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This volume, the third in the Cassel Hospital Monograph series, is dedicated to the work with children and adolescents and brings together a number of papers, some amended versions of ones that have been previously published. This may account for the repetitious description of this unique institution; some judicious editing with a general preface describing the setting could have been helpful.
The Cassel is one of a small number of specialist hospitals within the National Health Service offering in-patient treatment for people with severe personality disorders. It has a long tradition of combining psychosocial nursing and psychoanalytic psychotherapy within a therapeutic community.
An extremely clear introduction by Lesley Day gives an overview of the work of the hospital with a summary of each chapter. This work is very helpfully set in the context of the provision (or rather lack of provision) of mental health services for children and adolescents and their parents in the NHS. The title of the book reflects the reality of these patients’ less than favourable experiences and the life histories described make uncomfortable reading. The authors describe the way in which patients internalized their experiences, and how these unfolded during their stay in the hospital, in a setting which offered a structured and containing environment. More often than not, the patients’ life experiences were re-enacted in the relationship to therapist and nurse as well as the wider community, and the book explores to what extent these experiences could be worked through and modified during the course of their treatment.
The majority of the papers are clinical accounts of treatment of the most disturbed and disturbing patients e.g. those with Munchausen syndrome by proxy, and borderline adolescents. The book