[1][2] The child's estrangement may manifest itself as fear, disrespect or hostility toward the distant parent, and may extend to additional relatives or parties.
[9] Some propose that parental alienation be recognized as a form of child abuse or family violence.
[18] They assert that the research performed to date does not support the theory that parental alienation results in the harm described by proponents of the concept.
[19] Studies suggest that independent of other marital issues, acts of parental alienation may be harmful to children.
While not all adults who experience acts of parental alienation during childhood report negative consequences, many report outcomes that they attribute to parental alienation, including low self-esteem, addiction and substance abuse, trust issues, and relationship problems.
For example, a retrospective study of adults found that independent of damage of a child's relationship with the other parent, perceived experiences with parental alienation during childhood correlate in adulthood with lower self-sufficiency, lower self-esteem, higher rates of major depressive disorder, and insecure attachment styles.
[12] Assessment of the impact of parental alienation within the context of legal proceedings, such as child custody litigation, is complicated by the participation of other professionals, including psychologists, lawyers and judges, whose actions and decisions may negatively affect family relationships.
[18] Some mental health professionals argue that severe parental alienation should be established as a form of emotional abuse and domestic violence.
[10] However, controversy persists as to whether parental alienation should be treated as a form of child abuse or family violence.
[19]: 32 It is also necessary to diagnose the whole family system in order to avoid misattributing a child's estrangement to the actions of a parent.
Five treatment programs were evaluated in terms of the levels of evidence provided by the empirical research said to support them.
[44] In order to avoid regulations and oversight that apply to psychological and medical treatment, these programs are often billed as educational or psycho-educational.
[41][45] Some children who have been compelled to participate in family reunification therapy have reported that they were forced to deny their truthful complaints about the parent that was alleged to be alienated.
The rationale of this argument is that the attitude and actions of children who reject a parent without clear evidence of abuse reflects mental illness.
Key among their concerns is that advocates of parental alienation concepts have presented a highly simplified explanation of visitation and contact resistance or refusal by children of couples in high-conflict divorces.
Another concern is that there is a lack of evidentiary support for the concept of parental alienation, as proponents of this theory have failed to meet standards for evidence-based treatment and have never produced empirical support for claimed symptoms of alienation such as "black and white thinking".
[52] Cafcass recognizes the possibility of parental alienating behaviours in family separation cases.
[58][59] During 2019 to 2021 thirty of the thirty-one Irish councils have asked the government to recognise and address parental alienation.
[60] In 2021 the Irish Government included international parental alienation research and public consultation in its Justice Action Plan.
Some courts recognize parental alienation as a serious issue with potential long-term effects and serious outcomes for the child.
[67] An examination of parental alienation U.S. custody decisions, based upon a review of appellate cases, found that courts are significantly more skeptical of child physical and sexual abuse allegations made by mothers as compared to similar claims made by fathers, rendering parental alienation a powerful defense for fathers accused of abuse but not for mothers.
[17] In 2012, in anticipation of the release of the DSM-5, the fifth version of the Diagnostic and Statistical Manual of Mental Disorders, an argument was made for the inclusion of PAS in the DSM-5 as a diagnosis related to parental alienation.
Those advocates assert that children who are exposed to intimate partner distress between their parents may develop psychological symptoms as a result of that exposure.
[85] However, single-factor explanations for a child's estrangement from a parent have not proved valid, and multi-factor models are more complex and difficult to argue in a court setting.
[86] In late 2005, a Canadian activist named Sarvy Emo proposed that March 28 be designated Parental Alienation Awareness Day.
[89][90] There are also organizations that actively oppose the use of the concept of parental alienation and the making of custody decisions based on this belief system.
For example, the Center for Judicial Excellence argues against the use of the parental alienation argument in custody cases.
[92] The Institute on Violence, Abuse, and Trauma (IVAT) devoted a three-hour session at its September 2019 meeting to arguments opposing the use of parental alienation concepts and related claims.