Ending Child Psychotherapy: Continuing the Cycle of Life

The child therapist works from two perspectives: the perspective of illness, or pathology, and the perspective of dynamics of growth and development. Indeed, psychopathology in childhood can be defined not only in terms of constellations of symptoms, but rather in terms of a lag, or foreclosure upon the usual course of unfolding development. Development in childhood occurs within a context of family and social-cultural milieu. Assessment of the child's situation is always relative to these environmental factors, as well as to unique constitutional and temperamental determinants. Child psychotherapy exists as part of the ecology of the life cycle of the family. The child comes into treatment because he and his caregivers require assistance. He ends treatment when generational boundaries are strengthened and the life cycle continues with the child in the care of responsible and competent adults.

To be comprehensible, the child's difficulties require an analysis of the context in which they occur. Any intervention on the therapist's part also impacts on those who care for the child. One way of conceptualizing maladjustment is as the child's inability to cope with environmental contingencies, given his level of development and inherent capacities. Therapeutic intervention becomes necessary because the child has encountered some loss of his secure base. This loss was not contained by the child and resulted in injury to himself and discomfort to his caregivers. The loss of security reflects a change in relationship to his caregivers, as well as to himself. The child requires assistance to continue along the path of future development.

When the course of ongoing development becomes derailed, therapy then becomes necessary. Once the course of development is able to resume, psychotherapy for the child is no longer necessary. Rather than being stated in absolute terms