The Child Psychotherapist and the Patient's Family*

Those of us who work with children are more dependent on the co-operation of the patient's family than the adult therapist is as a rule. If the patient is a young child it is usually the mother, sometimes the father, who has to bring the child to treatment; the older child or adolescent still needs parental backing and encouragement at times to continue during difficult periods.

In this paper I am putting down some of my thoughts as a child psychotherapist and analyst who works with children in a clinic setting and also in private practice. For some years I have been working in the Department for Children and Parents at the Tavistock Clinic. In this Clinic we have a variety of approaches, so my reflections about work with children and their families must be taken as stemming from my own particular experience and practice and do not necessarily represent the views of other people there.

A common pattern in this Department is for the child to be treated once or twice, or up to five times weekly by a child psychotherapist or psychiatrist, while the mother is seen by a psychiatric social worker or social caseworker. In a fair number of cases the father is treated regularly as well, and occasionally treatment may be offered to some other member of the family too. In some cases, and these are likely to be the older children, neither parent receives regular treatment: it may be because they are receiving this elsewhere, e.g. analysis or group treatment.

As a non-medical child psychotherapist I may not see my patient until he has been interviewed by the psychiatrist and has received psychological tests, until the problem has been investigated with the parents and some idea has been obtained of the role of the patient within the family, of the motivation of both parents and child in seeking treatment, and of their capacity to cooperate. This is usually determined in the case of the parents as a result of in