When children reject a parent: Dilemmas for mental health professionals
Abigail M. Judge, Ph.D. & Robin M. Deutsch, Ph.D., ABPP
Children who resist or reject contact with a parent following a contentious separation or divorce is a vexing problem for mental health professionals and family courts. Research on this topic is in its infancy, and stakeholders voice strong, polarized narratives on what the problem is and what the solution should be. This context makes effective intervention very challenging.
Why should this population of children matter to the mental health community?
- Cases are on the rise internationally. 
- Outcomes for children can be poor , and it is increasingly difficult to make changes as children mature.
- These matters exact a disproportionate amount of the Court’s time and parents’ resources .
- Traditional mental health interventions in these cases can range from ineffective to frankly harmful.
Parent-child contact problems are on a continuum, and vary from problems related to developmental factors to exposure to abuse or intimate partner violence, misattuned parenting, or some combination therein. Other children’s strident rejection does not comport with the reality of a previous loving relationship (i.e., alienation). Obviously, each of these scenarios will require a different treatment approach. A differential approach to assessing the contact problem is the first critical step .
Unfortunately, too few mental health professionals specialize in this area of practice. Recent writing on family-based interventions for these dynamics provides an overview of the field and highlights one promising approach . Although it is premature to use the language of “best practices,” we can name key principles for working with affected families   :
- Whenever possible, a whole family solution is best.
- Families need a team that works from a shared clinical formulation.
- Clinicians must have competence in navigating court-involved therapy.
- Judicial oversight, coupled with effective treatment, can help families heal.
- The level of conflict among families may be mirrored among treatment teams; careful attention to such dynamics is paramount.
Parent-child contact resistance and refusal is a complex problem that requires a developmental and systems-based lens. Clinicians can help identify these dynamics early in the history of family conflict, prevent entrenched rejection and help children resume healthy development.
Abigail M. Judge, Ph.D. is a clinical and forensic psychologist in private practice in Cambridge, and at the Massachusetts General Hospital. She is on the part-time clinical faculty at Harvard Medical School. Dr. Judge is Clinical Director of Stable Paths of MA, which offers intensive reunification workshops for families affected by high conflict divorce and other trauma. Visit Dr. Judge at: www.abigailjudge.com
Robin M. Deutsch, Ph.D., ABPP is the Director of the Center of Excellence for Children, Families and the Law at William James College in Newton and former Associate Professor of Psychology at Harvard Medical School. She is Board certified in couple and family psychology, a founding member of Overcoming Barriers and a senior consultant for Stable Paths of MA. Visit Dr. Deutsch at www.comprehensiveforensicassoc.com and www.williamjames.edu/cffc
 Bala, N., Hunt, S. & McCarney, C. (2010). Parental alienation: Canadian court cases 1989-2008. Family Court Review, 48, 1: 164-179.
 Johnston, J. R., Walters, M. G., & Olesen, N. W. (2005). The psychological functioning of alienated children in custody disputing families: An exploratory study. American Journal of Forensic Psychology, 23 (3), 49-64
 Sullivan, M.J. (2017). Visitation resistance. Webinar for the Association of Family and Conciliation Courts
 Fidler, B.J., Bala, N., & Saini , M.S. (2013). Children who resist postseparation parental contact: A differential approach for legal and mental health professionals. American Psychology-Law Society Series. New York: Oxford University Press.
 Drozd, L. M. & Olesen, N. W. (2004). Is it abuse, alienation, and/or estrangement? A decision tree. Journal of Child Custody, 1, 65-106.
 Judge, A.M. & Deutsch, R.M. (Eds.) (2017). Overcoming parent-child contact problems: Family-based interventions for resistance, rejection, and alienation. New York: Oxford University Press.
 Fidnick, L., Koch, K., Greenberg, L.R., & Sullivan, M.J. (2011). Guidelines for court-involved therapy: A best practice approach for mental health professionals. Family Court Review, 49, 564-581.
 Judge, A.M. & Ward, P. (2017). The perfect storm: High conflict family dynamics, complex therapist reactions and suggestions for clinical management (pp. 107-130). In A.M. Judge & R.M. Deutsch (Eds.) Overcoming parent-child contact problems: Family-based interventions for resistance, rejection and alienation. New York: Oxford University Press.