considering PA as a form of family violence changes the focus from the aberrant
behaviours of the child to the cruel behaviours of the alienating parent (Haines et al., 2020).
This shift in conceptualisation has also been suggesting recently in the literature by Harman,
Kruk and Hines (2018) and Haines et al. (2020). These authors stated that alienating
behaviours can be considered as acts of aggression with the main aim of altering or
terminating the relationship between the child and the targeted parent.
Considering targeted parents as survivors of IPV acknowledges PA as a form of
family violence and as such, interventions for targeted parents should be developed
accordingly.
Key finding no.4: Targeted parents are active in their attempts to get their children back
and regain the relationship they once had with them.
Targeted parents who participated in this study described engaging in several
behaviours and actions to regain the relationship with their children. These behaviours and
actions included keeping communication and contact with their children (e.g. through
telephone, email, mail, face to face or sending gifts for birthdays and Christmas); being
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available for them (e.g. keeping a room for them at their house in case they come back;
keeping the same address and telephone number); engaging in self-care (e.g. seeking
professional help); making a last-ditch attempt to reconnect with their child (e.g. making their
cases public, hiring a private investigator or keeping record of everything they do as evidence
they have not abandoned their children) or just changing the focus of attention away from the
alienation because they realised it was harmful to both themselves and their children.
These findings are an important piece of evidence because they contradict previous
descriptions of targeted parents reported in the literature. Targeted parents have been
described as being passive and withdrawn in the face of high conflict; lacking in parenting
skills, empathy and sensitivity to the child; counter-rejection of their children; self-centred,
immature and violent; and having critical and demanding traits (Johnston, Walters, &
Friedlander, 2001; Kelly & Johnston, 2001; Kopetski, 1998b; Waldron & Joanis, 1996). In
addition, they have also been accused of being the cause of their own alienation (Johnston,
2003), with some authors suggesting that alienated fathers are likely to have neglected or
abused their children in the past (Johnston, Walters, & Olesen, 2005).
Targeted parents who participated in this study described the numerous ways they
tried to maintain a relationship with their children. They expressed their unconditional love
for their child despite being rejected by their child. Describing the adverse psychological
consequences of being rejected by their children, targeted parents detailed remaining active in
their attempts to reunify with their children and none of the participants had ceased hoping
that one day their children will come back to them. Therefore, the descriptions participants
gave of their own experience are consistent with parents who are proactive, resilient and
acting within the constraints of PA.
It might be possible that discrepancies in the descriptions of targeted parents are due
to differences in studies such as sample size, research designs, context and aims of each of
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the studies, or even researcher bias. It is also worth considering that previous descriptions of
targeted parents as lacking in empathy, self-centred, immature and having critical and
demanding traits (Johnston, Walters, & Friedlander, 2001; Kelly & Johnston, 2001; Kopetski,
1998b; Waldron & Joanis, 1996) are observations of outwards signs of people experiencing
distress at a confusing and traumatic time. More research is needed to gain a better and more
accurate picture of targeted parents of PA.
Key finding no.5: There are other alienators besides the alienating parent.
It has been established in the literature (Baker & Darnall, 2006; Haines et al., 2020)
that alienating parents use strategies to alienate targeted parents from their children.
However, most of the time they do not act alone. Alliances between alienating parents and
other parties to accomplish the alienation was a common theme emerging from the targeted
parents’ narratives in this study. These findings are consistent with previous research
showing that siblings, extended family members and friends can assist in the alienation
process (Baker & Fine, 2014; Golly, 2016; Harman & Biringen, 2016; Sauber, 2006;
Vassiliou & Cartwright, 2001). The results of this study showed that extended family
(alienating parent’s and targeted parent’s family), friends of the alienating parent and older
children can align with the alienating parent and engage in alienating behaviours. Moreover,
it was found that the children’s schools can participate in the alienation. Principals, teachers
and administrative staff were described by participants as people who in one way or another
hindered the relationship or contact between the targeted parent and their children.
It would seem that the third alienating party might act consciously or unconsciously,
either in a passive or active manner (Harman & Biringen, 2016). For example, a third
alienating party acting consciously and actively was identified by one targeted father
(Participant no.3) as the children’s maternal grandmother who reportedly explicitly

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verbalised her intentions of fighting until the children were taken away from him. On the
other hand, third parties acting unconsciously and passively were found in the narratives of
those targeted parents who reported that their children’s schools did not send them academic
reports or invitations to school events their children were involved in. In these instances,
there was no explicit or active intention of the school to alienate targeted parents from their
children. However, schools denying targeted parents the opportunity to be involved in their
children’s activities contributes, in an unconscious and passive way, to the alienation process.
Harman and Biringen (2016) explained that supporters of the alienating parent can
become third parties when they take the alienating parent’s side after hearing repeated
negative stories about the targeted parent. It is the current researcher’s opinion that this
alliance begins when the third parties believe these complains despite no evidence to the
contrary and without hearing the other side of the story. This is important to bear in mind
because it seems there are third parties that take the alienating parent’s side not knowing the
whole story. This can be avoided by educating and creating more awareness in the
community about what PA is and how it can be prevented.
Key finding no.6: Disenfranchised grief and ambiguous loss are reportedly experienced by
targeted parents.
Targeted parents who participated in this study described the loss of their children,
they defined this experience as a grief of a child who is still alive, a grief that no one
understands or supports. All 54 participants described the common experience of an
ambiguous loss and disenfranchised grief. According to Boss (2010) ambiguous loss appears
in two forms: the first one is when a loved one is physically present but psychologically
missing as is the case of Alzheimer’s disease, autism, coma, etc.; and the second one, when
there is a physical absence with psychological presence, which is consistent with the
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experience described by targeted parents in this study (targeted parents think about, feel and
care for their children who are no longer with them). When Boss’ (2007) definition of
ambiguous loss is considered, it is consistent with the narratives of the participants. A
summary of the aspects of Boss’ definition and how it relates to the narratives of participants
is described in Table 7.3.
Table 7.3
Aspects of the Ambiguous Loss (Boss, 2007) related to the Narratives of Targeted Parents who Participated
in this Study.
Aspects of Ambiguous Loss Aspects found in the narratives of TPs
The loss is confusing, and it is very difficult to make Targeted parents could not understand how, why or
sense of the loss experience. when their children started to reject them. Most of
the targeted parents had a good, loving and healthy
relationship with their children before the alienation
occurred. The rejection and the loss of their children
creates a state of confusion and lack of understanding
from the targeted parents and others.
Because the situation is indeterminate, the Targeted parents experience the loss of a living child.
experience may feel like a loss but not be readily They lose contact and a relationship with them;
identified as one. Therefore, hope can be raised and however, because they are not dead, targeted parents
destroyed so many times, that individuals may constantly hope they will someday return to them.
become physically numb and unable to Sometimes children try to approach the targeted
react. parent, as ‘testing the waters’, they test whether it is
safe or not to initiate contact, yet they do it little by
little: they approach the targeted parent and then
disappear, then they try again and disappear again.
These attempts can come and go many times, leaving
targeted parents bewildered.
Because of ongoing confusion about the loss, there Some targeted parents find it difficult to move
are frequent conflicting thoughts and emotions, such forward in their lives, because they are caught
as dread and then relief, hope and hopelessness, between the confusion-despair and the hope-belief
wanting to take action and then profound paralysis. dyads. There were cases in which targeted parents
would not move house, change phone numbers or
jobs just to ‘be there’ when their children come back.
Difficulty problem-solving because the loss may be All targeted parents hope the alienation is temporary
temporary or permanent. and someday their children will grow up, they will
realize the situation and will try to re-establish
contact with them. Consequently, some targeted
parents were suspended in their grief with no
apparent solutions for resolution.
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There are no associated rituals and very little The loss experienced by targeted parents is
validation of the loss. ambiguous and their grief is disenfranchised. They
cannot bury their children or prepare a funeral
because they are not dead, yet they are physically
absent. Targeted parents reported not having help or
understanding from people around them and they
claimed that PA is not recognised by the legal or
mental health systems, thus, when loss and grief are
not recognized, closure is almost impossible.
There is still hope that things may return to the way Targeted parents wait for reunification exposing
they used to be, but there is no indication of how themselves to a constant distress due to the
long that may take or if it will ever happen. ambiguity of this situation.
Because of the ambiguity, people tend to withdraw Almost all targeted parents claimed lack of support
instead of offering support because they do not know and understanding. Also, they preferred to suffer in
how to respond, or there is some social stigma silence because people cannot understand how a
attached to the experience. child would not want to have a relationship with a
parent without a reason to justify such rejection.
Because the loss is ongoing in nature, the relentless Targeted parents reported being tired, exhausted,
uncertainty causes exhaustion in the family members frustrated, hopeless and drained, just to mention a
and burnout of supports. few, due to the alienation.
Grieving an ambiguous loss with no help or understanding from others has been
identified in the literature as disenfranchised grief (Doka, 1989, 2002, 2008). Targeted
parents who participated in this study were unable to mourn the loss of their children in
public and unable to formally process their grief and loss; consequently, they have problems
moving on with their lives (Harman, Kruk, & Hines, 2018). Frequently, targeted parents
were reluctant to share their suffering with close people, or even with professionals due to the
social stigma (by ignorance) that is generated among people when a loving parent, who has
not done anything wrong, is rejected by his/her own children.
The consequences of a disenfranchised grief are devastating. When coupled with the
consequences of surviving family violence, the emotional sequalae for targeted parents is
dire. Targeted parents in this study reported a series of clinical symptoms that they attributed
to be a consequence of the alienation. These symptoms included depression, anxiety, panic
attack, sleep disturbance, cognitive dysfunction and psychological and adjustment difficulties
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to mention a few. The most common social consequence was rejection and isolation, either
by family or friends. Targeted parents said they felt isolated because of people’s lack of
understanding and negative judgments about what they are experiencing (Kruk, 2011;
Whitcombe, 2014). Similarly, Boss (1999, 2006, 2007) agrees that people suffering
ambiguous loss are criticised and left on their own to cope, isolated and confined between
hope and despair.
The consequences of PA on targeted parents in this study are similar to those reported
by Weiner (1999) who described the consequences of experiencing ambiguous losses (See
Table 7.4).
Table 7.4
Comparison Between the Consequences of Ambiguous Loss according to Weiner (1999) and the
Consequences of Parental Alienation reported by Targeted Parents who Participated in this Study
Consequences Ambiguous Loss (Weiner, 1999) Parental Alienation (reported by
TPs of this study)
Physical Fatigue, sleep disturbances and Physical health problems in general,
somatic complaints that may affect weight-loss, weight-gain, sleep
various body system. disturbances and different types of
somatic issues, such as headaches,
chest pain and arrythmias.
Cognitive Preoccupation, rumination, Overthinking (including negative

forgetfulness and difficulties automatic thoughts and suicide
concentrating. thoughts), difficulties to concentrate
and mental stress.
Behavioural Agitation, withdrawal, avoidance, Suicide attempts and self-isolation,

dependence or a pressing need to although they also reported not
talk at times. eating, eating and drinking in
excess, taking antidepressants and
going several times to hospitals for
different somatic issues.
Emotional Anxiety, depression, irritation, Frustration, upset, sadness,

numbness or anger. overwhelm, no longer feeling joy or
pleasure in life, rejection,
embarrassment, drain, guilt,
confusion, brake, anger, isolation
and disempowerment. Other words
mentioned by the participants to
describe how they felt were
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exhaustion, hurt, insecurity and

powerless.
It is important to recognise the consequences of ambiguous loss and disenfranchised
grief, especially because it is not uncommon for individuals experiencing these to be
misdiagnosed with an anxiety disorder, major depressive disorder or personality disorders
(Marwit, 1996; Weiner, 1999). Moreover, special attention should be paid to targeted parents
who are experiencing ambiguous loss and disenfranchised grief because they may also be
experiencing learned helplessness. Learned helplessness as a psychological state, occurs
when individuals face uncontrollable events about which they can do nothing at all
(Seligman, 1972). Learned helplessness may also occur when people have no control over
their environment, whether in belief or reality. It is associated with cognitive, emotional, and
motivational deficits (Maier & Seligman, 1976; Seligman, 1975). Uncontrollable events can
produce passivity in the face of trauma and inability to realise that responding is effective,
causing emotional stress and possibly depression (Seligman, 1972). Considering how much
of the alienation is process is out of the control of targeted parents and the process is
unrelenting, it is unsurprising that they may also experience learned helplessness and reduced
motivation to act in a proactive manner (Maier & Seligman, 1976).
Thus, targeted parents who participated in this study have experienced the alienation
of their children as an ambiguous loss, as a disenfranchised grief and possibly presenting with
learned helplessness. From their narratives, it has been seen that they have been left suffering
alone. People around them have shown little compassion, understanding and support. It is
important to acknowledge targeted parents’ ambiguous loss, disenfranchised grief and
learned helplessness because future actions can be made aiming to improve their well-being.
The next Key Finding describes some of the emotions targeted parents have experienced as
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consequence of being alienated from their children. The description of these emotions will
help in the understanding of the experiences of the targeted parents in this study.
Key finding no.7: Targeted parents display sadness, distress, frustration, anger, guilt and
shame due to the alienation.
Targeted parents in this study described the emotions they felt as a consequence of the
alienation. Several words were identified in their narratives to explain how they felt being
rejected by their children. These words were homologised to Roseman’s model of the
structure of the emotion system (Roseman, 2011). Hence, following this model, targeted
parents experienced six out of 16 discrete emotions. These were sadness, distress, frustration,
anger, guilt and shame.
The identification of these discrete emotions is useful to understanding theoretically
targeted parents’ experiences. Roseman (2011) proposed that the various responses of each
discrete emotion constitute a functional behaviour class. This means that each discrete
emotion corresponds to a different response strategy. Although all instances of an emotion
will not be identical, there may still be significant response consistencies related to five
components (Roseman, 2011; Roseman, Wiest, & Swartz, 1994): phenomenological
(characteristic thoughts and feelings), expressive (facial, vocal and postural changes),
behavioural (tendencies or readiness to take particular actions), emotivational (goals that
people want to pursue when the emotions are experienced) and physiological (central and
peripheral patterns of neural, chemical and muscular responses).
According to Roseman et al. (1994) sadness is felt like a lump in the throat, or feeling
very tired. Sadness makes people think about what they are missing with a tendency to feel
like they are doing nothing but cry. When people are sad, the emotivational goals are the
desires to be comforted and to recover what they have lost. The distress is felt like agitation,
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creating thoughts that things are going badly. People with distress move around or leave, with
the emotivational goal of ending or moving away from the situation they are experiencing.
Sometimes this can be misunderstood as detachment, lack of empathy, immaturity or
withdrawal when facing high conflicts, as seen in previous research about targeted parents
(e.g., Kelly & Johnston, 2001; Johnston, 2003). Frustration produces the feeling that there is
an obstacle that is in the way. People experiencing frustration think that they are blocked,
they may lash out; and their emotivational goal is to get past or overcome the obstacle. The
most common description of targeted parents’ experiences who participated in this study was
frustration. They reported feeling frustrated because they have to prove their ‘innocence’ to
people all the time, they have to explain themselves because people do not understand their
pain and they find no one who can help them. Other participants reported feeling frustrated
because they did not know what was happening to them or their children, and they did not
know what else to do to get their children back. On the other hand, anger is felt as blood
rushing through the body, like an explosion; produces the thought of unfairness and injustice.
Anger is related to thoughts about hitting and yelling with the emotivational goal of hurting
or getting back at someone. No parent in this study reported a desire to hurt anyone. In fact,
some targeted parents expressed empathy and concern for the alienating parent. The anger
felt by targeted parents in this study was manifested through the feeling and thoughts that
what they were experiencing was unfair.
Targeted parents also described feeling guilt and shame. People feel guilty when they
believe they have done something wrong. Instead of blaming the alienating parent, some
targeted parents in this study blamed themselves for the way they responded to the alienation
or for being naive to it. Guilt can drive people to want to punish themselves. The
emotivational goal is to make up for what they have done wrong and seek forgiveness. On the
other hand, shame can trigger beliefs of unworthiness and a desire to withdraw. Targeted
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parents who feel shame might be experiencing this as a consequence of their disenfranchised
grief, because their grief is not recognised neither is it understood by other. As in their own
words ‘people might think I have done something terrible for my children to reject me’.
Indeed, some targeted parents felt so much shame that they were driven to attempt suicide.
To understand targeted parents’ experiences, it is also necessary to understand each of
the emotions they might display during the alienation. Some of the emotions reported by
participants in this study have been reported in previous literature as distress (Balmer,
Matthewson, & Haines, 2017; Poustie et al, 2018); frustration (Baker, 2010b; Baker &
Andre, 2008; Baker & Darnall, 2006; Poustie et al., 2018; Vassiliou & Cartwright, 2001);
anger and guilt (Finzi-Dottan, Goldblatt, & Cohen-Masica, 2012; Goldberg & Goldberg,
2013); and shame (Baker, 2010b; Baker & Andre, 2008; Goldberg & Goldberg, 2013).
Key finding no.8: Targeted parents are at risk of serious psychological difficulties.
To be a targeted parent is to be a survivor of PA, IPV and psychological aggression.
Targeted parents in this study reported having been affected emotionally, cognitively,
behaviourally, socially and physically due to the alienation. They also described the financial
and work-related consequences of experiencing PA (details in Chapter VI). Targeted parents
are in clinical and psychological risk because the consequences of PA are devastating to
them. Targeted parents who participated in this study reported being in constant
psychological and physical distress. They felt their lives were not the same. Their health,
their jobs, their relationships have been affected in a negative way. Almost a quarter of the
targeted parents in this study had attempted suicide, while others reported experiencing
suicidal ideation. PA as a form of psychological IPV leaves the targeted parent vulnerable,
sometimes, unable to cope with it.
Targeted parents in this study described experiences consistent with the symptoms of
post-traumatic stress disorder, depression, and anxiety. These findings are consistent with
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previous literature on PA which report the same symptoms as consequence of the alienation
in their samples (Baker, 2010b; Baker & Verrocchio, 2016; Balmer et al., 2017; Sher, 2015).
Importantly, the experiences of targeted parents in the current study and described in
previous literature are the same psychological consequences reported by survivors of IPV and
survivors of psychological aggression (Campbell, Kub, & Rose, 1996; Golding, 1999; Kruk,
2015; Lawrence, Yoon, Langer, & Ro, 2009; Marshall, 1999; Sher, 2017; Stewart & Vigod,
2017; Taft et al., 2006; Woods, 2000; Zlotnick, Johnson, & Kohn, 2006).
In addition, there are other consequences of PA reported by targeted parents in this
study (see Chapter VI) that are similar to those reported by survivors of IPV. Harman, Kruk
and Hines (2018) informed that survivors of IPV experience economic issues and can become
homeless when ending their relationships (Johnson & Zlotnick, 2009). This was seen in
Study Three in the subtheme consequences-finances/work in this thesis. Other survivors of
IPV increase substance use (Shorey, Rhatigan, Fite, & Stuart, 2011), as was seen in subtheme
consequences-behavioural in Study Three. Some survivors of IPV experience limited
physical and cognitive functioning (Straight, Harper, & Arias, 2003), as seen in the sub-
themes consequences-physical and consequences-cognitive in Study Three. An increase in
somatic complaints is common in IPV survivors (Kaura & Lohman, 2007; Próspero, 2007),
which was seen in subtheme consequences-physical in Study Three. Finally, survivors of
IPV can experience difficulties in their ability to work (Coker, Smith, Bethea, King, &
McKeown, 2000), which was also seen in subtheme consequences-finances/work in Study
Three.
When considering PA as a form of family violence, IPV or psychological aggression,
the immediate impact and the long-term consequences of these types of aggression must also
be taken into account. Several studies have reported that beyond injury and death, survivors
of IPV are more likely to report a range of negative mental and physical health outcomes that
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are both acute and chronic in nature (Black, 2011; Breiding, Black, & Ryan, 2008; Breiding,
Smith, Basile, Walters, Chen, & Merrick, 2011; Campbell, 2002; Coker et al., 2002; Golding,
1999; Woods, 2000), affecting indirectly other health conditions (Coker, Smith, Bethea,
King, & McKeown, 2000; Smith & Gittelman, 1994) such as chronic diseases and somatic
complaints. The literature suggests that the link between IPV and chronic diseases and
somatic complaints is the biological response to long term or ongoing stress (Brownridge,
2006; Crofford, 2007). For example, it has been documented that both physical and
psychological IPV have a significant impact on the endocrine system of women (Pico-
Alfonso, Garcia-Linares, Celda-Navarro, Herbert, & Martinez, 2004); other studies have
linked IPV, stress and somatic and chronic diseases showing an increase and higher incidence
of chronic pain, fibromyalgia, chronic fatigue syndrome, temporomandibular disorder,
irritable bowel syndrome, migraines, headaches, asthma, diabetes, gastrointestinal disorder
and cardiovascular diseases such as heart attack and strokes (Black & Garbutt, 2002;
Brownridge, 2006; Coker et al., 2000; Crofford, 2007; Leserman & Drossman, 2007). Most
of these symptoms have been identified in the narratives of the targeted parents in this study
(see Table 6.8 in Chapter 6). Furthermore, Crofford (2007) suggests that exposure to the
stressor of violence would contribute to the expression and severity of the symptoms of
somatic syndromes related to stress.
In summary, targeted parents of PA are at high risk of experience serious and
clinically significant psychological and physical difficulties associated with PA. Targeted
parents are survivors of family violence who are also suffering the ambiguous loss of their
children while trying to cope with the associated disenfranchised grief. Targeted parents deal
with the emotional, psychological and physical burden every day since losing their children.
Therefore, it is important to understand how they have coped with this burden, if they have
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coped at all. The next section presents the final key finding which helps to understand how
targeted parents are coping with PA.
Key finding no.9: Coping with PA.
Coping with PA is not easy for targeted parents. This thesis demonstrated that almost
half of the sample reported not coping well or not coping at all. It is important to understand
the experiences of targeted parents to be aware of what they are facing and from there,
provide them support and help. Targeted parents who participated in this study suffer in
silence without emotional or social support due to the lack of recognition of what is PA and
its consequences. Targeted parents have been affected in different areas of their lives,
experiencing psychological distress to the point of risking their own lives, getting sick or
attempting suicide.
Facing PA from the targeted parent’s perspective requires a coping strategy (Baker,
2013; Woodall & Woodall, 2017). A coping strategy is a plan for dealing with what is
happening now and over time. According to Woodall and Woodall (2017) approaching the
problem of alienation entails building multilayered strategies to operate sometimes
simultaneously and sometimes individually otherwise targeted parents will find themselves
sinking under the weight of PA tactics. Some of the strategies should bring targeted parents
to a place of awareness and others will help them to work with professionals and the family
court (Woodall & Woodall, 2017).
Some of the targeted parents in this study described that being active was a way to
cope with the alienation. They described engaging in intellectual, social, physical and
spiritual activities, or they kept busy at work, found a hobby or sought family and
professional support. Although these activities did not directly address the PA, neither were
part of a coping strategy plan to address PA, they provided (according to targeted parents) an
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increase in their well-being. Targeted parents found by themselves a way to feel better in a
stormy context full of uncertainties.
The literature reporting strategies for coping with the alienation is not abundant.
However, Baker and Fine (2013, 2014), Haines et al. (2020) and Woodall and Woodall
(2017) suggest a series of steps that targeted parents should take into account when dealing
with PA. This includes: obtaining psychoeducation to understand the reality of the situation;
identifying and managing the child’s behaviours; encouraging empathy; maintaining
boundaries with the child and being present as a parent; using critical thinking; seeking
social, therapeutical and legal support; and self-care (e.g., mindfulness, appreciating the
good, developing mantras, finding serenity, etc.).
It is necessary to consider both what the literature suggests (Baker & Fine, 2013,
2014; Haines et al., 2020; Woodall & Woodall, 2017) and the experiences reported by the
participants of this study in order to create an effective action plan focused on the target
parent’s wellbeing. Targeted parents would perhaps be in a better position to manage the
challenges of PA (including dealing with the legal system, facing the alienating behaviours of
the alienating parent and the behaviours of the children) if they felt empowered, and were
psychologically and physically healthy.
This thesis has contributed to the existing literature by identifying and describing how
a group of 54 parents have faced and dealt with being alienated from their children. They
described the consequences and how they have managed to survive PA. This thesis also
developed a greater understanding of targeted parents’ experiences and their needs. The
following section focuses on suggestions and factors to be considered when working with or
developing interventions for targeted parents in a clinical context.

189
7.2. Suggestions for interventions with targeted parents
There are six factors to be considered as suggestions when working with targeted
parents of PA, all of them have been extracted from the results of this study. In a clinical
context, it is important to consider the following: targeted parents are survivors of family
violence; they suffer ambiguous loss and experience disenfranchised grief; most of them do
not cope well or not cope at all; and PA is a complex, systemic and dysfunctional family
dynamic. It is also important to consider what the literature has previously suggested when
working with this population; and finally, that targeted parents seek a legal resolution to the
alienation.
Considering targeted parents are survivors of family violence.
Survivors of family violence, including coercive controlling violence (Kelly &
Johnson, 2008) and IPV, are people who suffer psychological difficulties. Those
psychological difficulties include: fear, anxiety (Dobash & Dobash, 1979; Ferraro, 2006;
Kirkwood, 1993; Sackett & Saunders, 1999; Sutherland, Bybee, & Sullivan, 1998), loss of
self-esteem (Chang, 1996; Kirkwood, 1993), depression (Golding, 1999; Taft et al., 2006)
and posttraumatic stress symptoms (Johnson & Leone, 2000; Kruk, 2015; Lawrence et al.,
2009; Saunders, 1994). Psychological difficulties as consequences of coercive controlling
violence or IPV have a more intense impact on those who experience it. Survivors of family
violence perceive the psychological impact of their experiences as worse than the physical
effects of it (Kelly & Johnson, 2008; Williams et al., 2012).
If targeted parents are to be considered survivors of IPV, it is important to recognise
that they are then vulnerable to experiencing significant distress, limited physical and
cognitive functioning, difficulties in their ability to work and they might suffer an increase in
somatic complaints due to the long term or ongoing distress they face. Therefore,
190
professionals working with targeted parents, especially mental health practitioners, need to be
aware of the psychological distress targeted parents experience. If their distress is ignored, it
could increase some targeted parents’ suicide risk. Mental health practitioners who find
themselves working with targeted parents should be aware of suicide risk factors, which
might include expressions of psychological distress, feelings of worthlessness, sadness,
shame and social withdrawal. All mental health practitioners working with targeted parents
should consider asking their clients about suicidal thoughts or any plans to attempt suicide.
Considering targeted parents suffer ambiguous loss and disenfranchised grief.
Ambiguous loss is the most stressful and traumatising loss one can experience
because there is no verification, no closure, no rituals for support and thus, no resolution of
grief (Boss, 1999). Social support is key to overcoming this experience (Abrams, 2001;
Harman et al., 2018). Targeted parents in this study described self-isolation and being
isolated from their friends and family because of their lack of understanding. This resulted in
many targeted parents being left unsupported during a distressing time. When helping
targeted parents through their ambiguous loss and disenfranchised grief, a group modality
type of counselling may be beneficial (Cheung & Hocking, 2004; Duggleby et al., 2013;
Hebert et al., 2013; Pillai-Friedman & Ashline, 2014) because it can reduce isolation, stigma
and provides social acknowledgement.
In addition, individual counselling in order to resolve this type of loss is
recommended. Encouraging people to find new meaning to their situation through
counselling can be helpful (Abrams, 2001). It is important to note that gaining new meaning
might be difficult for people suffering ambiguous loss or experiencing disenfranchised grief
because the grief itself remains unresolved (Boss, 1999). Hence, mental health practitioners
should consider, along with the group counselling, individual support to help targeted parents
191
build resilience and develop an arsenal of coping resources. Boss (2010) proposed a guide for
resilience building in these cases which includes:
- Finding meaning, or being able to make sense of what is happening. This can be
achieved through non-judgmental psychoeducation. Psychoeducation will help
targeted parents to understand PA and the complexities of the alienating process. Self-
blame and shame can be addressed by using strengths-based approaches.
- Tempering mastery, which means regaining control through adopting a ‘both/and’
mind set, holding two opposite ideas at the same time. Targeted parents experience
the loss of their children, yet they are still around. They described it as the grief of an
alive child. Targeted parents need to be cognitively able to adopt two opposite ideas at
the same time. For example, even if they know their children are alive, they might not
have contact with them; or they know their children are absent now, but they might
come back anytime in the future. To work on this cognitive dissonance, cognitive-
behavioural therapy is recommended.
- Reconstructing identity, involving the construction of a new self-identity and the lost
loved one. Targeted parents can experience problems with being called parents when
they are unable to fulfil that role. This can be addressed in individual counselling.
- Normalizing ambivalence, encouraging people to talk, acknowledging and bringing
ambivalent emotions (often negatives emotions) into the open. In doing so, people
will be better able to minimise and manage their ambivalence. It is important for
targeted parents to talk. They need to verbalise their thoughts and their emotions and
be guided to challenge cognitive distortions that perpetuate the distress. Targeted
parents need to talk in a clinical context and also in a social context.
- Revising attachment, involves being able to celebrate the person they are grieving
while the connections are no longer available. Remembering the good times with their
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children, while they were still together, keeping pictures, telling their stories to others
might help in keeping the ‘memory alive’, at the same time acknowledging they are
currently separated.
- Discovering hope, which is thinking less of themselves and more about larger
purposes (hopeful ones). Faith, religion, volunteering, PA advocacy can help targeted
parents to minimise their distress.
Considering that many targeted parents do not cope well or not at all.
Targeted parents need to be guided on the construction of a strategy plan to cope with
the alienation and their psychological difficulties. Mental health practitioners working with
targeted parents need to be aware that many targeted parents do not know what they are
experiencing, therefore, they do not cope well at all with the alienation.
When working with targeted parents on the construction of a coping strategy plan, it
is advisable that the aims of it are primarily to become educated in the topic and to improve
their personal well-being. Knowing what is happening to them can help to buffer against
adverse psychological reactions and are more likely to face the challenges that come with PA
in an adaptive way. Improving wellbeing might include some of the activities recommended
by Baker and Fine (2014) which are: learning to appreciate the good, taking care of
themselves, getting social support, finding a mental health provider who understand PA,
finding serenity, developing a mantra, calling on a helpful image and validating their identity
as a parent.
Mental health practitioners should encourage targeted parents to remain active,
finding activities or hobbies according to their interests. These activities might be physical
(e.g., doing exercises), mental (e.g., studying or researching) or social (e.g., spending time
with friends). Strategies such as behavioural activation or positive activity scheduling are
193
recommended in order to motivate targeted parents to get involved in these types of activities.
These techniques promote well-being and encourage people to approach activities that they
have been avoiding and assist them in refocusing on their goals and valued directions in life
(Veale, 2008).
Considering that PA is a complex, systemic and dysfunctional family dynamic.
When working with targeted parents, mental health practitioners should bear in mind
that they are working with people involved in a complex and dysfunctional family dynamic.
PA involves not only targeted parents, but also children, alienating parents, extended family
and the entire social network surrounding the affected family. Further, targeted parents may
be embroiled in the family law system and may have been in this system for some time.
Professionals working with targeted parents must understand the phenomenon, its dynamics,
its causes and its consequences. Working in PA matters requires trained professionals with
specific knowledge and specific skills because working in this field can be stressful and
frustrating (Baker, 2013; Haines et al., 2020) for families and for the social, clinical and legal
support network.
Clinicians working with targeted parents must be empathic and realistic, be able to set
clear limits with their clients and be aware that working with targeted parents can take a
personal toll. Some of the feelings clinicians experience when working with targeted parents
include: shame of being unable to fix the targeted parents’ problems (Goldberg & Goldberg,
2013); feeling overworked or overloaded; feeling like a failure; developing a negative
attitude toward the client and finding difficult to suspend critical judgment; experiencing
non-specific symptoms, such as headaches, stomach aches or increase susceptibility to
viruses (Haines et al., 2020). It is highly recommended that clinicians working in the PA field
take regular breaks from work in order to recharge and regain focus for tackling the complex
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problem that is PA (Baker, 2013; Goldberg & Goldberg, 2013); obtain regular mentoring or
peer supervision; and engage in regular self-reflective and self-care practice (Haines et al.,
2020). Clinicians should also keep abreast of current advances in the research.
Considering what the academic literature has suggested when working with PA families.
The academic literature has demonstrated that traditional therapy alone is not
effective in addressing PA (Dunne & Hedrick, 1994; Rand, Rand, & Kopetski, 2005). A
specialised type of therapy for an effective management of this dysfunctional family dynamic
that focus on the restoring the family relationships and the family functioning is required
(Templer, Matthewson, Haines, & Cox, 2017). In addition, it has been suggested that PA
cases require a coordinated approach from therapists and legal practitioners facilitating
improved family functioning (Gardner, 1998; Sullivan & Kelly, 2001; Templer et al., 2017).
For intervention programs to be effective in addressing PA, they must be court-mandated
with court sanctions for non-compliance (Friedlander & Walters, 2010; Lowenstein, 1998;
Reay, 2015; Sullivan, Ward, & Deutsch, 2010; Templer et al., 2017; Toren et al., 2013;
Warshak, 2010b). Such court sanctions are especially important because the goals of these
types of interventions are contrary to the alienating parents’ wishes; therefore, getting
alienating parents involved in the therapy needs to be externally driven (Templer et al.,
2017).
Specialised forms of family therapy and family intervention programs for addressing
PA have been reported in the literature, including:
- The Multimodal Family Intervention, MMFI (Friedlander & Walters, 2010)
- Family Reflexions Reunification Program, FRRP (Reay, 2015)
- Overcoming Barriers Family Camp, OBFC (Sullivan, Ward, & Deutsch, 2010)
- Parallel Group Therapy for Parental Alienation (Toren et al, 2013)

195
- Family Bridges Workshop (Warshak, 2010b)
All of these programs are a form of specialised systemic family therapy and their aims
are to (Templer et al., 2017): protect the child from further harm caused by the alienation;
improve the child’s psychological well-being; challenge the child’s distorted thinking;
strengthen their critical thinking skills; improve targeted parent-child relationship; prepare
the alienating parent for an improvement in the quality of the targeted parent-child
relationship and support them through this change; repair the co-parenting relationships;
strengthen family communication and healthy boundaries within the new family structure;
psychoeducation for all family members on the nature and treatment of PA.
Mental health practitioners working with targeted parents of PA should keep in mind
that these parents are involved in a dysfunctional family. Practitioners working with
individual targeted parents can assist them to cope better with the loss of their children and
the consequences of alienating behaviours. When working with alienated families,
practitioners should be aware of risk of doing more harm than good. Also, it is important to
consider that working with targeted parents of PA alone, the practitioner is working at a
micro-level and will unlikely be able to make a substantial difference to the wider problem-
the alienation. Interventions at a micro-level will help targeted parents to cope better with the
consequences of PA. To address PA, as it was mentioned before, an approach involving
therapists, legal practitioners and court orders is needed. The next section presents the
evaluation of this thesis, emphasising its strengths and its limitation, and providing
recommendations for future research.
Consider that targeted parents seek a legal resolution to the alienation.
This thesis has helped to reveal the necessity for a legal resolution to the alienation.
Most of targeted parents in this study said they were dissatisfied with the legal system,
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describing it as having insufficient knowledge of PA and inefficient with unsatisfactory
outcomes with regard to resolving the alienation. Frustration and exhaustion felt by targeted
parents appeared to also be as a result of the excessive amount of money they had spent on
PA matters such as paying for solicitors, lawyers, barristers and court proceedings with no
positive results, and still being unable to contact their children. It is important to point out
that 59% of the sample in this thesis were in financial difficulty. Many targeted parents
needed to represent themselves in court because they could not afford legal representation.
Some, gave up the legal fight after trying every legal avenue available to them. Hence, when
working with targeted parents, it is important to consider that they often seek legal resolution
to alienation with little or no positive outcome.
Parental alienation in courts is a challenge because it often involves allegation of
family violence and abuse that are denied by the other party (Haines et al., 2020). PA is a
complex phenomenon and the legal system needs to be aware of it, and importantly, the
judiciary needs to be informed about the existence of effective interventions for PA.
Moreover, people working with targeted parents, such as legal counsels, need to be aware
that they are working with clients who are distressed and may be suicidal. It is important to
consider this because the way people work with or represent targeted parents not knowing
about what they are experiencing, could exacerbate their distress, putting them at risk of
further harm and making the scenario worse.
The current system in Australia provides parents with every opportunity to resolve
their conflict post family separation themselves before a judge determines their fate.
However, the legal process in resolving PA involves competing issues (e.g., views expressed
by the child about with whom they wish to reside or allegations of family violence and abuse)
that complicates the cases before the court (Haines et al., 2020). Because of the competing
issues, substantial amounts of evidence are presented in court trials making the process
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lengthy and costly. Meanwhile, alienating parents can use the length of time of this process to
their advantage, having the opportunity to be with the children to continue their alienating
behaviours while the child has limited counteracting contact with the targeted parent
(Vassiliou & Cartwright, 2001).
Recently, an interim report presented by the Joint Select Committee on Australia’s
Family Law System (Parliament of Australia, 2020) reviewed how the Family Court and
Federal Magistrates Court handles complex matters. The findings of this inquiry are
consistent with the findings of this thesis, especially those regarding the disadvantageous
situation in which target parents find themselves in the judicial system. One topic discusses in
this interim report was the issue of shared parental responsibility. The topic of Shared
Parental Responsibility was introduced in the Family Law Amendment, Act 2006 (Cth) of the
Family Law Act 1975 (Cth) (FLA) by the Australian Parliament in 2006. This Act ensures
that after family separation, both parents automatically have shared parental responsibility of
their children unless a court orders says otherwise. The interim report recommends this part
of the Act be repealed. Repealing this legal presumption would make it easier for an
alienating parent to legally engage in alienating behaviours and harder for a targeted parent to
combat these behaviours. Therefore, professionals working with targeted parents must
consider that these parents may be trying to seek legal resolution to the alienation in a system
that may be unable to facilitate the desired outcome.
7.3. Evaluation: strengths, limitations and future research.
The research in this thesis was conducted in order to develop a greater understanding
of targeted parents’ experiences and needs; and assist in the development of future
appropriate support services and intervention programs for them. This thesis has provided
valuable information about the experiences of targeted parents of PA and it has contributed to
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the literature by adding and confirming evidence in this field of research. Although research
about targeted parents is still limited, research about PA is growing. Because of the
seriousness of the problem, it is the interest of scholars and researchers to generate more
knowledge and understanding of this phenomenon, as shown in the systematic literature
review (Chapter IV). This systematic literature review has been an important piece of
research contributing to the research field because it identified gaps in the prior literature. It
presented the need for further research in PA, especially regarding targeted parents
experiences around the world. Further, research questions that remain unanswered include:
How is PA experienced by gender of targeted parent? How does PA affect the identity of a
parent? Is the experience of PA similar or different cross-culturally? These questions are an
opportunity to maintain the efforts of increasing the understanding of targeted parents’
experiences through evidence-based research.
It is important to recognise the limitations of the systematic literature review
presented in this thesis in order to take them into account when conducting future reviews on
this topic. First, the scarce number of articles meeting inclusion criteria and the
methodological nature of the studies restricted any possibility to compare the findings or
conduct a meta-analysis. Second, the review was limited to published peer-reviewed research
excluding grey literature. Finally, the findings of this review may not be generalisable as
most of the studies were conducted in the United States and therefore lacking information
across cultures.
Furthermore, it is recommended from the review presented in this thesis that future
studies investigate personality profiles of alienating and targeted parents because this
information may help to elucidate whether there are any common characteristics shared by
targeted parents and alienating parents. It is also recommended that valid and reliable
instruments to measure PA and assess risk of becoming a targeted parent be developed. In

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general, more qualitative studies are needed to understand the experience of targeted parents
from their perspective and more quantitative studies are required to elaborate a profile of the
targeted parent. Understanding how individuals experience PA and identifying the common
characteristics might be the first step in developing appropriate interventions.
In addition, this thesis has reported on the experiences of 54 targeted parents. These
reports have contributed important information to the academic literature. From Study Two
and Study Three (Chapter V and Chapter VI) it has been possible to demonstrate, verify and
confirm the suffering targeted parents experience when they are rejected by or alienated from
their own children and how they have coped with this experience.
It is important to bear in mind that the findings from Study Two and Study Three are
based on self-reports which are vulnerable to bias. A sample of 54 participants is a large
sample for a qualitative-descriptive study. Such a large sample allowed for a rich description
of the experiences of targeted parents of PA direct from the sample of interest. The narratives
of the participants have been treated as true in these studies; however, it cannot be guaranteed
that all participants were indeed targeted parents or that targeted parents had an adequate
level of self-awareness to allow accurate descriptions. In addition, selection bias may also
have had an impact in the narratives of the participants because targeted parents participating
in this study were recruited mostly from social support online groups and legal and
psychological practices. From this, it can be inferred that the participants were more likely to
speak out about their experiences than those targeted parents that suffer alone with no help
and support. Nevertheless, the employed method was the best way to obtain and access
information pertaining to their experiences of targeted parents.
Future research into the experience of PA can avoid this limitation by using a variety
of sampling and data collection methods such as snowballing, referrals from healthcare and
legal providers or direct advertising in newspapers or bulletin boards. Furthermore, future

200
research should consider conducting prospective studies, following targeted parents’
experiences in ‘real time’ avoiding disclosure of memories.
A qualitative descriptive study has the strength of providing a comprehensive
summary, in everyday terms, of specific events experienced by individuals when researchers
seek to describe a phenomenon, wanting to know the who, what and where of the events
using a low inference interpretation (Bradshaw et al., 2017; Sandelowski, 2000). However,
one possible limitation of this type of design is that summarising and finding commonalities
via themes avert the exploration of unique individual experiences. Future research might
consider exploring the lived experience of targeted parents from a more traditional qualitative
perspective (e.g., phenomenology) to capture the deep meaning of the phenomenon and more
specifically the experiences of targeted parents of PA.
Equally important is investigating gender differences to understand divergence of the
impact of PA on targeted parents. Certainly, targeted mothers who are alienated from their
children may have different experiences than targeted fathers, especially in relation to
experiences of family violence (Balmer et al., 2017; Poustie et al., 2018). Although Chapter
V presented some gender differences regarding family violence experienced by targeted
parents before the alienation occurred, the aim of this thesis was not to considering gender
differences in the targeted parents’ experiences of PA. The aim of this thesis focused on
targeted parents’ experiences of PA broadly. It is highly recommended that future research
includes this variable. It has been suggested (Kruk, 2010ab) that legal and judicial system
hold responsibility in perpetuating PA, being a significant barrier to targeted parents having
ongoing meaningful relationships with their children. Future research should consider
exploring this further.
Researcher bias may have also influenced the results, as an inherent limitation of
thematic analysis. However, every attempt was made to conduct the research within a purely
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inductive, data-driven manner and following the trustworthiness criteria to avoid bias
(described in Chapter III). Future research could employ both qualitative and quantitative
research methods to address this. In addition, this study might lack statistical generalisability
as it is qualitative descriptive research. However, it allows for theoretical generalisation that
can be compared and contrasted with other contexts and settings (Yin, 2003), contributing to
the knowledge base around targeted parents’ experiences of PA and giving them a voice to
express and share those experiences. Future research should also consider working with a
sample consisting of as many ‘players’ in the PA dynamic as realistically possible and access
to collateral documents where appropriate. Exploring the experiences of each member of the
alienated family and consulted collateral documents may cover the need to verify the
accuracy of the data.
This thesis has contributed important research to the field of PA, specifically by
filling gaps regarding targeted parents’ experiences. However, there is still a need for more
research particularly in relation to targeted parents’ experience of disenfranchised grief; on
how PA affects their well-being; and on how they address their feelings and their ability to
cope. Finally, it is important to highlight the necessity of more research based on the
development, implementation and evaluation of intervention programs for targeted parents in
order to assist them in coping with the alienation.
In conclusion, despite the limitations this research can present, the strengths of this
research are in the contribution it makes to the academic literature on understanding the
experience of targeted parents. This research contributes to a blossoming field of research
(Harman, Bernet, & Harman, 2019) on, until now, the forgotten parents.
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Appendix A: Information sheet
Targeted Parents’ Perspective of Parental

Alienation
You are invited to participate in a study exploring the experiences of parents who have been
alienated from their children. This study is being conducted by Sau-Lyn Lee Maturana (PhD
candidate) and Lauren Reading (Master of Clinical Psychology student) under the
supervision of Dr Mandy Matthewson.
What is the purpose of this study?
The aim of this study is to examine the experiences of parental alienation from the
perspective of the parent who is alienated from their child and how they have coped with
parental alienation.
Who can participate?
You have been invited to participate in this study because our research targets are a parent
over the age of 18 years in the general population, who is currently alienated from one of
your biological children. It is important to acknowledge that your participation is voluntary,
whilst your involvement is appreciated, your right to decline this invitation is respected and
this decision will have no consequences. Additionally, if you decide to withdraw your
consent to participate at any stage during the study, you may do so without providing an
explanation. Your information will be kept completely confidential, you will be identified by
a unique code, and no names will be used in the publication of this research. All information
will be kept in a locked storage compartment and a secure computer file.
What will I be asked to do?
You will be asked to attend an interview at the Psychology Research Centre at the University
of Tasmania in Sandy Bay. If you are unable to attend University of Tasmania an interview
via Skype or telephone can be arranged. This interview will be conducted by one of the
researchers and will involve being asked a range of questions about your experience with
parental alienation and how you have coped with it. These interviews will be audio recorded
for data accuracy purposes, and you will be provided with a copy of your interview transcript.
You have the option to edit this transcript if you choose. Only the edited version of your
transcript will be used in the research. The interview will take approximately 1 hour.
Are there any possible benefits from participation in this study?
If you participate in this study you may gain a greater understanding of your own experiences
of parental alienation and how you cope with this experience. The results of the study may
have implications for the development of improved therapeutic assistance for people
struggling with similar alienated relationships.
Are there any possible risks from participation in this study?

215
There are no specific risks associated with participating in this study. However, if you do
become concerned or stressed during or after the interview please inform Dr Mandy
Matthewson, Sau-Lyn Lee Maturana or Lauren Reading who will provide you with
information about free counselling services that may assist you or you can contact the free
counselling services listed below:
Family Relationships Advice Line - Ph: 1800 050 321
Lifeline (Crisis Counselling) - Ph: 13 11 14
Family Violence Counselling and Support - Ph: 1800 608 122
Beyond Blue - Ph: 1300 22 4636
What if I change my mind during or after the study?
You are free to withdraw from this study at any time, and if you decide to do so, you may
without providing an explanation. Also, you can withdraw your information provided to us
up to three months after your interview.
What will happen to the information when this study is over?
The data from this study will be stored in a Division of Psychology locked storage
compartment and a secure computer database. The data will be destroyed five years after the
publication of the thesis via secure document disposal and deletion of files (November 2021).
The data will be kept in a confidential manner and only the researchers involved in this study
will have access to this data.
How will the results of the study be published?
This study following completion will be accessible on the University of Tasmania website
(www.utas.edu.au), and will be produced as publication in a journal. Participants will be non-
identifiable in the publication of results. It is anticipated that results will be available by the
end of 2017.
What if I have questions about this study?
Please direct any questions or concerns about this study to Dr Mandy Matthewson:
Parental.Alienation@utas.edu.au
“This study has been approved by the Tasmanian Social Sciences Human Research Ethics
Committee. If you have concerns or complaints about the conduct of this study, please
contact the Executive Officer of the HREC (Tasmania) Network on (03) 6226 7479 or email
human.ethics@utas.edu.au. The Executive Officer is the person nominated to receive
complaints from research participants. Please quote ethics reference number H0015333.”
216
Appendix B: Consent Form
Targeted Parents’ Perspective of Parental Alienation
Consent Form for Individuals:
1. I have read and understood the Information Sheet for this study.
2. The nature and possible effects of the study have been explained to me.
3. I understand that the study involves examining the experiences of parental alienation, and
how this might help the researchers better understand the phenomenon of parental alienation
in an attempt to better assist people dealing with this issue.
4. I understand that participation involves no foreseeable risks.
5. I understand that all research data will be securely stored on the University of Tasmania
secured server, and that all questionnaire hard copies will be securely stored in a locked filing
cabinet on the University of Tasmania premises for five years from the publication of the
study results, and will then be destroyed
6. Any questions that I have asked have been answered to my satisfaction.
7. I understand that participation in this study is voluntary and any information I provide will be
will kept confidential.
8. I understand that the results of the study will be published so that I cannot be identified
9. I understand that participation is voluntary and that all individuals may withdraw at any time
without any effect. I understand that I can withdraw any information I provide to the
researchers up to three months after participation.
10. I agree to participate.
Participant’s name: _______________________________________________________
Participant’s signature: ____________________________________________________
Date: ________________________
Statement by Investigator
I have explained the project and the implications of participation in it to this volunteer and
I believe that the consent is informed and that he/she understands the implications of
participation.
If the Investigator has not had an opportunity to talk to participants prior to them participating, the
following must be ticked.
The participant has received the Information Sheet where my details have been provided so
participants have had the opportunity to contact me prior to consenting to participate in this
project.
Investigator’s name: _______________________________________________________
Investigator’s signature: ____________________________________________________
Date: ________________________
217
Appendix C: Targeted parents’ screening tool
Targeted parents’ perspective of parental alienation

study: Check list with rating scale
HREC Reference No: H0015333
Please indicate whether you have experienced any of the following:
1. Has the other parent of your child(ren) denigrated you to you and others?
Yes ☐ No
Never Sometimes Often Very Often Always
2. Has the other parent of your child(ren) vilified you? (for example, has the other parent
alleged that you are dangerous in some way without any evidence to support these
allegations)
☐ Yes ☐ No
3. Has the other parent interfered with your time with your child(ren)? (for example, made
plans that directly disrupted contact with your child(ren)
☐ Yes ☐ No
4. Has the other parent attempted to eradicate you from your child(ren)’s life? (for example,
deliberately failed to pass on messages, birthday cards, gifts, etc. to your child(ren) from
you)
☐ Yes ☐ No
5. Has the other parent controlled the information you receive about your child(ren)? (for
example, the other parent has failed to inform you of important school events or medical
appointments)
☐ Yes ☐ No

218
6. Are you aware of instances when the other parent has interrogated your child(ren) about
time they have spent with you? (for example, the other parent has wanted to know what
happens while you were with you in detail)
☐ Yes ☐ No
7. Has the other parent deliberately tried to damage the loving connection between you and
your child(ren) (for example, told your child untrue stories to make them question your
relationship with you)?
☐ Yes ☐ No
8. Are you aware of the other parent telling your child(ren) inappropriate negative
information about you? (for example, disclosing negative information about you with the
intention of portraying you as flawed)
☐ Yes ☐ No
9. Are you aware of the other parent actively encouraging your child(ren) to defy you? (for
example, encouraging your child(ren) to confront or resist you)
☐ Yes ☐ No
10. Are you aware of instances where the other parent has emotionally manipulated your
child(ren)? (for example, the other parent withdrawing affection if your child(ren) speak
positively about you)
☐ Yes ☐ No
11. Are you aware of instances where the other parent encourages your child(ren) to choose
between you and them? (for example, the other parent making it clear that they were not
willing to tolerate your child(ren) having a relationship with both their parents)
☐ Yes ☐ No

219
12. Are you aware of instances where the other parent has encouraged your child(ren) to be
excessively dependent on them? (for example, the other parent leading your child(ren) to
believe that they are the only one who can look after them properly)
☐ Yes ☐ No
13. Does the other parent use outside forces to facilitate the separation of you and your
child(ren)? (for example, making false allegations about you to child protective services,
police, lawyers etc)
☐ Yes ☐ No
Thank you for your time

220
Appendix D: Ethical Approval

222
Appendix E: Reflexive Statement
I felt it was necessary to write and share this reflective statement with the readers in
order to make known what it has been like as a PhD student studying parental alienation from
the perspective of targeted parents.
I have been a psychologist since 2005 and I am a mother of two beautiful kids, a 10-
year-old girl and a two-year old boy. At the beginning of my career, I worked as a clinical
psychologist and I also worked for two years full time in a school, always with a focus on
families and children. I also have been working as a lecturer since 2007, at the ‘Universidad
de Tarapacá’ (University of Tarapacá) in my home country Chile; teaching human
developmental psychology, social psychology, communication and social skills and
psychological assessments. As part of my duties as a lecturer, I was involved in research. It
was then when I decided to come to Australia to study my PhD. I wanted to acquire the
knowledge and skills to become a researcher. Until then, I was not aware of what parental
alienation was.
I started to read about parental alienation, in books, magazines, blogs and journal
articles. It was hard to believe the stories. It was hard to make sense of the literature, not
because the contents were hard to understand or because reading was difficult, but because it
was difficult to understand how there can be such bad practices in the handling of parental
alienation cases.
The most difficult part I had to face was at the beginning of the research, when I
started to interview targeted parents. I guess my experience as a psychologist made me
handle the interviews well (or at least I thought I did), even though the English language was
at all times a challenge (I am a Spanish speaker). The worst part came after the interviews, at
night, when I was at home. I remember feeling distressed, sad and anxious for no apparent
reason. I remember looking at my kids with that feeling of gratitude because I had them with
223
me, but at the same time with a pain in my heart of just thinking that I could lose them. I
realised I was feeling the pain of the targeted parents. I was being affected by their stories. I
was being consumed. I was emotionally exhausted.
I talked to my primary supervisor about how I was feeling. She kindly supported me
and understood what I was going through. She suggested to me to start self-care practice. For
example, I limited the number of interviews per day, and I started to leave work out of home.
I also went to a psychologist. It is always good to get some help in solving internal-
unresolved issues. Fortunately, the source of my distress was the way I was getting into a
topic that is complex and emotionally overwhelming. But, knowing what I was facing and
putting into practice some self-care activities I was able to continue with the interviews, with
the research, with my studies. I focused again on the research and managed to retake the
empathetic but neutral posture that a psychologist should have.
Identification with the participants? Failure to split the roles of professional and
mother? Ignorance about the topic and how to handle it? Lack of experience on the topic?
Unconscious and unknown fears? Lack of skills? Whichever it is, I learned that working in
the parental alienation field, even if it is from an external position as is research, it is hard.
And it is harder if you do not know or understand what you are getting into. As confident as I
felt as a psychologist, as a PhD student and as a person, I felt during that period that I was
failing. Now, I think it was part of the process; a process of learning, a process of getting to
know the phenomenon of parental alienation.
From this, a couple of questions came into my mind. For example, would this
emotional burden be the reason why people avoid working with or studying parental
alienation? Or maybe, because it provokes so many revolting emotions, clinicians or law
practitioners find themselves a little lost in this area? Maybe, maybe not.
224
However, I’m happy to share what was part of my process during my PhD study. I am
happy I had the opportunity to realised what was happening to me, so I could focus and tried
as much as possible to keep myself out of interpretations of the participants’ narratives, and
subsequent analysis. I am happy to have had the opportunity to study and understand the
phenomenon of parental alienation. And I am happy to have met people as brave as targeted
parents are.

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University of Tasmania Open Access Repository

Sau-lyn Lee Maturana, Psy. Mg.

Submitted in fulfilment of the requirements for the Degree of Doctor of

Signed: Date: 15 June 2020

Statement of Authority of Access

copying is permitted in accordance with the Copyright Act 1968.

Signed: Date: 15 June 2020

Statement of Ethical Conduct

No: H0015333 (See Appendix D).

Signed: Date: 15 June 2020

Candidate: Sau-lyn Lee Maturana (SLM), School of Psychological Sciences.

Author 1: Dr. Mandy Matthewson (MM), School of Psychological Sciences, University

Author 3: Dr. Kimberley Norris (KN), School of Psychological Sciences, University of

Contribution of work by co‐authors for each paper:

PAPER 1: Located in Chapter IV

Conceptualised the paper: Candidate

Assisted in conceptualising the paper: Author 1, Author 2

Conceived and designed the study: Candidate

Designed and conducted the systematic literature review: Candidate

Analysed the data: Candidate

Assisted in analysing the data: Author 1

Wrote the manuscript: Candidate, Author 1

Review and edit drafts: Candidate, Author 1, Author 2

Review and provided feedback: Author 1, Author 2, Author 3

Help with the development of resubmission letters and revisions: Author 1

PAPER 2: Located in Chapter V

Lee-Maturana, S.L., Matthewson, M., & Dwan, C. (accepted). Understanding targeted

Assisted in conceptualising the paper: Author 1, Author 2

Conceived and designed the study: Candidate

Collected and analysed the data: Candidate

Assisted in analysing the data: Author 1

Wrote the manuscript: Candidate

Review and edit drafts: Author 1, Author 2

Review and provided feedback: Author 1, Author 2

PAPER 3: Located in Chapter VI

Assisted in conceptualising the paper: Author 1, Author 2

Conceived and designed the study: Candidate

Collected and analysed the data: Candidate

Assisted in analysing the data: Author 1

Wrote the manuscript: Candidate

Review and edit drafts: Author 1, Author 2

Review and provided feedback: Author 1, Author 2

______________________ ______________________ ______________________

15 June 2020 28 June 2020 13 July 2020

Statement regarding Published Work contained in this Thesis

copying and communication in accordance with the Copyright Act 1968.

Signed: Date: 15 June 2020

to come several times to help us with the kids.

consider different perspectives of my research.

Statement of authority of access……………………………………………….. III

Statement of ethical conduct…………………………………………………… IV

Statement regarding published work contained in this thesis………………….. VIII

List of figures…………………………………………………………………... XVII

List of abbreviations……………………………………………………………. XVIII

2. Theoretical and historical background...…………...…..…………………………….........32

2.2. Syndromes that describe PA.................................................................................34

2.3. History of PA........................……………………………………………………42

2.4. The alienating parent…………………………………….……………………....56

2.5. The child…………..............……………………………………………………..60

2.6.The targeted parent……………………………………………………………….61

3. Methodology and Methods.......…..…………………………………………......................65

3.1. Research questions and aims.................................................................................65

__