Intake Questionnaire for Formerly Alienated Children

Mild: Subtle undermining, occasional negative comments about the targeted parent

Moderate: Consistent interference, clear pattern of alienating behavior

Severe: Deliberate sustained campaign to destroy the relationship

Complete: I was entirely cut off and had no meaningful contact with the targeted parent

Two separate households with court-ordered visitation or custody arrangement

Two separate households with no formal court structure with some contact with the targeted parent

Two separate households with no formal court structure and no contact with the targeted parent.

One intact household — both parents lived under the same roof throughout

I moved between multiple households including grandparents or extended family

A stepparent in the alienating parent's household

A stepparent in the targeted parent's household

Extended family members actively involved in the alienation

Cross-cultural or cross-language dynamics between households

International elements — different countries involved

Yes but we occupied different roles in the family

Yes, some of my siblings lived with the targeted parent. 

Yes, some of my siblings were alienated from me when I reunited with the targeted parent

Yes and I was directly involved in the process

Yes and it was unhelpful or made things worse