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This volume makes a timely contribution to understanding the role of psychoanalysis, psychotherapy and psychoanalytic thinking in the NHS today. Its publication coincides with unprecedented pressures on psychotherapy services; these include financial pressures, the widespread introduction of outcome measures, pressures to meet certain targets (many of which may seem tangential to the actual quality of treatment) and competition from brief manualised therapies which are ‘evidence based’ and cheaper to deliver. This book explores such issues as they affect psychoanalytic thinking and psychoanalytic treatment in different parts of the NHS, including adult and child services, inpatient and outpatient units, the use of psychoanalytic frameworks by other health professionals and the application of psychoanalytic thinking to staff groups.
Alison Vaspe’s introduction explores the history and development of psychoanalysis within the NHS; the NHS was founded just after the Second World War, such that it was from the outset ‘informed by a belief in the power of the unconscious mind’ (p. xxii) at a time of ‘hope and idealism for a better future’ (p. xxiii). Vaspe examines the role of key psychoanalytic institutions which were part of the NHS from the start,
including the Tavistock Clinic and Cassel Hospital, as well as the use of Balint groups by GPs. She notes specific concerns about the current state of the NHS which are taken up in more detail in later chapters, including the existence of a ‘target culture’ in which ‘performance and box-ticking might be privileged over care of the person’ and an environment where there is ‘continuous and destabilising change’ (p. xxxvi).
The chapter of most direct relevance to child psychotherapy is written by four child psychotherapists: Judy Shuttleworth, Julia Britton, Amanda Keenan and Kyriakos Thomaidis-Zades. They note the tension which many child psychotherapy trainees experience between the study of psychoanalytic concepts and pract