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I was asked to comment on this session because it takes place in the school setting, which is familiar to me through my work over the past six years for the Islington CAMHS in Education Service. In the context of my own attempts at working therapeutically in both mainstream schools and units for excluded pupils, the first sentence in the ‘Background’ paragraph of the material provided immediately interested me: here was a therapist who sounded quite confident that what she was providing to her patient in this setting was once weekly psychotherapy. In my own Service, those of us who are psychotherapists have been debating for a long time whether what we offer in the educational setting, even when it is long-term, once-weekly individual work, could ever be called psychoanalytic psychotherapy, due to the many adaptations in technique necessitated by not being in a clinic environment and culture. We have come to the conclusion that at times we are able to offer something akin to what Otto Kernberg (2004) called ‘supportive psychotherapy’, and after reading to the end of the clinical session presented, it seemed to me that it was very much that particular form of psychotherapy this therapist was offering to Sam. I will come back to this perhaps controversial point later.
Sam's life history and present living circumstances sounded sadly familiar in the context of my Pupil Referral Unit (PRU) work. I found myself impressed that he had managed to reintegrate relatively successfully back into a mainstream school, given the level of neglect, physical and emotional abuse he had suffered during his early years, and the statement that his emotional needs were still not being met at home by his father and his new family. He sounded like a resilient and resourceful young person to me, who was able to make the best of whatever help was bei