Reunification Therapy: A Comparison of Outcomes in the UK Family Court System

The Family Separation Clinic specialises in reunification therapy in cases where children resist or reject contact with a once loved parent.  We regularly achieve successful outcomes in our work using a wide range of different approaches and interventions which are matched to our differentiation of the underlying reasons why a child is in such a situation.

This week we have been reviewing two cases in which we have successfully reunited children with the parent they were once adamantly rejecting and I thought it would be worth sharing some of the key indicators in these two very different cases.

The only thing at the outset which was the same in each of these cases was that the children involved were completely rejecting, all to the point of hysterical refusal on attempts to help them see a parent.

Case 1: Four children, aged between 8 and 13, all rejecting their mother. Children were refusing outright, had not seen their mother for 18 months and had made allegations of physical abuse.  Children were removed from father and took less than 2 days to reunite with her as part of a planned therapeutic removal and intervention.

Case 2:Two children aged 7 and 11, both rejecting their father.Children were refusing outright, had not seen their father for 24 months and took 18 months to move from refusal to being able to spend one overnight each week with their father under a therapeutic support plan which involved intensive work with mother, father and children.

Key indicators.

Case 1:  Assessed as pure alienation in which father had consciously or unconsciously influenced all of the children and in which role corruption was at play with the eldest female child acting as pseudo wife to father.   Assessment showed high levels of anxiety, control and manipulation behaviours in father and sharing of adult information with the eldest two children who then maintained a strong influence over the younger two until they too rejected their mother.  Court decision was to remove and reunite children with their mother using a stepping stone intervention via foster care. In the event the foster care process lasted less than 48 hours as the children all asked to see their mother on removal from father. Key intervention was removal from the unhealthy parent and therapeutic work to support reconnection with mother and processing of influenced beliefs. Reconnection with father is pending work to help him to establish insight.

Case 2: Assessed as hybrid alienation in which mother had been seen to influence the children but father had been seen to contribute to the children’s lack of trust due to his withdrawal from seeing the children on three occasions throughout the  12 months prior to reunification work. Case was reconfigured as on the cusp of pure as father was seen to change his behaviours and show insight and mother continued to be fixed in her views. Use of the court process to determine the facts in the case and enforce intervention lead to change of heart in mother who then joined the reunification programme and committed to change. Process took eighteen months to both children being able to spend overnights with father. Key intervention was use of the court process to clarify facts and to ensure that progress was made consistently in line with therapeutic intervention.

Case references for both of these cases will be available shortly.



Both of these cases were assessed using the differentiation and triage route developed by the Clinic.*  Intervention was planned by mapping the outcome of assessment against the delivery of a planned treatment intervention within a court managed process.

Neither of these parents were assessed as having a personality disorder in clinical assessment, in case one there was a demonstrable issue with role corruption which was recognised and acknowledged in assessment, in case two there were no concerns raised in assessment about mother’s psychological or psychiatric profile.

In both cases court management and the mental health intervention was interlinked with the therapist taking responsibility for ensuring that the therapy made progress or the intervention worked by using the court to enforce where necessary.

These cases demonstrate for us at the Clinic that it is not yet possible to determine that a routine separation protocol for all cases identified as alienation of a child is the right way to approach the problem of children’s resistance or rejection of a parent after separation.

Whilst it is always desirable to relieve children of the burden of their adaptive behaviours when captured in an alienation situation, it is not possible in our view to achieve that quickly in every case because every case is not a pure case and every case of alienation does not involve a personality disordered parent.

Whilst we note that the campaign to embed the analysis of Dr Craig Childress’s pathogenic parenting profile into the American Psychological Association is gathering pace, we do not believe that it is useful to support that approach for the UK at the present moment without significant research evidence and education of British Psychologists and Psychiatrists who are working with the issue of alienation.  For as long as we are receiving assessments from psychologists and psychiatrists which identify alienation but do not identify parents as having personality disorders, we will continue to use the differentiation route which has been developed at the Family Separation Clinic to match intervention to case profile, delivering separation protocols where they are indicated as necessary and therapeutic intervention which is court managed elsewhere.

We are in agreement however, that family therapy as a standard intervention in parental alienation cases is contraindicated and would urge anyone who is recommended to have any kind of stand alone family, child or adult therapy without court management included to exercise the greatest caution.  Anyone who professes to be expert in the field of parental alienation should be aware that therapy in these cases cannot be delivered without strong court management and that therapists delivering this must be prepared to both manage the therapy and the court intervention necessary to make this work. Failure to do so is, in our view, placing children and parents into open ended therapeutic programmes which could make matters worse not better.  Any expert who recommends family therapy for a case of parental alienation, without being able to explain why it is not contraindicated or how it will be managed within the court process, should be treated with caution.  An expert who is unable to offer testimonials from families who have been helped or case reference numbers for successful cases should be avoided.

* The differentiation route used at the Family Separation Clinic is based upon the work of Bala and Fidler.  Cases are triaged, categorised and then matched to previously successful cases. Where necessary psychological or psychiatric profiling is requested in order to closely match intervention to treatment route.  Currently we are refining a co-working model in which clinical psychologists/psychiatrists, therapists, therapeutic mediators, parenting co-ordinators and on occasion Guardians and Social Workers all work together on a case from start to finish. Evaluation is ongoing and will be available this year.






  1. This is wonderful Karen and well done. Such professional acts you promote and provide a loving reconciliation is worthy of a Nobel Peace prize, for real peace. All I would add that such reconciliations would be naturally forthcoming if we had Anti-Parental Alienation legislation which I have written about on this blog and is now well known. The whole situation as you know is coming to a head, like the mega volcanic activity under the Yellowstone Ecosystem area in NW America!


  2. Hi Karen, glad to see some successes here. However, isn’t it sad that situations still progress to this level of alienation. I commend all the work that is being conducted at the moment to stop things ever escalating to this level and I am sure we all welcome the day when interventions such as this are unnecessary. In the meantime I believe we should all be doing our best to raise the evil profile of parental alienation amongst general public.


  3. This was not a scientific study, but an observation, and I observed a few other conclusions. First, reunification with protective separation took 2 days while reunification without protective separation took 18 months! That’s a lifetime to an 11 year old. Are you saying that the family in case 2 would NOT have reunified if you had implemented protective separation? If so, on what basis? If not, why prolong and delay reaching the desired outcome?
    Second, clinically diagnosing personality disorders is inconclusive at best, but that is not the primary issue. Regardless of the parent’s diagnoses, the children had been subjected to intense trauma from one parent. This abuse was disrupting their normal development. Third, I have never heard of a targeted parent, simply “opting out” of placement time with their children. In fact, I find it offensive to conclude that the targeted parent contributed in any way to the children’s rejection of them. If the targeted parent was not committed to the relationships, then why were they even at your clinic?
    Fourth, the primary issue is that the children were expressing the clinical indicators of child psychological abuse. I am assuming that your outcome is to ameliorate these symptoms in the most efficient and effective way.


    1. Kay, No-one claimed it was a scientific study. No-one claimed that the Clinic was the decision maker in the two cases. No-one said that 2 days versus 18 months was a good thing. No-one said that the Clinic has an automatic right to implement a protective separation but chose not to. You read all those things into this piece becauseyou are a fan of Doc C and you are convinced that he is right and everyone else is wrong. You are also a fan of psychological splitting – one parent good, one parent bad, I can see that. You clearly do not see Doc C’s repeated advice that personality disorder is at the heart of what he calls pathogenic parenting, I am not sure why you cannot see that, he says it often enough. You clearly have not met, worked with or even known parents who opt out of parenting time, there are plenty of them and some of them contribute to their children’s rejection of them, to not take that into consideration is folly. However, no-one said on this blog or at the Clinic or anywhere connected to me that target parents are to blame. Neither did anyone say that protective separation where it is indicated is not what we argue for in such cases. In the UK the Judge makes the decision about whether a child is separated and that is made on the basis that the welfare threshold is met. The welfare threshold is the bar placed on measuring harm to a child, the Judge decides that not the Clinic. The Clinic argues it where it is needed but the Judge makes the decision. Before you come on here telling me what my business is I suggest that you a) read what I write very carefully and b) know what you are talking about. Remember, I dont just write about this stuff I actually go and remove children from alienating parents and place them with the rejected parent. That’s why and how I know what I am talking about. It’s not easy work, it’s not made any easier when someone like Doc C starts targeting me for somehow being something that I am not. There’s a very odd parallell process going on here, I don’t live in a world where you are either with me or agin me, I live in a world where I have learned and am continuing to learn how to live in shades instead of polarised absolutes. Splitting the people who care about alienated children into goodies and baddies is not, in my view, a very useful way to approach the problem. Discussion and dialogue yes, attack and blame, no thank you very much, not on here, not now, not ever.


  4. I have to say though, at the end of the day, Doc C and I are somewhat alike, I cannot help but recognise myself in him. That said, I am learning to live in shades, every day in every way my world is becoming less polarised, more integrated, less absolute, more uncertain. That’s my journey. It makes me a better therapist. I retain my strengths in my work whilst learning not to reflect the splitting which I work with every day. I think splitting is a risk for those of us who work in the field of alienation. Having been the recipient of another professional’s negative projections I see the risks all around us. I am learning daily that this is not about goodies and baddies, it is about people, in all their fragile glory. I like the cut of Doc C’s jib but I am not going to get pulled into this because it is his stuff not mine. We press on. There is much to do.


  5. Hi Karen, interesting subject matter – thank you for posting. 2 quick things:

    Never heard the phrase “hysterical refusal” before. How did this manifest itself?

    Will you be revisiting these cases at some point. In experience , the process of reunification with mum lasts for many years (possibly a lifetime?) and is rarely smooth.


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