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‘This important area of clinical practice’ is how Margaret Rustin describes ‘work with parents’ in her introduction to the EFPP clinical Monograph which carries that title (Rustin, 2000), and several remarkable papers in recent issues of the Journal of Child Psychotherapy (2003; Palacio Espasa, 2004) and elsewhere (Barrows, 2003) have confirmed that observation. Indeed, as Christine Frisch-Desmarez (2004) points out, ‘these new ideas emphasize in particular the impact of the family unconscious on child development and force us to re-think the individual treatment procedures used in the field of psychoanalytic psychotherapy’. Saralea Chazan's book, now in its second edition, is an important contribution to the discussion of the many questions raised by this kind of work - all the more so, perhaps, in that her approach is somewhat eclectic.
It is therefore probably better to begin by having as clear an idea as possible about what the author means by ‘simultaneous treatment of parent and child’; Chazan defines this in the first page of her Introduction as ‘the treatment of both members of a dyadic relationship, parent and child, separately by the same therapist’. Therein perhaps lies a problem… This, then, is no ordinary (and, nowadays, classic) approach in which a child has individual psychotherapy with his or her therapist, while the parents (both, if possible) are seen regularly or in parallel by the referring consultant or some other therapist - but in any case not the one who is working with the child. Nor is it the psychoanalytic ‘family therapy’ paradigm in which parents and child/children have treatment, as a family unit, in joint sessions with the same therapist. Nor again is it what Piovano (1998) calls ‘parallel’ treatment - child and parent(s) have separate sessions at the same time with two therapists who, at the end of each hour, meet to discuss relevant material.
The methodological difficulties to which Chazan's approach may give rise are briefly discussed