Correspondence

It seems that Shuttleworth's dilemma (Journal of Child Psychotherapy 25(1)) echoes the same problem with which health professionals in Sydney have had to grapple. It is the struggle to adjust a way of dunking into a psychosocial milieu which does not value it as the ‘one and only’, or even as having any value at all. With the advent of evidence-based strategies, the emphasis is on numbers and identifying target populations with a degree of need in the community rather than a degree of need in the individual child or adult. These could be considered opposing forces. However, it is the task of health professionals utilizing psychoanalytic thinking to understand this as a normal tension of their professional lives and to find a ‘good enough’ balance for the needs of the individual and the community. Part of this struggle involves keeping alive the practice of child psychotherapy.

The practice of child psychotherapy in Sydney, NSW, is established in a very different way from that in the United Kingdom. The role of the child psychotherapist is hardly, acknowledged by the NSW Department of Health so that those working in the area of child mental health are employed to work genetically as social workers, psychologists, occupational therapists and child psychiatrists. Some of these health professionals would have had an exposure to the analytic way of working either in their training or during their professional life. Being thus analytically informed may lead them to choose child psychotherapy as one of their preferred ways of working. However, because their training is not in ‘pure’ child psychotherapy or psychoanalysis, the struggles discussed by Shuttleworth facing the district child psychotherapist and the question of ‘dual citizenship’ is not a burning issue.

Historically, the model of the Child Guidance Clinic (CGC) was imported from the Uni