The Child Psychotherapist and Problems of Young People

Views: 1299
Ratings: (0)

Many parents at some time dread that a child of theirs may be mentally ill or disturbed. But even after a generation of child psychology, psychiatry and psychotherapy, they still frequently fear to admit their fears, and fear the mystery of the remedy as much as the mystery of the problem.It is therefore important that parents should come to easy terms with the work of the psychotherapist, and be reassured that it is based on sympathetic understanding, not mysteries.It was to explain themselves to parents and others who work with other young people that sixteen psychotherapists and analysts (mostly following the principles of Anna Freud or Melanie Klein and largely drawn from the Hampstead Child Therapy and the Tavistock clinics in London) decided to collaborate in the preparation of this book. In it they set out to describe their work in schools, hospitals, clinics, day centres, etc and to discuss their fundamental approach to the treatment of the disturbed child. It is their hope that by stripping away many of the misconceptions in the minds of parents, teachers and social workers about child psychotherapy then can give reassurance to many.

List price: $28.99

Your Price: $23.19

You Save: 20%

 

15 Slices

Format Buy Remix

CHAPTER ONE The Contribution of the Child Psychotherapist

ePub

by Mary Boston

This chapter takes a first look at the incidence and causation of emotional disturbance in children. It highlights the importance of the pre-school years and the desirability of increased social and emotional support for parents together with their young infants. The need for social and economic change and for further research into environmental factors is considered, joined with the specific contribution of the child psychotherapist in effecting changes in the inner world of the growing child. The psychotherapist’s basic methods are outlined. M.B., D.D.

Child psychotherapists are concerned primarily with the treatment of emotional disturbance in children and young people, although they also work in a consultative capacity in a variety of settings which touch the growing individual. The wide range of maladjustment which comes within the psychotherapist’s province will be clearly illustrated in the chapters which follow. When carrying out individual treatment the analytic child psychotherapist attempts to help the patient to understand his or her own situation and, in particular, any unconscious factors which may be contributing to current difficulties. The therapist is, in other words, concerned with the patient’s ‘inner world’ - the subjective picture of people and things we all carry around within us, sometimes without even being aware of it, and which may or may not adequately correspond to outward reality.

 

CHAPTER TWO: Working with Small Groups of Children in Primary Schools

ePub

by Susan Reid, Eva Fry and Maria Rhode

This chapter takes a closer look at emotional disturbance as faced by teachers. Some children experience their emotional and developmental difficulties principally in the school situation. Here we show one of the ways in which they may be helped in the school setting itself.

The Tavistock students who worked with the small groups described were already professionally qualified either as psychologists or teachers. They undertook this group work during the pre-clinical part of their further training in child psychotherapy. The techniques used are not the same as those of the individual psychotherapy session, which are described elsewhere. The purpose of this chapter is not to particularize the differences and resemblances in the two situations, but to give further examples of the kinds of behaviour which the psychotherapist tries to illuminate. M.B., D.D.

Tavistock students began taking small groups of children in primary schools in 1966, when a trainee employed as a remedial teacher realized that the children were using her classes to work on their personal emotional problems. This realization led to the establishment of groups specifically for that purpose. Knowledge of these groups spread by word of mouth among heads of schools. Many felt that there was a real need which the groups might help to meet. When the Tavistock Clinic became involved in this work, it was found that almost all teaching staff agreed that they had more disturbed children in their classes than they could hope to deal with while conscientiously pursuing their job as teachers. Some staff were more hopeful or more despondent than we were ourselves about the amount of improvement that might be expected as the result of forming these small groups.

 

CHAPTER THREE The Child Guidance Clinic

ePub

by Dora Lush, B.A., PH.D.

In the previous chapter we were given a glimpse of some of the kinds of children who have difficulty adjusting at school. We saw how some of them can be helped in small groups. These disturbed children are often those who have been deprived of adequate opportunity for an understanding relationship with concerned adults, either because of problems in the home background or because of too large classes in schools. Such children are able to make good use of the extra opportunity which is offered by the groups. There are other children, however, for whom the small groups do not seem enough - and in any case many schools at present do not have such facilities.

Some disturbed children may therefore need to attend a psychiatric clinic. In this chapter a typical setting where child psychotherapists work and where children may receive psychotherapy is described and the details are set out of what happens when children are referred by their schools, or by their parents, or by a doctor. We are introduced to the child guidance team, their methods of assessment and to a sample of the problems the children present. The classified symptoms and backgrounds of one hundred children who were considered suitable for individual psychotherapy are included in the review. Some of these are examined in detail. M.B., D.D.

 

CHAPTER FOUR Child Psychotherapy in a Day Unit

ePub

by Dilys Daws

Chapter 3 described how the child guidance clinic is organized and how the child psychotherapist functions in that setting. This chapter describes the practice of psychotherapy in a day unit, where children spend the whole day in the building in which they receive therapy. The effects of the setting on the children are discussed, and something of the meaning of the framework in which therapy takes place emerges. M.B., D.D.

I work as a child psychotherapist in a day unit connected with a child guidance clinic. As in the clinic itself, the therapeutic staff of the Unit is a team comprising a psychiatrist, a psychiatric social worker, an educational psychologist and a child psychotherapist. In my Unit they all work part-time, and the staff also consists of three teachers, employed by the I.L.E.A., together with three assistants who are employed by the Health Service. Finally, there is a full-time secretary, a caretaker and a cook, all of whom are also employees of the Health Service.

 

CHAPTER FIVE: The Child Psychotherapists in a Day Centre for Young Children and Parents

ePub

by Mary Boston

This chapter describes the work of a psychotherapist in another kind of day unit. We have seen suggestions in previous chapters that our attention in the future may need to be directed much more towards support for parent-and-child, in particular for the mother vulnerable to isolation and depression - such support may be vital to the promotion of healthy emotional development. At the day centre for preschool children described here, an attempt is made to offer help to parents in the company of their children. M.B., D.D.

First we will look at some of the problems of children attending the Day Centre.

Some children are excessively anxious and literally cling to their mothers, perhaps making nursery school attendance impossible.

Tessa, a pretty, wide-eyed, soft-spoken little girl of two-and-a-half, was so clinging that her mother was unable to go anywhere without her, even to the toilet. She would not sleep alone and also had temper tantrums. Six-year-old Nita was similarly clinging and rather slow in her speech development. She had a feeding problem which seemed to date back to a traumatic weaning from the breast, when she refused to take a bottle. Sally, at two, had become phobic about dolls and about her own feet. Angela was another child inseparable from her mother, but she was aggressive towards her, scratching and attacking her in a way which her mother felt unable to cope with - Angela, in fact, partly belongs to the next category.

 

CHAPTER SIX Working in a Hospital

ePub

by Rolene Szur

This chapter describes further aspects of work in a hospital setting and returns to the subject of individual therapy with both out-patients and in-patients. The functions of a residen tial psychiatric unit for children are discussed. In hospital, the child psychotherapist may work in close liaison not only with the psychiatric team but also with the staff in other branches of the hospital. M.B., D.D.

A child psychiatric department in a hospital may offer certain facilities not always present in a child guidance clinic. The Day Centre described in the last chapter is an example. In some hospitals there may be a residential psychiatric unit for children or adolescents. The close links with other hospital services are important and interesting for the psychotherapist. Work with out-patients, however, follows very similar lines to that carried out in local clinics. Both see the same wide range of problems - including learning difficulties, school refusal, bed-wetting, conduct disorders and so on. Occasionally, a child is referred specifically to a hospital because the symptoms are very long standing, or are causing severe anxieties.

 

CHAPTER SEVEN Counselling Young People

ePub

by Isca Salzberger-Wittenberg

This chapter is about work with adolescents, (see also appendix, Doubly Deprived). Work with adolescents extends naturally into work with young adults, and in many cases the style of work is nearer to that undertaken with adults than to the work with younger children. In her role as therapist in a university counselling service and with other young people in a National Health Counselling Service, Isca Salzberger- Wittenberg decided to find out what could be achieved within the limits of a few consultations. She gives examples of how some young people were able to make good use of such brief depth exploration. She concludes that limited work of this kind can give clients enough insight to enable them to mobilize their own resources, and to continue working on their problems in ways that help them over a crisis situation. This approach of limited consultation may be particularly suitable for young people who are in any case not prepared at this stage of life to commit themselves to long-term psycho therapy, and with some it serves as a way of exploring their feelings about whether they do in fact wish to undertake longer-term psychoanalytic treatment. M. B., D. D.

 

CHAPTER EIGHT A Study of an Elective Mute

ePub

by Pat Radford

We now turn to a more detailed case study of a younger child. This chapter describes in detail the course of psycho therapy, over a period of years, with a little boy of six who did not speak outside the home. We are shown the vivid phantasy play of this child and the events leading up to his first words in the treatment sessions. The case well illustrates the therapeutic process and the complex dynamics behind this unusual symptom. Above all, we see the careful, painstaking work over a period of time which a child psychotherapist may undertake with an individual child. M.B., D.D.

Rob was just six years old when psychotherapy began. My first impression was of a little marionette, a puppet on strings - pale-faced, clumsy, uncoordinated in all his non-stop jigging, feverishly giggling while he pressed his fingertips together, walking on tip-toes. His odd appearance was not helped by his particularly large head, nor by his exaggerated miming - his only method of communicating with me.

 

CHAPTER NINE Beginnings in Communication: Two Children in Psychotherapy

ePub

by Jess Guthrie

What happens if a child not only does not talk, like the one described in the previous chapter, but cannot even play? Jess Guthrie, a psychotherapist with long experience, who has died since this chapter was first published, gives a sensitive and illuminating account of a psychotherapist’s attempt to get into contact with two very disturbed children, who could not communicate in an ordinary way. M. B., D. D.

In their everyday living children naturally express themselves through their play. By this means inner feelings, fears, wishes and phantasies find form in relation to the outside world. Their expression helps to relieve anxiety and contributes to the child’s growing ability to discriminate between inner and outer reality. If, however, anxiety has become more acute than a child can satisfactorily manage, he may come into psychotherapy for help with his emotional difficulties. Then, if he is able to play, that self-expression can be used as a medium of natural communication between himself and the therapist. At the same time, of course, one is in touch with the child through spoken language, absorbing what he says, at times conveying one’s understanding and helping him to put his thoughts and feelings into words. Some children, through no lack of intelligence, come into treatment unable to speak, or with their speech restricted to certain persons to the exclusion of others. Many of these are children who have achieved speech development appropriate to their age, but whose use of language has become impaired through some experience which has proved traumatic. They may nevertheless be well able to relate to their therapist, and to communicate, in other than verbal terms, until the use of words is again freely available to them both in treatment and their daily living.

 

CHAPTER TEN Play and Communication

ePub

by Shirley Hoxter

The previous chapter traced in detail the connections between patterns of behaviour and communication shown in the therapeutic situation and the kind of infantile experiences which the children concerned had probably had. These infantile experiences had not, of course, actually been observed, but were inferred from the patient’s session material, along with information and impressions gained from the parents.

In this chapter something of the theoretical basis of the assumptions involved is explained. They derive from Freud’s work and its development by Melanie Klein. We are first given some direct observations of an infant’s behaviour. Then the development of play and of symbolic thought from earliest infancy onwards is traced. We are shown how such understanding is used in the Kleinian technique of child analysis and psychotherapy. We also see a further case study of a boy for whom normal methods of communication and interaction with the mother had not been available in infancy. As a consequence the child had developed almost no powers of symbol formation. M.B., D.D.

 

CHAPTER ELEVEN Psychotherapy with Psychotic Children

ePub

by Frances Tustin

The preceding chapter described vividly the course of psychotherapy with a little boy whose communications were at first of a very primitive and chaotic kind. A therapist with a great deal of experience in treating psychotic children gives us now a further glimpse into the psychotic layers of the mind and the awful ‘black hole’ feeling which these patients experience. The nature of childhood psychosis is discussed and the problem of diagnosis. We see the extremely difficult, dedicated and firmly disciplined work which is necessary for getting in touch with these children. In it, agonizing primi tive feelings have to be shared with the patient before psychotherapy proper can be begun and established. The parents of psychotic children need great sympathy: the task of the psychotherapist is to try to heal the formidable break between mother and child. M.B., D.D.

In this chapter I want to describe the conditions I have come to regard as necessary for the psychotherapeutic treatment of a psychotic child. My account is based on over two decades of experience with such children. I hope it will warn the reader of the pitfalls inherent in work with these children, and perhaps also save him from the holes I have dug for myself.

 

CHAPTER TWELVE Freud and Child Psychotherapy

ePub

by A. C. Reeves

The scene turns now to the beginnings from which child psychotherapy developed, in particular to the work of Freud. We learn how Freud’s thinking led him to the idea of unconscious conflict. A summary then follows of those aspects of Freud’s theories which are especially relevant to the understanding of this book.

The contributions of the pioneer child analysts, Anna Freud and Melanie Klein, are discussed, showing how each developed and applied Freud’s ideas to work with children in somewhat different ways. Mention is also made of some more recent developments in child psychiatry and child psycho therapy by other well-known workers. M.B., D.D.

The previous chapters have already described practical applications of the analytic techniques of child psychotherapy in various settings. Inevitably, the reader will have noticed instances of the therapist’s intervention by word or act, whose ultimate justification depended on a framework of knowledge beyond the issues presented by the particular case. So we must consider the question - what body of theory supports the practice of analytic child psychotherapy, and how did its principles become established?

 

CHAPTER THIRTEEN Some Comments on Clinical Casework

ePub

by Sara Rosenfeld

Sara Rosenfeld had agreed to write a chapter for this book before her tragically early death in 1973. Because she was unable to complete the chapter, it was decided to include instead an already published paper. We hope this will serve as a memorial to the creativity of her work, the richness of her psychotherapeutic insight and the inspiration of her teaching. This paper gives a detailed overview of work conducted by Mrs Rosenfeld’s colleagues at the Hampstead Child Therapy Clinic and elsewhere. It provides a useful counter-balance to the next chapter, which is a Tavistock description of an alternative training in child psychotherapy. M.B., D.D.

This chapter evaluates some aspects of clinical casework as conducted by a group of child psychotherapists. The survey is confined to the experience of my colleagues and myself at the Hampstead Child Therapy Clinic; there is therefore emphasis on one clinical and theoretical standpoint only. However, we recall that Freud stated there can be no monopoly in the field of psychotherapy. He reminds us: ‘There are many ways and means of practising psychotherapy. All that lead to recovery are good.’ (Freud, 1905)

 

CHAPTER FOURTEEN The Tavistock Training and Philosophy

ePub

by Martha Harris

The following is an account of one of the three trainings in child psychotherapy which currently exist - that of the Tavistock Clinic. The two alternative trainings are undertaken at the Hampstead Child Therapy Clinic and the Society of Analytical Psychology.

The Hampstead course has its theoretical orientation briefly described in the previous chapter by Sara Rosenfeld. The newly inaugurated training at the Society of Analytical Psychology is not described in detail here. It is a Jungian course, and the writings of Michael Fordham form a very relevant introduction to that training.

To describe and compare all three of these trainings in detail would go beyond the scope of this book. We have therefore included one full account only. This is of the Tavistock training. In it we are shown vividly the process of self-discovery that the child psychotherapy student there undergoes. It is believed that something of this process is also experienced in the other available trainings. Anyone seriously attracted to this work will of course wish to investigate the alternative approaches to discover the one most suitable for them personally.

 

APPENDIX Doubly Deprived

ePub

by Gianna Henry

This additional case study gives an account of psychotherapy with a patient very different from others described in this book. In fact, the doubly deprived patient described by Gianna Henry belongs to a group of children often considered inaccessible to psychotherapy. Mrs Henry, however, gives an impressive and hopeful account of how she patiently made contact and progress with a boy at first almost impossible to reach. M.B., D.D.

I intend to present some aspects of the first two years of treatment of an adolescent boy whom I saw once a week for just over a year and then on a twice weekly basis. Martin was referred to the clinic because of considerable learning difficulties (he was nearly fourteen when he started treatment and his reading age was six), aggressive behaviour and stealing. Two years prior to referral he had made a suicide attempt when he tried to jump from a second floor window.

Martin is the illegitimate child of West Indian parents. His mother died when he was seven years old, but she had had no contact with him after the age of two months, when he was placed in residential care. His father had disappeared at the beginning of the mother’s pregnancy. Martin had three placements up to the age of two, when he was fostered by an English couple with a child of their own, a boy four years older than Martin. He was with the foster parents for ten years, until fostering broke down. Martin was at that time twelve years old. It seems that the foster parents found Martin increasingly unmanageable because of his stealing and defiant behaviour. They felt that they were no longer able ‘to accept him or have any trust in him’. There is no indication of the impact that the attempted suicide (one year before the breakdown of fostering) might have had on the foster parents and how it might have contributed to their feeling of inadequacy. They discontinued contact with Martin after he left the foster home to return to a children’s home.

 

Details

Print Book
E-Books
Slices

Format name
ePub (DRM)
Encrypted
true
Sku
9781781811504
Isbn
9781781811504
File size
0 Bytes
Printing
Disabled
Copying
Disabled
Read aloud
No
Format name
ePub
Encrypted
No
Printing
Allowed
Copying
Allowed
Read aloud
Allowed
Sku
In metadata
Isbn
In metadata
File size
In metadata