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The use of the terminal profile at the Hampstead Clinic has shown its value both as a tool for research and as a clinical assessment of the child's response to analysis. The main functions of the terminal profile are: (1) re—evaluation of the original diagnostic assessment; (2) re—assessment of the child at the end of treatment with a special focus on changes which have occurred since diagnostic assessment; and (3) a clinical assessment of therapeutic agents which have contributed to improvement.
This paper consists of the Treatment Summary, Terminal Profile and Minutes of the discussion of this profile on Jim, a 17-year-old adolescent boy of Latin—American origin, who ended treatment with me after a period of seven months’ analysis. Where termination has been premature as in Jim's case, the terminal profile is also useful in assessing the patient's inner situation at the time of leaving treatment, the precipitants that may have led to the early termination and, prognostically, in assessing what elements of the analysis have been internalised and might prove beneficial and long—lasting. This terminal profile is based on all the clinical material and information obtained during Jim's treatment, on interviews with his father during the boy's treatment and on the original diagnostic material.
Jim manifested an incipient obsessional symptomatology as a means of defending against intense sexual and aggressive urges. He was frequently distracted from school work and sleep by worrying sexual concerns and thoughts of injury and destruction to himself and his loved ones. He employed many unsuccessful compulsive rituals to combat these thoughts. After a month of once and twice weekly exploratory meetings with me, he showed much enthusiasm, insight and a desire to start analysis. From the commencement there were several factors, some possibly ominous, which stood out and developed as time went on, militating against treatment.
At the diagnostic conference we w