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Long-term psychoanalytical psychotherapy, thorough and necessary though it may well be for many, does not suit our times, hurried, impatient and hyper-managed as they are in the realm of social and health provision. It does not sit well in the public health arena in which the mental health needs of populations are now well known to far exceed the supply of appropriate services. Child and adolescent mental health services, forever chronically underfunded, are having a particularly hard time, carrying unbearable strain in the prevailing climate of serious cutbacks in health and social services. It cannot be of any surprise that local commissioners of services, transfixed as they are with trimming budgets, should now welcome recent so-called ‘transformations’ in these services, predominantly based as they are on brief cognitive behaviour therapies, supposedly cheaper and more effective. The commissioners' plain message to psychodynamic therapists is to speed up or else (your job is on the line). And so those who are having to listen are busy doing whatever they can to sharpen up their short-term psychotherapy skills.
The arrival of this book is thus timely. The author, who has extensive experience in the field of child and adolescent mental health, has taken up the challenge and has done so with force. Of course, she is aware of all the ravages of costcutting, but she is emphatic that what she has in mind with her version of time-limited psychodynamic psychotherapy is not a watered down solution, distorted for the purpose of survival. It is rather a distinct form of therapy that stands in its own right in clear contrast to other more fashionable approaches. She is dismissive of the biomedical approach with its emphasis on psychiatric diagnosis of individual children at the expense of due consideration being given to the relational, family and social context in which children live. She is set against providing any kind of manualized prescriptive procedures which she sees