Through Assessment to Consultation: Independent Psychoanalytic Approaches with Children and Adolescents

209 Pages·2009·1.78 MB·English

by  Ann Horne

Through Assessment to Consultation
Winnicott’s description of ‘doing something else’ or ‘working as a psycho-
analyst’ when not engaged in the actual analysis of his patients resonates
with the child psychotherapist today. Individual psychotherapy is certainly
a valuable part of the work but much of the time the child psychotherapist
is‘doing something appropriatetotheoccasion’. Someofthis timeisspent
in assessment work – for therapy, for the multiprofessional team and for
other agencies – and some in consultation to colleagues and other
professional staff or in a combination of the two.
Drawing from the Independent tradition in psychoanalysis, Through
Assessment to Consultation explores the application of psychoanalytic
thinking to this daily work, reflecting on what is actually done and why.
Contributors to the three parts – ‘Assessment’, ‘Overlaps’, ‘Consultation
and Beyond’ – provide a variety of clinical illustrations as they describe a
array of approaches and settings in the tasks of both assessment and
consultation, ranging from the light impact of the analyst’s presence in the
grief of post 9/11 New York to the call to political potency of ‘Beyond
Consultation’.
This book will help both new and experienced child and adolescent
psychotherapists re-examine their role and function in the team and in the
outside world, and will also be of interest to specialist health workers,
educational psychologists and those wanting to explore more Winnicottian
approaches to therapeutic work.
Ann Horne trained in the Independent tradition at the British Association
of Psychotherapists. She has discovered that retirement (after ten years
latterly at the Portman Clinic, London) can become very crowded and
makes occasional sorties from behind the keyboard to speak and teach in
the UK and abroad.
Monica Lanyado is a training supervisor at the British Association of
Psychotherapists. She is co-editor with Ann Horne of The Handbook of
Child and Adolescent Psychotherapy and A Question of Technique and
author of The Presence of the Therapist.
Independent Psychoanalytic Approaches with Children and
Adolescents series
Series Editors: Ann Horne and Monica Lanyado
Titles in the series
A Question of Technique
Edited by Monica Lanyado and Ann Horne
Through Assessment to Consultation
Edited by Ann Horne and Monica Lanyado
‘‘ThisbookisawelcomeadditiontotheclinicalaccountsofAnalyticworkwith
children,youngpeopleandtheirfamilies.Theunderstandingprovidedhereisa
timelyreminderthatworkingindirectlytohelpfrontlinestaffreflectisessential
if good, objective decision making is to underpin the complex situations con-
fronting workers in a whole range of settings in Children’s services.’’
Judith Trowell, Professor of Child Mental Health, CSIP, University
of Worcester & Honorary Consultant Psychiatrist, Tavistock Clinic.
‘‘The application of a psychoanalytic approach to areas other than individual
treatment forms an essential part of child psychotherapy practice. The wide-
ranging and insightful contributions to this book address some of the most
difficult and complex areas of work, including inpatient treatment, court
reports,consultationtostaffcaringforvictimsofsexualabuse,andmanymore.
Clinicians seeking to help new client groups while retaining a psychoanalytic
perspective will find this an invaluable resource.’’
Maria Rhode, Professor of Child Psychotherapy,
Tavistock Clinic/University of East London.
‘‘I highly recommend this book to anyone who is interested in the future of
childandadolescentmentalhealth.Inthefuturechildpsychotherapistswillrely
increasingly upon the development and adaptation of their psychoanalytic
knowledge and skills in the practice of assessment and consultation. This book
addresses complex issues that thepractitioner will face, such asthe impactof a
traumatised child’s disturbance, race and culture, and the use of the trans-
ferenceandcounter-transference.Theinformativeandaccessiblechapterscover
workinCAMHSandspecialistsettings,includingassessmentsforcourt,aswell
as special problems presented by under fives, the dangerous child, adolescents
andriskassessments.Ialsorecommendthisbooktopolicymakers,membersof
multi-disciplinary teams, and those in management and commissioning who
would like to know how child psychotherapists could help to deepen and
broaden the provision of mental health care for children and adolescents.’’
Donald Campbell, Child, Adolescent and Adult Psychoanalyst
& Past President of the British Psychoanalytical Society.
Through Assessment to
Consultation
Independent Psychoanalytic
Approaches with Children and
Adolescents
Edited by Ann Horne
and Monica Lanyado
Firstpublished2009byRoutledge
27ChurchRoad,Hove,EastSussexBN32FA
SimultaneouslypublishedintheUSAandCanada
byRoutledge
270MadisonAvenue,NewYork,NY10016
RoutledgeisanimprintoftheTaylor&FrancisGroup,anInforma
business
This edition published in the Taylor & Francis e-Library, 2010.
To purchase your own copy of this or any of Taylor & Francis or Routledge’s
collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.
Copyright(cid:216)2009Selectionandeditorialmatter,AnnHorneand
MonicaLanyado;individualchapters,thecontributors
Allrightsreserved.Nopartofthisbookmaybereprintedor
reproducedorutilisedinanyformorbyanyelectronic,mechanical,
orothermeans,nowknownorhereafterinvented,including
photocopyingandrecording,orinanyinformationstorageor
retrievalsystem,withoutpermissioninwritingfromthepublishers.
BritishLibraryCataloguinginPublicationData
AcataloguerecordforthisbookisavailablefromtheBritishLibrary
LibraryofCongressCataloging-in-PublicationData
Throughassessmenttoconsultation:independentpsychoanalytic
approacheswithchildrenandadolescents/editedbyAnnHorne&
MonicaLanyado. – 1sted.
p.cm.
Includesindex.
ISBN978-0-415-46289-1(hardback) – ISBN978-0-415-46290-7
(pbk.)
1.Psychoanalysis.2.Children.3.Childanalysis.4.Adulthood.5.
Adolescentanalysis.I.Horne,Ann,1944– II.Lanyado,Monica,
1949–
BF173.T5542009
618.92'8917–dc22
2008043458
ISBN 0-203-87661-X Master e-book ISBN
ISBN978-0-415-46289-1(hbk)
ISBN978-0-415-46290-7(pbk)
In memoriam
Wallace Hamilton
Catriona Hood
Isabel Menzies Lyth
with affection and gratitude

Contents
Contributors ix
Acknowledgements xiii
1 Introduction: ‘appropriate to the occasion’ 1
ANNHORNEANDMONICALANYADO
PART I
Assessment 7
2 Every assessment matters: the child psychotherapist’s role
in assessment in child and adolescent mental health settings 9
MARYWALKER
3 Thinking aloud: a child psychotherapist assessing families
for court 26
DEIRDREDOWLING
4 Anxiety, projection and the quest for magic fixes: when
one is asked to assess risk 44
MARIANNEPARSONSANDANNHORNE
5 Peculiarities and problems in assessing adolescents 59
JOELLEALFILLE´-COOK
PART II
Overlaps 75
6 Infant mental health: a conversation with Dilys Daws 77
CARYNONIONS
viii Contents
7 Reflections on race and culture in therapeutic consultation
and assessment 93
IRISGIBBS
8 Death in the family: post 9/11 at Pier 94 Manhattan 103
VICTORIAHAMILTON
9 From intimacy to acting out: assessment and consultation
about a dangerous child 110
ANNHORNE
PART III
Consultation and beyond 125
10 Consultation to an Under Fives Service 127
SOPHIEROBSON
11 The impact of listening on the listener: consultation to
the helping professions who work with sexually abused
young people 141
MONICALANYADO
12 ‘You are paid to be a nuisance’: tensions in the role of a
clinician-manager 157
GETHSIMANIVASTARDIS
13 Beyond consultation: towards YoungMinds 168
PETERWILSON
Index 187
Contributors
Joelle Alfille´-Cook trained as a child psychotherapist at the British
Association of Psychotherapists (BAP) after working as a teacher. On
qualification she did a further specialist training in work with older
adolescents at the BAP. A staff member at the Brent Centre for Young
People, she is involved with the BCYP Schools Project. She teaches on
the MSc course run jointly by Birkbeck College (University of London)
and theBAPand isa member of theChild& AdolescentPsychotherapy
Training Committee of the BAP.
Dilys Daws trained as a psychoanalytic child and adolescent psychothera-
pist at the Tavistock Clinic and worked on the staff of the Child
Guidance Training Centre and the Tavistock Clinic until her recent
retirementfromtheNHS.Shecontinuestoteach attheTavistockwhere
she holds a post of Honorary Consultant Child Psychotherapist.
Qualified as anadult psychotherapist, shealso works inprivatepractice.
Amongst her many publications is the seminal work Through the Night:
Helping Parents and Sleepless Infants (1989) and with Mary Boston she
co-edited the groundbreaking introduction to the profession, The Child
Psychotherapist and the Problems of Young People (1977).
Deirdre Dowling is Head Child Psychotherapist at the Cassel Hospital. She
trained at the British Association of Psychotherapists. Previously she
worked as a social worker, manager and trainer in child care. She has a
particularinterestinparent–infantwork,workingwithseverelydeprived
families, and teaching and consulting to other professions interested in
applying psychoanalytic ideas to their work with families.
Iris Gibbs trained as a psychoanalytic child and adolescent psychotherapist
with the British Association of Psychotherapists. She has worked as a
therapist for a private fostering organisation for the last 13 years and is
also involved in their teaching programmes and the supervision of other
therapists. She worked for five years in the Parent and Infant Project at
the Anna Freud Centre, London and is in private practice. Her publi-
cations include chapters in The Practice of Parent–Infant Psychotherapy