Case Study of an Adolescent Girl

IN THIS PAPER I shall discuss the treatment of an adolescent girl, but I should like first to describe briefly the setting in which the treatment took place. I work in a large local authority clinic with staff from varied theoretical backgrounds and trainings. The clinic is particularly interested in family group methods and we have large numbers of referrals. Only a very small proportion of cases seen are taken on for individual psychotherapy.

In discussing the reaction of the patient to treatment it is important to take into consideration the selection of cases. Children and adolescents are referred to the clinic by parents, doctors, educational psychologists, teachers or social workers. They are seen for diagnosis by a child psychiatrist, in a family group, with the parents, or sometimes separately. The parents are usually seen by a psychiatric social worker, either jointly with the psychiatrist or at one or more separate interviews. Following these diagnostic procedures certain children are selected by the psychiatrist for individual psychotherapy. In some cases the child psychotherapist sees the child individually to assess the suitability of the case for treatment.

After selection the child can sometimes be offered treatment immediately, but more often there is a waiting period of from three to nine months.

I have my own room in the clinic and this is used for treating children and adolescents of all ages as well as for interviewing parents, students, teachers, social workers or other visitors. It would be possible to use a separate room for adolescents but I do not think this desirable. I think it is important that whatever the patient's age the treatment room should be clean and comfortable, with armchairs for both patient and therapist. In my room most of the toys are kept in a cupboard which can be shut when not in use. There are plants in the windows and the larger toys, such as doll's pram containing dolls, show that the room is used by children