Psychoanalytic Work with the Under-fives: Forty Years' Experience

It may be useful, in order to place these reports in context, to outline here briefly the major programme of research on the process and outcome of child analysis currently being undertaken at the Anna Freud Centre.1

It was felt that there was a need to investigate and establish the contexts and problems for which child psychoanalysis is especially effective and other circumstances where its value is limited. We were aware that there has been very little research on intensive treatments for either children or adults, with the important exception of Wallerstein's (1986) work2 on the assessment of the outcome of analytic treatment of forty-two adult patients. We were also aware that we were well placed to undertake such research since we hold the well-documented case records of several hundred children and adolescents in analytic treatment, and further we have a uniquely high number of experienced therapists and of children currently being assessed and treated in child analysis. Our work in these respects over the past 2 years has recently been bolstered by an invitation to participate in the collaborative multi-site programme of psychoanalytic therapy research being organized by Professor Robert Wallerstein under the auspices of the American Psychoanalytic Association.

Our long term goal is to establish a prospective study of the process and outcome of child analytic treatment. To achieve this goal a number of intermediate steps need to be taken. It is important that our psychoanalytic diagnoses of children should be aligned with psychiatric research nosology, so that children treated analytically