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Sarah was referred by her GP three years ago as a 7-year-old to an outpatient CAMHS clinic. Her father took Sarah to Africa at the age of two, against her mother's wishes. Mother, Ms P, attempted legal action but she only managed to gain access for three visits per year. Father remarried abroad, and had three children with H, who had been married previously, and already had children of her own. Mother was contacted by the authorities abroad and informed that Sarah had been taken out of school as serious bruising was found on her body and that Sarah's father and stepmother were being investigated. Sarah stated that she had hurt herself in an accident, but there had been a history of suspicious incidents. Sarah was removed from her father's home, and after complicated legal proceedings was brought back to England to live with her mother. A psychiatrist was involved in the assessment and stated that Sarah had suffered serious ongoing physical and emotional abuse and was displaying features of post-traumatic stress disorder.
I assessed Sarah on three occasions and found her to be a bright, articulate little girl who was able to give a clear narrative relating to her abuse. She played imaginatively, engaged well, and had the ability to hold her previous session in mind. I felt she was a hyper-vigilant child who was clearly traumatised.
I had been seeing Sarah, who was aged nine at the time of this session, weekly for approximately two-and-a-half years and a senior therapist saw Ms P or her partner R weekly. Ms P seemed very distressed, particularly about ongoing harassment from father's family.
In my first few sessions with Sarah, I was impressed by how much she had remembered from her assessment sessions with me. She had fears that I would be unavailable and she would have to see somebody else and that this pattern would repeat itself so that everybody would know everything about her. She alluded to the fact that she and her mother s