Findings from a clinical project aiming to make psychodynamic psychotherapy more effective for children with disruptive disorders are summarised and discussed. In this project a supportive expressive model was used and the therapists worked with both children and parents. Nine boys aged 6-10 years were treated; all were reported to function better…

The subject of sexual abuse is a major focus of professional and public concern. Sexual abuse of (and by) people with learning disabilities evokes even greater disquieting emotions, and makes severe demands on the social services, and the criminal justice system. The aims of the project were: 1) to determine whether group psychotherapy produced…

This paper attempts to explore the nature and consequences of early trauma on the mental development of a 9-year-old boy I have called Luke. The traumatic event occurred within the context of a more chronic and ongoing trauma, which was due to the lack of receptive and containing parental figures. The combination of these two kinds of traumatic…

This paper illustrates one kind of "impasse" in psychoanalytic psychotherapy described by Rosenfeld (1987 [1995]. Clinical illustrations from the experiences of two adolescent patients are given. The author emphasises that perversion reinforced the confusion these patients felt in the transference and in their lives outside treatment. An internal…

The following is the text of an introductory presentation given on the occasion of the 40th Birthday Conference of the Journal of Child Psychotherapy. It provides an historical overview of the Journal's development, and in particular compares and contrasts the first two issues of the Journal with the two most recent. The importance of research is…

This paper describes clinical work carried out as part of the Tavistock Clinic Under Fives Service, which offers brief focused psychoanalytically based interventions to families with young children, as well as longer-term work. It elaborates psychoanalyst Annette Watillon's idea that it is the dramatic way in which children enact their (and their…

In this paper I shall describe the psychotherapeutic treatment of a 14-year-old boy, who suffered from mild Asperger's syndrome. This adolescent had a multiplicity of imaginary friends, which protected him from catastrophic feelings of loneliness and deadness, but at the same time interfered with the possibility of establishing meaningful…

This paper considers the meaning, reference and clinical relevance of Winnicott's concept of "riddance". Taking its starting point from the infant's behaviour in letting go the spatula, as described in his paper, "The observation of infants in a set situation", it explores his explanation of riddance activity in the context of…

This paper describes a framework for evaluating the effectiveness of child psychotherapy used by child psychotherapists in an inner city Child and Adolescent Mental Health Service (CAMHS). The Hopes and Expectations for Treatment Approach (HETA) involves using the assessment for psychotherapy that normally precedes treatment to derive a baseline…

In understanding delinquency in adolescence the key theoretical papers on the role of oedipal resolution and superego development remain essential and are summarized. To this we need to add our knowledge of trauma and of developmental deficit if we are to offer appropriate strategies for young delinquents and to be able to select those for whom…

In this paper the course of the therapy of an adopted latency-aged girl is described in some detail. There was considerable improvement outside the sessions while within sessions she remained a not-very-vocal child and continued to play in the way that a younger child might. The clinical material is examined in a discussion of the possible…

The technical difficulties posed for the child psychotherapist working with children who have themselves experienced violence and abuse are addressed. A distinction is drawn between violence in the service of communicating about such experiences and violence that arises from more perverse aspects of the patient. The therapist's need to pay close…

The author reviews the main points in Freud's 1917 paper "Mourning and Melancholia" and relates them to the process of both normal and troubled adolescent development. Using clinical examples she illustrates the ways in which the processes Freud describes in melancholia operate in some disturbed adolescents such that instead of mourning the lost…

The author discusses two concepts of transference: the broader use of transference as the "total situation", as it was called by Melanie Klein and further elaborated by post-Kleinians, and the narrow use of transference in the traditional sense. Using clinical material from the four-times-a-week analysis of a severely disturbed…

This paper explores the process and value of concurrent work with parents when their child is being treated in individual psychotherapy. The position taken is that psychoanalytic understanding generally and the specific formulations presented in this paper have a broader applicability in other aspects and approaches in child and adolescent mental…