Presented at the XXI International School Psychology Colloquium -- 31 July - 4 August 1998 in Riga, Latvia
Published in Identity & Self Esteem: Interactions of Students, Family, & Society, eds. S. Sebre, M. Rascevska, S. Miezite, pp. 253-260, Riga: SIA

Intervention-guided single case-help and parental alienation syndrome (PAS)
differential diagnosis and treatment approaches

Dr. Werner G. Leitner, Bamberg, Germany

Due to high divorce rates children and parents involved in separation- and divorce conflicts comprise a significant fraction among the clients of school psychological counseling. From the viewpoint of school psychology, the so-called "parental alienation syndrome" appears to be especially relevant for the mental health of affected children. The term "parental alienation syndrome" is attributed to GARDNER, who has extensively dealt with the subject in his work "The Parental Alienation Syndrome. A Guide for Mental Health and Legal Professionals" (GARDNER, 1992).

PAS could also be described as conscious and unconscious programming of children within visitation- and custody conflicts of their parents.

KODJOE and KOEPPEL (1998) consider also the designation "Induced parent-child alienation" to be adequate.

In his article "recommendations for dealing with parents who induced a parental alienation syndrome in their children" (GARDNER, 1997, 1) the parental alienation syndrome is seen to be "a disorder that arises almost exclusively in the context of child-custody disputes. It is a disorder in which children, programmed by the allegedly 'loved' parent embark upon a campain of denigration of the 'allegedly' hated parent." In this context GARDNER (see above) notices that "unfortunately the term parental alienation syndrome is often used to refer to the animosity that a child may harbor against a parent, who has actually abused the child, especially over an extented period. The term has been used to apply to the major categories of parental abuse, namely, physical, sexual, and emotional". Such application would indicate a misunderstanding of PAS. "This term is applicable only when the parent has not exhibited anything close to the degree of alienating behaviour that might warrant the campain of denigratiion exhibeted by the child" (see above).

GARDNER (see above) sees a difference between mothers and fathers concerning such programming, but it is also to be seen that mothers in the majority of cases are in a different position concerning custody and visitation right:

"Most often mothers are the initiators of such programming and fathers are the victims of the campain of deprecation. Less often it is the father who is the victimizing parent. Furthermore we are not dealing here with simple 'brainwashing' by one parent against the other."

GARDNER (1992 / 1997) describes three types, the mild, the moderate and the severe type of parental alienation syndrome: "In the mild type the alienation is relatively superficial and the children basically cooperate with visitation, but are intermittently critical and discruntled. In the moderate type, the alienation is more formidable, the children are more disruptive and disrespectful, and the campain of denigration may be almost continual. In the severe type visitation may be impossible so hostile are the children, hostile even to the point of being physically violent toward the allegedly hated parent" (GARDNER, 1997, 1) also describes other forms of acting out. "In many cases the children's hostility has reached paranoid levels, that is, delusions of persecution and/or fears that they will be murdered where there is absolutely no evidence that such will be the case".

According to GARDNER (1992 / 1997) there are the following primary manifestations of the parental alienations syndrome.

* The Campain of Denigration

* Weak, Frivolous, or Absurd Rationalizations of the Deprecation

* Lack of Ambivalence

* The independent-Thinker Phenomenon

* Reflexive support of the Alienating Parent in the Parental Conflict

* Absence of Guilt Over Cruelty to and/or Exploitation of the Alienated Parent

* The Presence of Borrowed Scenarios

* Spread of the Animosity of the Friends and/or Extended Family of the Alienated Parent

Eight Primary manifestations of PAS according to GARDNER (1997, 1)

Differential Diagnosis and Treatment Approaches

GARDNER (see above) also remarks that his article concerning recommendations for dealing with parents has been written because of certain misinterpretations of the recommendations he made in his book on the PAS. "Although these recommendations are stated in the book, there are situations in which they have not been implemented in the appropriate manner, sometimes with unfortunate and even disastrous results“ (see abpove). In addition, he now presents certain refinements and elaborations that he has come to appreciate since the publication of the original book in 1992. These are summarized in the following tables.







The Campaign of Denigration




Weak, Frivolous or Absurd Rationalizations for the Deprecation



Multiple absurd


Lack of Ambivalence

Normal ambivalence

No ambivalence

No ambivalence

The Independent-Thinker Phenomenon

Usually Absent



Reflexive Support of the Alienating Parent in the Parental Conflict




Absence of Guilt

Normal guilt

Minimal to no guilt

No guilt

Borrowed Scenarios




Spread of the Animosity to the Extended Familiy of the Hated Parent



Formidable, often fanatic

Transitional Difficulties at the Time of Visitation

Usually absent


Formidable or visit not possible

Behavior During Visitation


Intermittently antagonistic and provocative

No visit or destructive and continually provocative behavior throughout visit

Bonding with the Alienator

Strong, healthy

Strong, mildly to moderately pathological

Severely pathological, often paranoid bonding

Bonding with the Alienated Parent

Strong, healthy, or minimally pathological

Strong, healthy, or minimally pathological

Strong, healthy, or minimally pathological

Differential Diagnosis of the Three Types of Parental Alienation Syndrome according to GARDNER (1997, 9)

Legal Approaches Court ruling that primary custody shall remain with the alienating parent.
Plan A
(Most Common)
  1. Court ruling that primary custody shall remain with the alienating parent.
  2. Court appointment of PAS therapist.
  3. Sanction:
    1. Money
    2. House arrest
    3. Incarceration
Plan B
(Occasionally Necessary)
  1. Court ruling that primary custody shall be transferred to the alienated parent.
  2. Extremely restricted visitation by the alienating parent, under supervision if necessary, to prevent indoctrination.
  1. Court-ordered transfer of primary custody to the alienated parent (in most cases).
  2. Court-ordered transitional site program.
Psychotherapeutic Approaches None usually necessary Plan A
(Most common)
Treatment by a court-appointed PAS therapist

Plan B
(Occasionally necessary)
Monitored transitional site program

Therapist-monitored transitional site program

Differential Treatment of the Three Types of Parental Alienation Syndrome according to GARDNER (1997, 10)

GARDNER (1997, 8) empasizes that evaluators never should lose sight of the "crucial medical dictum: diagnosis before treatment". In his book concerning "Intervention-guided single case-help in counseling" LEITNER (1994) however notices that diagnosis and treatment should not be separated too much. Therefore, an intervention-guided single-case help in cases of PAS would empasize specific connections concerning diagnosis and treatment in a flexible way also in cases of PAS:

Nevertheless beyond this background, according to GARDNER (1997, 8) it seems to be very important to define PAS and its specific category exactly.

PAS in publications and psychological expert assessments ordered by family courts in Germany

One finds a number of publications in the American scientific literature in the fields of psychology, psychiatry and forensic science concerning PAS. Equally, PAS is also recognized and explicitly considered by American family courts. In Germany, however, PAS is rarely explicitly considered in family psychological expert assessments and by the courts ordering such assessments. Apart from the recent papers by KLENNER (1995), KODJOE & KOEPPEL (1998), WARD & HARVEY (1998), BAKALAR (1998), FISCHER (1998) there is hardly any literature in German dealing extensively and explicitly with PAS. KODJOE and KOEPPEL (1998) also could not find any explicit references to PAS or the pertinent literature in German psychological expert assessments. This deficit is confirmed by LEITNER (1998):






































N=50 psychological expert assessments ordered by german family courts


Family psychological expert statements represent a basis for decisions with lasting consequences for the life of children after separation and divorce and have a decisive influence also on the cooperation between custodial person - school also concerning school psychological services.

New relevant research regarding also the parental alienation syndrome should no longer be explicitely excluded in these assessments.

Professional differential diagnosis and treatment approaches in the context of an intervention-guilded single-case help may be important on different levels to help children coping with those conflicts and to avoid the inducing of a parental alienation syndrome with lasting consequences concerning the whole life-span.


Bakalar, E. (1998). Das „Parental Alienation Syndrome“ (PAS) in der Tschechischen Republik, ZfJ 85, 6, 268.

Fischer, W. (1998). Die Bedeutung des PAS-Syndroms für die Jugendhilfe-Praxis. Insitut für Familienmediation. Unveröffentlichtes Manuskript.

Gardner, R.A. (1992). The Parental Alienation Syndrome, Cresskill, New Jersey, Creative Therapeutics.

Gardner, R.A.(1997). Recommendations for Dealing with Parents who induce a Parental Alienation Syndrome in their Children, Cresskill, New Jersey, Creative Therapeutics.

Klenner, W. (1995). Rituale der Umgangsverweigerung bei getrennt lebenden oder geschiedenen Eltern, FamRZ 12, 1530.

Kodjoe, U. & Koeppel, P. (1998). The Parental Alienation Syndrome (PAS), Der Amtsvormund 1, 10-140.

Leitner, W.G. (1994). Interventionsgeleitete Einzelfallhilfe im Rahmen einer Beratung im Schulbereich. Bezugs­rah­men und theo­retische Grundlegung. Intervention-guided single case-help in counseling within schools. Frame of reference and theoretical foundation. Regensburg: Roderer.

Ward, P. & Harvey, J.D. (1998). Familienkriege - die Entfremdung von Kindern, ZfJ 85, 6, 237-245