The world of child mental health has radically changed since Anna Freud’s classic papers about the assessment of children’s suitability for psychoanalysis. The field has been flooded with therapies, some influenced by psychoanalytic principles but many from other traditions, and the patient population is comprised of children with a greater range of psychopathology. This paper suggests that Anna Freud’s Provisional Diagnostic Profile, which encompasses history, present circumstances, and current functioning, still serves as a useful guide to a thorough evaluation of patients and their potential for today’s updated psychoanalysis. Contemporary analytic goals include not only the classic unconscious conflict resolution and symptom relief, but also an amelioration of the child’s mental processes to facilitate affect regulation, mentalization, and insightfulness. The work thus addresses both pathogenic influences from the past and ongoing disturbances in mental functioning that impair the child’s capacity to deal with the future.