Extending Fields of Work*

The task I have been set is to give some indication of the variety of settings and the different kinds of work in which our members are engaged and the directions in which we seem to be developing. I would like briefly to survey the field of our activities and then bring illustrations from my own experience to show in which way I see these extensions linked to our primary aim and experience, namely, psychotherapy of children and adolescents.

Firstly, we have extended the range of ages we study and deal with. We have a particular interest in infants and very young children. Weekly observations of mothers and babies in their own home for one to two years (first introduced by Dr. E. Bick) form an essential part of our training at the Tavistock and the Hampstead Clinic. Discussions in seminars of these detailed observations of the interaction between mother and baby have proved of immense value to all those who have undertaken it. It has been a revelation to most to discover how much the baby contributes to the relationship and that it is possible to study the adjustments and mal-adjustments as they develop. It has also been a very good way of preparing students for their clinical observations, increasing their awareness of non-verbal communications and making them receptive to recognising the infantile aspects of their patients’ personalities.

At the other end of the age range, there has been a great expansion of work with adolescents. Their problems and those they present for their parents, teachers and society has resulted in adolescent psychiatry becoming a new specialisation. But where does adolescence end? More and more we find ourselves drawn into work with students and young adults (especially since the age of majority has dropped to 18 years) and the question arises whether it is appropriate to call ourselves child psychotherapists. I wonder whether the time has come to change our name and perhaps include the treatment of young adults in ou