Brief Work with Adolescents and Young Adults in a Counselling Service

The work I am about to describe is in the framework of a service which undertakes brief interventions with young people based on psychoanalytical knowledge. It was originally set up in the belief that certain adolescents in difficulty could be helped by an attempt at understanding which would be brief in nature and offered quickly. It was thought that such an intervention would be both helped by, and in its turn could help, normal growth and development. A number of young people of course would obviously require something more.

I propose in this paper to refer mainly to clinical material and problems, but will first say something about the setting in which I work, which is that of the Young People's Counselling Service at the Tavistock Clinic, London. The service is administratively linked to the Adolescent Department, but is clinically independent. It is staffed by child psychotherapists, clinical psychologists and social workers, all of whom are also engaged in longer term work. It has no direct access to the treatment services provided by other departments. I am grateful to my colleagues for helpful clinical discussions, but can of course only speak for my own work. We offer a series of appointments, normally up to four, with the possibility of a review, if wished, after a few months. Our clients are usually self-referred young people, although we do occasionally see parents or young couples. We do not have a rigid age limit. It is not a dropin service but appointments are usually offered within a few days time. The client comes to us directly without any intermediary apart from a telephone call or visit to our Secretary, who may be able to filter out a few people who would obviously be better referred elsewhere. Some workers like their clients to write something about themselves and their reasons for coming before they are seen. I prefer myself to experience the unknown situation with the client directly in the first instance, as I think this facilitates work in