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Photo credit: Aubry Noelle Photography, CA . It is estimated that one out of every 10 children will experience two divorces of the custodial parent before he or she turns 16 (Furstenberg, 1988). Assessing the impact and outcomes of negative
emotions and hopeful outlooks in co-parenting after divorce and stepfamily formation. We pick up where
courts leave off. Simply highlight, copy and past into a new Email, Answer and Return to ResearchResponse@StepfamilySystems.com. For more about the Research Project Manager, click here. Thank
you for your participation in our seven-year or 10,000 respsonse study of issued related to coparenting after divorce and remarriage.
This study is not funded by any outside agencies at this time.. . We are interested in hearing both good and challenging experiences. . ___ This is my first time participating in this research project. ___ This is the ___ year I have
participated in the project (Annual surveys are invited to track progress). . ___ Yes, contact me as a resource for the Parental Alienation Film Project. ___ Yes, I will network and share
this survey link to help reach the goal of 10,000 completed surveys. ___ Yes, I want to attend the movie
based on the A Richter Blend stories premiere (by lottery). . Survey completed by: ____ Biological parent ____ Stepparent ____
Unmarried partner ____ Grandparent ____ other: ____ adult son ____ adult daughter.
I ___ had /___ presently have ___ stepfather, ___ stepmother . State
of residence & county / Country: . If you are responding to this survey as a now-grown child of divorce or remarried parents, please share
more of your experience below part 3 of 3 in a 250 word
summary after checking off the behaviors you exx\perienced. . Begin research survey: . Have you or the children's
other parent disengaged from their co-parenting commitment? . If yes, please share the reason as you know it for the detachment: . ___ We Co-parent well and
have had relatively few problems. Please elaborate on the reasons you believe your households have done well. Was the divorce free from bitterness, etc. . If applicable, do you each simply accept remarriage
and each other's new partners? Please elaborate: . PART 1 of 3: Satisfaction
with Home Environment. 01. What are the characteristics
of a successful stepfamily? 02. What
are the characteristics of a healthy post divorce parent-child relationship? 03. Are you enjoying positive & healthy relationships today? 04. How do you define satisfaction? 05. Have you ever or do you plan on receiving support
services? a. If no, why
not? no I am the provider of disposable income.
b. If yes, what type of support services have you had (_X_); presently use (_P_);
are you considering (_C_): . ___ individual
therapy ___ couples therapy ___ family therapy
___ stepfamily coaching ___ SAM-TM Planning
___ self-help: ___
faith or church-based support ___ peer support via
___on-line chats ___ local support group
___ other: . How did you select your type of service used, and how did you find your
service provider? . Would you like a list of support/service providers mailed or E-mailed to you? . I am presently: 06. ___
Engaged – how long? 07. ___ Married –
how long? 08. ___ did / ___ did not have premarital
counseling. 09. ___ Cohabiting – how long? 10. ___ Never
Married 11. ___ Widow/Widower:
Yrs since death: 12. ____ Single ___Separated: __ Yrs since ___divorce___separation: 13. ____ Father/step ___:
how many marriages? How many biological children: Step: ___ Mother/step
___: how many marriages? How many biological children: Step: . Question: If you waited until your
stepchildren were grown to marry, why did you wait? . Reflction question if you have stepgranchildren or
stepgrandparents: . Please describe the stepgrandparent
- stepgrandchild relationship experience with its challenges and benefits: . 14. Custody Arrangements ___ are / ___ are not satisfactory / ___fair to me. General outline of custody arrangements: . 15.
What process was used for determining dissolution details including alimony, child support and custody arrangements: ___ Litigation ___ Mediation ___ Self-help, no representation
___ Paralegal service Other: . 16. My
child’s other parent is: ____ remarried; ____ cohabiting; ____ dating; ____ living with family (or) ____friends;
___ Incarcerated; ___ homeless; ___living in a car/truck; ___living in
a shelter . 17. My relationship with the other biological parent: 10 very cooperative to 1 very unpleasant, or 0 for parent absent for the most recent twelve months
or more. (Best - 10
9 8 7 6 5
4 3 2 1 -
Not good) ___ . 17. a. The relationship between my child/ren's other parent and
my current spouse/partner is: 10 very cooperative to 1 very unpleasant, or 0 for
parent absent for the most recent twelvemonths or more. (Best
- 10 9 8 7
6 5 4 3 2
1 - Not good) ___ . 18. Suspected Parental Alienation behaviors. (Expanded below, but please don’t skip ahead) I believe
the other parent ___has / ___has not targeted ___ me / ___ my spouse with
alienating behaviors and
___is adversely influencing (or) ___ is not damaging the relationship/s with the children. . 18.a.
Do you believe remarriage was a trigger for parental alienation behaviors? 18.b. Which parenting adult is actively
programming or adversely influencing the children? 18.c. Who is the target of the efforts? . (If applicable, 19 a - e) 19.
a. I believe [her/his] ___ boyfriend, ___ girlfriend, ___ is being lied to and believes they are supporting my child’s
other parent. 19. b. I believe [her/his] ___
boyfriend, ___ girlfriend, ___ is part of our problems because (briefly explain concern): . 19.c. ___ has filed false allegations of domestic violence against
me 19.d. ___ has filed false allegations of child
abuse against me 19.e. ___ Other: (briefly explain): . 20.
My relationship with his/her new partner rates: ___ on scale of 1 – 5 (high-conflict-1 to peaceful-5l) 21. My partner’s relationship with my former spouse rates: ___ on a scale of 1 – 5 (same
as above) A. I believe a stepparent has
overstepped ___ his / ___ her boundaries through the following behavior: B. Our present ___ boundary
/ ___ custody issues ___ were / ___ were not covered in the parenting agreement. . 22. Communication: a. between households ___is /___ is not an issue b.
between adults and children ___is (OR) ___ is not an issue. Clarification: . 23. ___ between me and my spouse is an issue: (opt) details: 24. ___ between (fill in the blanks) ____and ____is an issue because: . 25. Transitions ___You experience stress during custodial transitions 26. ___ Your spouse shows anxiety during custodial transitions 27. ___ The
children show anxiety when leaving: a. ___ those at home full-time b. ___those
changing households 28. ___ The children show anxiety when arriving: a. ___ those at home full-time
b. ___ those changing households . 29. Finances: ___ are / ___ not a concern. 30.
We are a ___ single- / ___ two-income household 31. and ___ have / ___ have not experienced
___ job loss / ___ reduced income in the most recent two years. 32. We ___ have / ___have not lost a home to foreclosure in the
last five yrs. . 22. Child Support payments ___ are / ___ are not an issue. 23.
Our household ___ pays, ___ receives, ___ pays and receives ___ regularly (or) ___ irregularly. Clarification,
if needed: . 24.
Child support payment status is: ___ current, ___ behind, ___ seldom current, ___seldom behind 25. Child support received status is: ___ current, ___ behind, ___ seldom
current, ___ seldom behind 26. I ___ do believe/ ___ do not believe
child support is an appropriate amount because: . 27. Education: I ___ do / do not believe our educational differences were an issue in our marriage. 28. My highest level of education: ___ High School,
___ Some College, ___ Vocational; ___ 2, ___ 4, ___ 6+ yrs degree: 29.
Spouse’s highest level was: ___ High School, ___ Some College, ___ Vocational;
___ 2, ___ 4, ___ 6+ yrs degree: 30. My ex’s
highest level was: ___ High School, ___ Some College, ___ Vocational; ___ 2,
___ 4, ___ 6+ yrs degree: 31. My ex’s new partner has ___ High
School, ___ Some College, ___ Vocational; ___ 2, ___ 4, ___ 6+ yrs degree: . 32. Housing: ___ is / is not an issue. Each
child: 33. ___ has
/ ___does not have own bed here; ___ has /___ does not have own bed at other home. 34.
___ shares / ___ does not share bedroom ___ here; ___ shares / ___ does not share bedroom at other home. 35. ___ has / ___ does not have own drawers and closet space here; ___ has / ___ does not have own
drawers and closet space there. 36. ___ prefers
to live out of own suitcase while ___ here / ___ there.Any clarifications: . 37. Boundaries: We ___ have / ___ haven’t
talked about the importance of physical and emotional boundaries & sensitivities because: . 38. We ___ do / ___ do not have family traditions of our own. They are: . 39. We ___ do / ___ do not worship / religious study together. Religion/denomination of faith (opt): . 40.
Academic Performance: We ___ do / ___ do not have concerns about our child/ren’s education. 41. Do you feel your child has under-performed academically
due to distressed stepfamily or shared-parenting dynamics? Why? (opt) 42.
Is there or has there ever been a problem with receiving your children’s report cards and attending school functions? 43. Their school ___ does / ___ does not make a good effort to keep me informed. 44. ___The school ___ will / ___
will not return calls I make. Clarifications: . 45. Life events and concerns most recent two years (This household = TH / Other household = OH/ Both = B): 46. ___ Separation from present spouse 47. ___ Intimacy Issues
48. ___ New litigation
over child support 49. ___ Anxiety / Depression :
a. ___ Commitment to therapy 50. ___ New litigation over custody 51.
___ Other major health issues: 52.
___ Resistance to therapy 53. ___ Concerns for legal fees repayment 54. ___ Active duty, military / ___returned 55.
____ Drug / ___ Alcohol Use 56. ___ Poor grades in school 57. ___ Out-of-marriage pregnancy/birth 58. ___ Jail / prison, ___ returned 59. ___ Domestic Violence 60.
___ Verifiable Child Abuse 61. ___ Suspected Child Abuse 62. ___ False Accusations made 63. ___ Custody Interference 64.
___ Other:.Clarifications for above. Please be concise. There are more open question
lines below: . . 65. ___:
We do not have any difficulties
with the other household.
65. a. It took _____ (number) years to achieve harmonious relationships. We believe things are working well for us because: . . Part
2 of 3: If applicable: Custody/Visitation Interference, Parental Alienation
(or) Divorce-Related Malicious Mother Experience (If
not applicable, please skip to section 3) . “The manner in which parents resolve conflict has been determined to affect child adjustment,” reports the
American Psychological Association website.
Furthermore, the 1997 American Coalition for Fathers and Children Shared Parenting Tool Kit reported, “A number of general research
studies consensus indicate that children adjust much more successfully in the immediate post-divorce period when a strong, positive relationship
is maintained with both parents (Cowan, 1982; Hetherington, Cox & Cox, 1982; more). .The stories of deadbeat dads and wicked stepmothers have overshadowed an area
of equal or greater importance – the alienating parent; this study will be closely looking at this as we strive to receive
a minimum of 10,000 surveys or run the project for seven years. The manipulation, programming or brainwashing of the children
can be difficult to prove. Douglas Darnall, Ph.D., author of “Divorce Casualties: Protecting your Children from
Parental Alienation,” defines parental
alienation as any constellation of behaviors, whether conscious or unconscious, that could evoke a disturbance in the
relationship between a child and the other parent.” Critics of Parental Alienation have stated that
sufficient statistical data is lacking. The data will help design programs for children and families impacted by these
behaviors. . 66. ___ My former spouse / ___ I filed for the original divorce 67.
___ My former spouse / ___ I had an affair 67. A. ___ My former
spouse has an inflated sense of self
Qualify your answer here: 67. B. a. ___ My former spouse
lacks empathy toward others / ___ toward our children b. ___ My former spouse was
more hungry for more attention than I could give him/her c. ___ My former spouse
constantly thought of fame and fotune d. ___ My former spouse thinks others are
jealous of his/her appearance & abilities e. ___ My former spouse gets
upset if he/she is not treated as he/she sees fit f. ___ My former spouse
did not mind taking advantage of others for personal gain g. ___ Most of our
arguments came back to his/her needs not being met h.
___ It was seldom about the children i.
___ It was seldom about me . j. Do any of the
qualifying statement apply to yourself? Y / N State those that apply: .
k. Have you or your children's other parent received any mental health support for these issues? .
Our Children: 68.
___ Parrot negative statements made by the other parent 69. ___ Display nonverbal messages of fear or panic 70. ___ Make statements they could not have possibly constructed
71. ___ Have difficulty showing excitement or enjoyment
with me 72.
___ Lied to officials regarding what goes on at our home 73. ___ Show uncertainty about expressing or receiving affection 74. ___ Get mouthy and make threats over small disagreements 75. ___ Appear to have been recruited to keep secrets 76. ___ Demonstrate an alliance with other household 77. ___ Has/have been caught snooping for income and other information 78.
___ Makes good parent / ___bad parent remarks 79. ___ Have extreme emotional outbursts 80.
___ Are ordered to call other parent’s spouse “mommy / daddy” 81. ___ Ask why I am mean to mommy / daddy 82. ___ Say they do not want to see my parents anymore 83. ___ Tell lies to friends, family and teachers 84. ___ Children elbow/hush/guard each others words 85.
___ Cannot take a call without parent nearby 86. ___ Other
. Observation question: How would you describe
the relationships between the children? . Where do relationships appear to be strongest
or weakest among the his/hers/ours variations? . What factors do you believe make the difference: age, birth order, custodial arrangements, other? . The Other Parent: . 87. ___ Attempts to interrupt visitation / my custodial period 88. ___ Engages in
whispering/finger pointing when I am present 89. ___ Sends Email or Calls more than weekly or without
reason 90.
___ Mishandles money, then tells the children I do not pay enough or at all 91. ___ Has not forgiven me for having an affair 92. ___ Does not tell the children when I call or give them my mail 93. ___ Does not inform me of school progress / ___ functions 94. ___ Has told lies about me / my spouse to friends, family, school 95. ___ Cont) and refuses to make things right by owning the stories by telling the truth 96.
___ Has had boyfriend / girlfriend make harassing contacts, threats 97. ___ Has personally made threats toward me, and ___ my partner/ spouse ___ 98. ___ Has taken excessive legal action against me 99. ___ Exaggerates / twists facts to appear victimized by me, and ___my partner/ spouse ___ 100.
__ Had an
affair, did not take responsibility and lied about the facts to protect self-image 101.
__ Discourages
the children from saying "I love you” 102. __ Withholds the children until I meet demands 103. __ Insists the kids do not call my spouse "mom/dad" 104. __ (cont) but, Encourages the kids to call his/her
___BF/GF or spouse ___ “mom/dad” 105. __ Makes derogatory remarks about my parents, disrupting the grandparent-grandchild
bonding 106.
__ Expressions
of love are withheld from the children if they do not follow her directions 107 __ Other: . PAUSE for reflection. As
you have noted what is applicable to the children and other parent's behavior, have you found any of the above also
apply to your own or your current partner's behavioral choices? Conversational research indicates there is a point
reached when many target-parents tire of being alienated and they will walk away or distance themselves from parent-child
relationships in frustration, or they begin to respond in-kind with similar choices out of fear of losing the respect
of their children or the parent-child relationship altogether if they do not defend themselves. Feel free to share
your experience here. Your name will not be used without permission. . Please go back and place + (plus) symbol by the appropriate selections:
+ for self / S+ for your spouse / MB+ MG+ for my boyfriend or my girlfriend / OS+ for Other Spouse / OB+ OG+ other
parent's boyfriend or girlfriend if you see that it is applicable. This helps us with our reporting. . In your opinion, rank these in order 1 (highest) - 4 (lowest) of detriment to the overall
development of children: 108. ___ arguing parents who yell and scream but end
up working together 109. ___ silent parents who feel walking away it is the only way
of attaining peace 110. ___ alienating parents who strategize "underground"
so that the children are unaware of the manipulation 111. ___ parents
who find ways around paying child support. 112. Other: . 113. What event or experience, in your opinion, served as the "trigger" of the PA behaviors? Additonal comments: . . Part
3 of 3: Bullet Point Overview of my Family Law Court Experience and my recommendations: . Bullet point complaints about your court-related
experience. Preface complaint with ATTORNEY,
MEDIATOR, JUDGE, SOCIAL SERVICES, etc. Limit three sentences per response, ending with area of greatest impact, such as My
current marriage, Children's academic focus, Children's anxiety, Co-parenting weakened, or Co-parenting strengthened. We seek
accurate accounts of both positive and negative experiences. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. . To conclude, you
may add up to 250 words (please use word count and print if handwriting is not legible) of information you believe would be
relevant to the study. Also, if you believe alienation has occured, do you believe it is possible
for the targeted parent/s to experience restored relationships with the children once the children are grown? . ___ I choose to submit anonymously, and realize because its integrity cannot
be verified nor can any clarifications be made, if needed, my Survey will be analyzed with other anonymous submissions,
separate from the collective, published findings of identified group. . ___ I
realize confidential practices are maintained among researchers. No identifying information is sold. The surveys become property of StepfamilySystems.com and only collective results of the study will be published. . ___ I think authorities should be called, but I am afraid. Please send me
shelter and family services information for my area to the following Address/Email: . ___ I would like to
participate in this annual study through 2024. I understand the results could benefit my future relationships with my
children and grandchildren. . ___ In order to participate, I realize I must return
annually during the same calendar quarter of my original survey submission. I will make a note of it. . ___ I DO NOT wish to receive confirmation that you received my response. . ___
Postal mail for further information is to be sent to: . ___ My phone number,
for verification or clarification purposes only, is: (
) . ___ You may call me anytime for stepfamily-related research purposes.
I understand they will be used for a dissertation project and a select team of researchers assigned to this study will
have the opportunity to apply research methods. . ___
By completing
and returning this research survey, you are stating that you have read and understand our: ___
Professional Statement & Disclosure LINK BELOW No identifying information will be sold under any circumstances. . All rights reserved. No part of this survey may be reproduced
by any process whatsoever for use apart from the individual survey responder without the written permission of the research
survey developer, StepfamilySystems.com. Permission to copy for school-based participation is granted - surveys must be returned exclusively
to StepfamilySystems.com for the study.
Survey alterations are strictly prohibited. . Rev. 19Dec2011
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