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Clinical commentary by Barbara Segal, a consultant child and adolescent psychotherapist working in University College London Hospitals
This moving clinical account describes the psychotherapeutic work undertaken in her hospital room with 13-year-old Maya, after the sudden onset of a terrifying and serious illness, Guillain–Barré syndrome, leaving her with paralysis and extreme weakness. The first session takes place almost three weeks after Maya's hospital admission and the second recorded session is the seventh, about five weeks later.
In the first meeting, the psychotherapist introduces him/herself and the service offered. Mother quite hastily leaves the room and the psychotherapist has the opportunity to hear from the patient about the onset of her illness and how she experienced this. Although Maya also tries to talk about the more ordinary aspects of her life and interests, she does convey her confusion and distress about her hospitalisation.
In the next meeting, the atmosphere is much changed. Maya's symptoms have worsened and she and mother are very tearful, trying not to show their distress to each other. The psychotherapist is required to bear some of the distress and to try to understand with Maya the fear and uncertainty that she is facing.
I shall look at the sessions in some detail, and discuss questions that arise in my mind. These are prompted by the clinical account here, which reflects some of the particular challenges and dilemmas that confront child and adolescent psychotherapists in paediatric liaison work in hospitals.
Child and adolescent psychotherapists working in hospitals are usually based within departments of psychological medicine within the hospital, offering a service in the areas of paediatrics and adolescent medicine. There are different models but mostly we work within the medical teams, functioning as an integral part of the multi-disciplinary medical specialities. The hospital, structured into wards, clinics, da