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Judith Trowell, with Gillian Miles, London, Karnac, 2011, 320 pp., RRP £23.74
This book is based on a study that has been extremely influential in getting psychoanalytic psychotherapy back on the map in the public sector. It is important for many reasons, not least that it was the first outcome study using psychoanalytic child psychotherapy that is cited in a National Institute for Clinical Evidence (NICE) guideline, the one for childhood depression. This is a major achievement and has meant that it could be argued at national and local levels that psychoanalytic child psychotherapy must be available to the National Health Service (NHS) and local Child and Adolescent Mental Health Services (CAMHS) services due to being prescribed by NICE as an effective evidence-based treatment. This study demonstrated the efficacy of non-cognitive behavioural therapy (CBT) psychotherapeutic treatments for childhood depression at a point when in many child mental health services the choice, at best, is between medication and CBT. It is also an example of research which set out to be non-partisan and aimed to investigate two central therapeutic modalities, psychoanalytic child psychotherapy and systemic family therapy, in a spirit of open-mindedness and lack of rivalry. These have been the two primary modalities central to therapeutic work in the Tavistock's Child and Family Department for many years, modalities that have long rubbed shoulders but not always without friction.
The vision for such a study could only have come from a clinician who is able to cross boundaries and therapeutic borders with both ease and dignity, a practicing and experienced psychoanalytic clinician who is theoretically sophisticated but whose primary interest is in thinking about what is best for patients and who has little time to waste on tribal rivalries. Dr Judith Trowell, as many know, is just such a person, a child psychiatrist and psychoanalyst with a distinguished record of achievements who has put h