This article describes the contributions that self psychology has made to the treatment of children and to psychotherapy under various circumstances: in hospital settings and in cases when psychotherapy is combined with the use of psychotropic medication. The relevance of self psychology beyond psychoanalysis is related two of its fundamental aspects: the empathic listening perspective and the selfobject concept. A therapeutic failure of a hospitalized patient is offered as an example where these two aspects of self psychology were not utilized.