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In the background to the clinical material, the therapist identifies these sessions as a ‘turning point in the work’. So I thought I would begin by considering the research on turning point sessions in child psychotherapy before thinking about the complex issues that this young child and her therapist were grappling with together.
Carlberg (1997: 331) defined a turning point session as
a session where the therapist notices that something qualitatively new may be identified concerning the behaviour of the child or the child's way of showing his/ her inner world, or where something new enters the interplay between the child and the therapist.
Carlberg's small qualitative study is fascinating to read, as he was able to identify common features, as well as a range of themes that emerged in the cases reported over a two-year period.
In relation to the clinical material described in this commentary, I was struck by the directness of Grace's communication to her therapist, and the way in which they came together to create a narrative, with the therapist giving voice to Grace's feelings. These moments – also captured by Grace's words and actions – seem to exemplify what Carlberg (1997: 345) described as a key principle behind these kinds of changes – ‘a moment of emotional meeting underlying the turning point’. That is, it is in the context of the relationship and the emotional quality of the interplay between child and therapist that seems to pave the way for such changes.
Carlberg (1997: 342) also noted that ‘there is often an extended significant process preceding the turning’. In the therapist's background information, we hear that in the initial period of the therapy, Grace was ‘often silent or spoke only in whispers … or was hidden in corners of the room or under