1st Edition

Through Assessment to Consultation Independent Psychoanalytic Approaches with Children and Adolescents

Edited By Ann Horne, Monica Lanyado Copyright 2009

    Winnicott’s description of "doing something else" or "working as a psychoanalyst" when not engaged in the actual analysis of his patients resonates with the child psychotherapist today. Individual psychotherapy is certainly a valuable part of the work but much of the time the CPT is "doing something appropriate to the occasion". Some of this time is spent in assessment work – for therapy, for the multi-professional team and for other agencies – and some in consultation to colleagues and other professional staff or in a combination of the two.

    Drawing from the Independent tradition in psychoanalysis, Through Assessment to Consultation explores the application of psychoanalytic thinking to this daily work, reflecting on what is actually done and why. Contributors to the three sections – ‘Assessment’, ‘Overlaps’, ‘Consultation and Beyond’ – provide a variety of clinical illustrations as they describe a range of approaches and settings in the tasks of both assessment and consultation, ranging from the light impact of the analyst’s presence in the grief of post-9/11 New York to the call to political potency of ‘beyond consultation.’

    This book will help both new and experienced Child and Adolescent Psychotherapists re-examine their role and function in the team and in the outside world, and will also be of interest to specialist health workers, educational psychologists and those wanting to explore more Winnicottian approaches to therapeutic work.

    Horne, Lanyado, Introduction: ‘Appropriate to the Occasion.’ Part I: Assessment. Walker, Every Assessment Matters: The Child Psychotherapist’s Role in Assessment in Child and Adolescent Mental Health Settings. Dowling, Thinking Aloud: A Child Psychotherapist Assessing Families for Court. Parsons, Horne, Anxiety, Projection and the Quest for Magic Fixes: When One is Asked to Assess Risk. Alfillé-Cook, Peculiarities and Problems in Assessing Adolescents. Part II: Overlaps. Onions, Infant Mental Health: A Conversation with Dilys Daws. Gibbs, Reflections on Race and Culture in Therapeutic Consultation and Assessment. Hamilton, Death in the Family: Post 9/11 at Pier 94 Manhattan. Horne, From Intimacy to Acting Out: Assessment and Consultation about a Dangerous Child. Part III: Consultation and Beyond. Robson, Consultation to an Under 5s’ Service. Lanyado, The Impact of Listening on the Listener: Consultation to the Helping Professions who Work with Sexually Abused Young People. Vastardis, ‘You are Paid to be a Nuisance’: Tensions in the Role of a Clinician-manager. Wilson, Beyond Consultation: Towards YoungMinds.


    Ann Horne trained in the Independent tradition at the BAP. She has discovered that retirement (after 10 years latterly at the Portman Clinic, London) can become very crowded and makes occasional sorties from behind the keyboard to speak and teach in the UK and abroad.

     Monica Lanyado is a training supervisor at the British Association of Psychotherapists. She is co-editor with Ann Horne of The Handbook of Child and Adolescent Psychotherapy and A Question of Technique and author of The Presence of the Therapist.

    "This book is a welcome addition to the clinical accounts of analytic work with children, young people and their families. The understanding provided here is a timely reminder that working indirectly to help frontline staff reflect is essential if good, objective decision making is to underpin the complex situations confronting workers in a whole range of settings in Children's services." - Judith Trowell, Professor of Child Mental Health, CSIP, University of Worcester and Honorary Consultant Psychiatrist, Tavistock Clinic, UK

    "The application of a psychoanalytic approach to areas other than individual treatment forms an essential part of child psychotherapy practice.  The  wide-ranging and insightful contributions to this book  address some of the most difficult and complex areas of work, including inpatient treatment, court reports, consultation to staff caring for victims of sexual abuse, and many more. Clinicians seeking to help new client groups while retaining a psychoanalytic perspective will find this an invaluable resource." - Maria Rhode, Professor of Child Psychotherapy, Tavistock Clinic/University of East London.

    "I highly recommend this book to anyone who is interested in the future of child and adolescent mental health.  In the future child psychotherapists will rely increasingly upon the development and adaptation of their psychoanalytic knowledge and skills in the practice of assessment and consultation.  This book addresses complex issues that the practitioner will face, such as the impact of a traumatised child's disturbance, race and culture, and the use of the transference and counter-transference.  The informative and accessible chapters cover work in CAMHS and specialist settings, including assessments for court, as well as special problems presented by under fives, the dangerous child, adolescents and risk assessments.  I also recommend this book to policy makers, members of multi-disciplinary teams, and those in management and commissioning who would like to know how child psychotherapists could help to deepen and broaden the provision of mental health care for children and adolescents."Donald Campbell, Child, Adolescent and Adult Psychoanalyst & Past President of the British Psychoanalytical Society.