HISTORICAL EVOLUTION OF RRD APPROACHES

In 1924, the League of Nations adopted a Declaration of the Rights of the Child³ which in its principle 3 stated that "The child should be the first to receive relief in times of distress," and later another Declaration in 1959 included ten principles of which the sixth stated that:

"The child, for the full and harmonious development of his or her personality, needs love and understanding. Whenever possible, the child should grow up under the protection and responsibility of his or her parents and always in an atmosphere of affection and moral and material security; except in exceptional circumstances, the child should not be separated from his or her mother at a young age.

However, this was not enough to protect children's rights, since the Declaration was not legally binding.

Child abuse in its different manifestations, some of them undeniable due to the evidence of the facts, was studied mainly from the second half of the 19th century onwards (^{Santos, 2002}). In these cases, it was understood that the refusal of the children to maintain contact with the parent or parents was something that could be explained by the fact of the abuse itself. Sometimes the attribution of responsibility was controversial, since the abusive parent or parents could argue that the act itself was an effective or traditional form of education given the behavior of the child.

In recent decades, another view has gained strength, complementary to the previous one, which specifies that child abuse, as it appears in the Spanish legislation⁴, is also exercised, for example, when children are witnesses to gender violence or any type of violence in the family environment, and even in cases of dissemination of private data.

What usually concerned the institutions and the professional was the situation of the abuse itself and its effect on the victims, not the situation of isolation of a parent due to the resistance or refusal of their children to have contact with the abusive parent. Similarly, in the case of separation or divorce, custody of the offspring was usually awarded almost exclusively to the mothers, with judicial custody disputes between the parents being infrequent. In the case of resistance and refusal of a child to contact with a parent (usually the father), it was attributed to problems in the exercise of parenting, among the main reasons motivated by mistreatment, sexual abuse, or neglect (^{Polak & Moran, 2017}). It is only now that refusals due to these types of causes have come to be called justified refusals.

On the other hand, in the 50's, 60's and 70's, therapists linked to systemic family therapy opened another avenue of study and terminology on child-to-parent resistance and refusal, most of which came from therapeutic work with children and/or schizophrenia. The explanations were more related to what are now called unjustified refusals (such as parental alienation) or hybrid situations (part of the refusal is justified and another part is unjustified). The conceptual path proposed by these authors is presented below in chronological order.

In 1956 the concept of the double bind was noteworthy, proposed by ^{Gregory Bateson, Don Jackson, Jay Haley, and John Weakland (1956)}. This concept arose in the attempt to explain the form of communication in families in which schizophrenia was present in a family member and, when applied to families with conflictive ruptures, it could be manifested by mixed messages, such as saying "you have to go with your father (or mother)" at the same time as, due to the tone or nonverbal expression, it is understood "I will be angry if you go with your father (or mother)." For the children, who have a strong bond with that parent, there would be no possible escape and they would always be acting badly, as they would have to disobey in order not to anger him/her, so either they would not go to visit the other parent, or they would anger the favored parent by obeying and going.

In turn, Theodore ^{Lidz and his collaborators (1957)} proposed to approach marital schism as the long-term effect of an asymmetrical escalation, a marital conflict in which neither of the parties gives in, finally involving the children who in turn participate in this dynamic, which could lead to some form of schizophrenia.

At the end of the 1960s, the concept of the triangle proposed by Murray ^{Bowen (1966)} arose in the context of dealing with the difficulty of individuation of children in certain families. Subsequently, in the following decade Salvador ^{Minuchin (1974)} proposed the concept of triangulation, and later Jay ^{Haley (1976)} the perverse triangle, to express the complexity of dyadic relationships in couples who end up incorporating a son or daughter into the conflict.

Also in the 1970s, Ivan ^{Boszormenyi-Nagy and Geraldine M. Spark (1973)} speak of invisible loyalties, loyalty conflicts, and the ledger (the debts and merits of each family member), terms proposed to define when the rejection that a child may feel towards a parent clashes with the loyalty owed to him or her, or on the contrary, is reinforced by the loyalty owed to the other parent.

In line with what has been explained, Judith S. ^{Wallerstein and Joan B. Kelly (1976)} examined the effects of divorce on child adjustment, and described the opposition observed in children to maintain a regime of communication and stays with the non-custodial parent, a behavior known as pathological alienation or unholy alliance between one of the parents and the child, in opposition to the other parent, and the child as rejecters. Meanwhile, Landrum S. Tucker and Thomas P. Cornwall published a case of psychosis of a mother influencing the child against the father, which they called Folie a Deux (madness of two), and Roy Meadow described Munchausen Syndrome by proxy, a concept related to child-to-parent refusal to the extent that one of the parents risks the health of their own son or daughter, inventing false symptoms or provoking real symptoms to prevent him or her from having contact with the other parent (^{Molina & Capdevila, 2019}).

In the 1980s in the United States, legislation was reformed to make shared custody of children in the event of divorce more evidently possible, and Judith S. ^{Wallerstein and Joan B. Kelly (1996)} observed how judicial disputes to obtain such custody were increasing. They also estimated that the prevalence of children closely allied with their mothers and participating in the campaign of denigration and refusal to see their fathers was 25% in cases of separation and divorce. The expression visitation time used in judicial settings was later replaced by parenting time, and from the conflicts over this there arise parenting time interferences, also called parental interferences (^{González, 2016}).

Towards the end of the 1980s, Richard Gardner defined parental alienation syndrome (PAS) as a disorder that arose almost exclusively in the context of a dispute over the custody of offspring and which he subsequently characterized by describing a series of symptoms. John W. Jacobs referred to the Medea syndrome alluding to the mother, and sometimes the father, venting their frustrations with aggression towards the offspring, even using the child as an instrument of power and revenge towards their ex-partner (^{Tejedor, 2015}).

It was in the 1980s that Michael White and David Epson proposed theories and techniques based on narrative, according to which the more alternative stories families are able to generate, the more possibilities their members have to grow, individuate, and develop their emotional and intellectual capacities. In 1989, ^{Mara Selvini Palazzoli, Stefano Cirillo, Matteo Selvini, and Anna Maria Sorrentino (1990)} published the book Los juegos psicóticos en la familia [psychotic games in the family] relating the problematic communication and dynamics that occur in certain families and the formation of psychosis in juvenile ages (^{Pereira, 1994}). In families with RRD it seems that these options are reduced, as they present more rigid visions, perhaps because widening the options could imply accepting the narratives of the other party with whom one is in conflict.

On November 20, 1989, the final text of the Convention on the Rights of the Child⁵ was approved, compliance with which was obligatory for all countries that ratified it, including Spain, and it became law in 1990. In its Article 9, in the first three paragraphs, it says:

"1. States Parties shall ensure that a child shall not be separated from his or her parents against their will, except when competent authorities subject to judicial review determine, in accordance with applicable law and procedures, that such separation is necessary for the best interests of the child. Such a determination may be necessary in a particular case such as one involving abuse or neglect of the child by the parents, or one where the parents are living separately and a decision must be made as to the child's place of residence. 2. In any proceedings pursuant to paragraph 1 of the present article, all interested parties shall be given an opportunity to participate in the proceedings and make their views known. 3. States Parties shall respect the right of the child who is separated from one or both parents to maintain personal relations and direct contact with both parents on a regular basis, except if it is contrary to the child's best interests.

Today, the Convention has been accepted by all countries in the world except the United States.

In the 1990s, in an attempt to explain family dynamics and co-parenting roles, understanding that in certain women there was an attempt to reinforce or safeguard their identity as mothers, Sara M. Allen and Alan J. Hawkins proposed the theoretical construct maternal gatekeeping. These authors considered that a series of beliefs and behaviors were observed in these mothers that succeeded in inhibiting the collaboration of men in the care of the home and offspring (^{Austin et al., 2013}). This idea derived from the gatekeeper concept proposed by Kurt Lewin in 1943, which described how mothers were the ones who controlled the food in families and fathers controlled the domestic finances.

In the 2000s, Joan B. Kelly and Janet R. Johnston explained child-parent refusal by focusing more on the child, and described the alienated child as "someone who freely and persistently expresses negative and irrational feelings of anger, hatred, rejection, or fear towards a parent, feelings that are disproportionate to the child's actual experience with the rejected parent." In turn, with their multi-factor model, they attempt to collect a whole series of possible explanatory factors for the child's refusal to see a parent; factors ranging from those related to the rejected parent, those of the allied parent, those related to the conflict or marital breakup, the child's own factors, the relationship with siblings, as well as those referring to the extended family or the institutions and professionals involved (^{Kelly & Johnston, 2001}).

Likewise, these researchers establish a continuum in child-parent relationships, ranging from 1. a normal relationship, in which the children want to be with both parents, or there may even be an affinity with one of them; 2. in the next state, ambivalence of the children's desires is detected, as sometimes they show alliance with one of the parents and/or distancing from the other parent due to previous abusive relationships; 3. the third state is one in which there is no ambivalence, but rather a continuous refusal of one of the parents, which may be due to parental alienation and/or a distancing from the rejected parent due to his or her maltreatment of the child (^{Kelly & Johnston, 2001}).

For their part, Amy Baker and Douglas Darnall identified a series of strategies of alienating parents to turn the offspring against the other parent and his or her extended family, such as: badmouthing the other parent, limiting or interfering in parenting time or communications with the son or daughter, emotional manipulation, unhealthy alliance, etc. (^{Molina & Capdevila, 2019}).

Developing the systemic approaches, and accepting to a large extent and at the same time questioning part of Kelly and Johnson's approaches, two researchers, ^{Jo-Anne M. Stoltz and Tara Ney (2002)}, respond that children's responses are not necessarily irrational, as they may be adjusted to the context in which they live. In other words, they are not the problem but an attempt to solve a very complex situation with conflicting paradigms (parental collaboration and attachment vs. custody rivalry) in which many systems are involved in different dynamics (family, school, care, clinical, judicial, etc.). These authors advocate not labeling what is happening, so as not to distort the approach to the conflict, i.e., it does not imply, in principle, the assumption of a diagnosis. They also reevaluate the problem using the term resistance to visitation, which they define as "any set of behaviors on the part of the child, parents, and others involved in the conflict that lead to the cessation or significant impediment of visitation with the non-custodial parent".

As an aid to the forensic psychology approach to the phenomenon, Benjamin B. ^{Garber (2007)} proposes a more descriptive and neutral denomination, without attributing causalities, and ^{Stoltz and Ney (2002)} also speak of family dynamics proposing the term child's visitation resistance and refusal (VRR). This is also intended to avoid automatically identifying the child's refusal of contact with one parent as an alienation intervention promoted by the other parent.

Therefore, attempts are beginning to be made to name and approach child-parental resistance and refusal in a more neutral and authentically systemic way, without naming this phenomenon in a way that could condition its understanding from the beginning and, therefore, the possible intervention. It is understood that situations of both abuse and conflictive family, coparenting, or conjugal dynamics are possible, sometimes with more weight of one or the other, and on other occasions, in hybrid situations.

In 2006, Leslie M. Drozd proposed the term protective gatekeeping, whereby one parent limits the other parent's access to their children because they believe there are good reasons to limit the other parent's involvement and parenting time, due to the risk of emotional or physical harm to the child. For Liz Trinder, this is called justified gatekeeping (^{Austin et al., 2013}).

In the 2010s, in an article entitled "Children resisting postseparation contact with a parent", Barbara ^{Fidler and Nick Bala (2010)} use the term parent-child contact problems (PCCP). This is one of the two terms most commonly used today in the Anglo-Saxon field, especially by professionals who participate in the Association of Family Conciliation and Courts (hereinafter AFCC), which is intended to be neutral, systemic, and does not refer to a specific causality.

At the same time Steven ^{Friedlander and Margorie G. Walters (2010)} distinguished between refusals according to whether they are due to realistic estrangement or enmeshment. Realistic estrangement is a deterioration of the parent-child relationship as a result of the limitations and shortcomings of the rejected parent, as a consequence of the existence of partner violence, abuse, or mistreatment, excessively rigid or distant, passive, immature, or narcissistic parenting styles, difficulties in controlling anger or disappointment, showing ambivalence in their relationship with their children, or blaming the refusal on the other parent. The entangled relationship is one in which the psychological boundaries between parent and child are poorly defined, blending their identities and roles.

Several authors (^{Austin, Pruett, Kirkpatrick, Flens, & Gould, 2013}) propose to redefine and name the term maternal gatekeeping in a more neutral way to disassociate it from the idea that it is only exercised by mothers, proposing the term parental gatekeeping, to define dynamics in which any parent could participate, placing him or herself at a point on a continuum ranging from very facilitative parental gatekeeping (supporting and encouraging contact with the other parent) to very restrictive parental gatekeeping (disapproving of and hindering contact between the children and the other parent).

Complementing the above, other authors (^{Saini, Drozd, & Olesen, 2017}) add the distinction of adaptive and non-adaptive parental control of access. Adaptive control of access, on the one hand, occurs when parents seek to encourage and support their offspring's sense of security and well-being, and may be adaptive facilitative, when contact is encouraged, or restrictive adaptive, which limits or prevents contact with the other parent who exercises inadequate parenting (which is what Leslie M. Drozd called protective) (Thomas & Holmes, 2019). On the other hand, non-adaptive parental control of access, can be maladaptive facilitative, when it refers to the abdication of a parent who allows the son or daughter to be with the other parent without taking into account the impact of this contact on the well-being and feelings of the child; or it can be maladaptive restrictive, which obstructs, prevents, or interferes with contact in an unjustified manner, motivated by their inability to separate their own feelings of anger and/or betrayal, which would give rise to dynamics such as parental alienation. As a fifth option there is inconsistent parental access control, which is exercised adaptively at times, and maladaptively at other times.

But not everything depends on the behavior of the parents. The child's vulnerabilities must also be taken into account (^{Drozd, Olesen, & Saini, 2013}), this aspect being relevant if before the age of five he or she has had temperamental (emotional) problems, if he or she has been exposed to trauma, if he or she has had an adverse childhood or, finally, if he or she has self-blaming or avoidant behavioral strategies.

Later Margorie G. ^{Walters and Steven Friedlander (2016)} also used concepts with a systemic perspective when speaking of resist-refuse dynamics (RRD), although initially they referred to dynamics related to parental alienation. However, most professionals in the Anglo-Saxon field currently use it in such a way that this term includes all types of refusal, so it would be equivalent to parent-child contact problems (PCCP). The two terms are currently used interchangeably in professional settings in Anglo-Saxon countries (^{Fidler & Bala, 2020}).

In Spain, firstly, the works of Francisco Granados towards the end of the eighties studied families with high conflict situations in divorces and, later, Marta Ramírez, Pilar de Luís, and Vicente J. Ibáñez towards the mid-nineties and related to mentalization, compared family situations of parental alienation with Stockholm syndrome. Around 2005, the term síndrome de alienación parental [parental alienation syndrome] began to be used in Spain by Ramón Arce, Francisca Fariña, and Dolores Seijo, together with Asunción Tejedor, this term being almost in disuse in the United States. Later, in 2013, Asunción Tejedor, Asunción ^{Molina, and Nuria Vázquez adopted the term parental interferences (Molina & Capdevila, 2019)} . Under parental interferences, parental alienation is included as a subtype of the former; they are not equivalent terms (^{González, 2016}). With a more systemic perspective, Juan Luís ^{Linares (2015)} proposed the concept of family alienating practices as a replacement of the term and concept of parental alienation, in the event that there was a successful manipulator and a failed manipulator in the family dynamic.

Also in Spain, in 2021, Organic Law 8/2021, of June 4, was approved, on the comprehensive protection of children and adolescents against violence⁶, which in its Article 11 talks about the right of minors to be heard, for which the need for professional training of the people who attend to them is raised and, in its third paragraph: "3. The public authorities shall take the necessary measures to prevent theoretical approaches or criteria without scientific backing that presume adult interference or manipulation, such as what is known as parental alienation syndrome, from being taken into consideration." In Article 26, dealing with prevention in the family environment, in section 3.a) it is added:

"In no case should actions to promote positive parenting be used with other objectives in case of conflict between parents, separations, or divorces, nor for the imposition of non-agreed shared custody. Nor should it be related to situations without scientific support such as parental alienation syndrome."

TOWARDS AN OPERATIONAL DEFINITION

The refusal of child-parent interaction has been the subject of much social, scientific, legal, and clinical controversy over the last three decades. Whether due to the complexity of the issue to be addressed, the interests of the different parties in cases of litigated family disputes, or ideological issues of defense of some groups or others, there is currently a disorientation among professionals on how to proceed when dealing with a situation in which there is resistance and refusal of children to contact with a parent.

For this important discussion, the first step should be to contemplate the development and subsequent generalization of the use of a construct and terminology that would have an adequate fit in the scientific methodology, that would be neutral, that would be observable and measurable, that would not refer to causalities, and that would generate inter- and intra-professional consensus, for the following reasons.

RRD, which are mainly triggered or intensified in highly conflictive family separation processes, usually involve the intervention of the judicial system, although they also have implications in other areas of intervention, such as the clinic (for somatic expression of refusal and the possible treatment of the emotional consequences for those involved), the protection system (protective measures for a child in a situation of neglect or risk of abuse), family treatment contexts (to minimize family conflict) or the education system (expression of child adjustment).

The current professional consensus, at least in the Anglo-Saxon field as reflected in the terms used in the last congress held in June 2021 by the AFCC⁷ on this issue or in the book by Abigail M. ^{Judge and Robin M. Deutsch (2017)} on this topic, is that it is generally more accurate to define and refer to this phenomenon in terms of problems of contact between children and a parent (^{Fidler & Bala, 2010}) or as dynamics of resistance and refusal expressed by the child towards one of his or her parents (^{Walters & Friedlander, 2016}).

Therefore, in the initial approach to these families, the phenomenon to be dealt with would not be denominated according to the occurrence of behaviors, attitudes, or supposed intentions shown by one, the other, or both parental figures, since they could have different explanations and not necessarily generate refusal of the son or daughter towards a parent.

The name and definition would be more accurately established according to the observable and measurable results that these events and family dynamics have on the relationship between the children and their parents, that is, the resistance and refusal to relate to a parent on the part of the children. This is a phenomenon to which in Spanish we can also add filio-parental [child-to-parent], as was also determined in defining and naming violencia filio-parental [VFP, child-to-parent violence in English] by Roberto ^{Pereira (2006)} , a term that is currently widely used.

In this sense, we propose to name this phenomenon “Dinámicas de Resistencia y Rechazo Filio-Parental (DRRFP) in Spanish [Child-to-Parent Resist Refuse Dynamics (RRD)]"⁸ (^{Álvarez et al., 2022}; ^{Arrospide, J., 2021}, ²⁰²²) and to define it as

"A complex dysfunctional relational pattern in which each and every one of the components of the family unit participate (albeit with different levels of involvement and responsibility), which is expressed through the child’s attitudes and behaviors of opposing to maintain an affective relationship with one of the parents, whom we call the rejected parent, usually showing a strong alliance with the other, whom we call the preferred parent".