Developing a Psychotherapy Clinic for Children, Parents and Young People at a Large Paediatric Hospital in Australia

This paper describes the establishment of a fee-for-service, not for profit, psychotherapy clinic in a large paediatric teaching hospital in Australia. The establishment of such a clinic required simultaneous attention to a number of different fields, i.e. the clinical, organizational and training issues, complementing each other in the provision of the service. The paper goes on to describe the development of the concurrent therapy model in the clinic where two therapists are allocated for each case, one to see the child and one to see the parents. The child's presenting problem is thus viewed within the family context and as part of an interactive process. Clinical examples are given which identify the nature of the ‘shared fantasy’ between child and parents and show how dynamically this therapeutic model can work in developing insight and creating change for both child and parents, particularly in short-term, focused psychotherapy. The paper describes how the fee-for-service clinic developed as an entrepreneurial initiative within a large institution and the advantages of such a model for child psychotherapy services elsewhere which operate on the boundary between the public and private sectors.

The paper goes on to outline the development of an Associate Training Programme for paediatricians in the clinic which served to develop clinical skills in observation, assessment and treatment and which could be applied by paediatricians in their everyday practice.

Finally, a personal view is given of how some of the presenting clinical problems can be viewed within the broader Australian context.