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One of the questions put to me at the selection interview was: “What would you see yourself doing here if you were offered the post?” I replied “Psychotherapy with the children”. In what follows I shall describe how I have tried to fulfil this aim. As the title of the paper suggests, I am concerned with describing the role of the child psychotherapist, but it should be pointed out that this is only one aspect of a larger programme: that of setting up a children's unit in a psychiatric hospital for adults. At times these two tasks have coincided and overlapped. It goes without saying that the planning and thinking was done in consultation with the head of the department.
The Cassel is a psychiatric hospital for adults. It offers its patients analytically orientated individual or group psychotherapy, in the setting of a therapeutic community. Among its patients are women with families who, when they are admitted, bring their children to live with them. This practice originated in 1948, through a mother who, when she was offered admission, asked for permission to bring her small son with her, since she had no one in whose care she could leave him. What was then an unusual event has become a general rule of the hospital (Main, 1958). Now, when a mother seeks admission she is expected to bring her child or children with her.
It is a point of general policy that the patients should retain as many responsibilities and ties with their outside life as is compatible with their illness. Mothers therefore continue to look after their children. Any problems they may have in the area of mothering can then be looked at in their treatment. Indeed, it became recognized that to “admit mother by herself was sometimes to collude with her hostility towards her children or at least her wish to be separated from them” (Main, 1958). The disturbances of mothering eventually became the object of special study (Lomas), and in turn this drew attention to disturbances in the children.