The handbook of child and adolescent psychotherapy Focusing on the development and practice of psychoanalytic psychotherapy with children and young people, this handbook provides both an introduction to this specialist profession and an insight into recent developments in technique and practice. It includes: • history, development and training • theoretical underpinnings • the process of work and the varied contexts in which it is carried out • the application of psychoanalytic approaches to different settings and client groups • in-depth expert overviews of current areas of specialist clinical interest • a review of research • an overview of international developments in the profession. The Handbook of Child and Adolescent Psychotherapy: Psychoanalytic Approaches is an essential resource for all professionals interested or working in Child, Adolescent and Family Mental Health, as well as those working in counselling and adult psychotherapy. Students of psychoanalysis will learn much from the detailed accounts of this specialised application of psychoanalytic thinking and technique. Monica Lanyado helped to found the Child and Adolescent Psychotherapy training in Scotland and remains involved with training issues at the British Association of Psychotherapists in London. Ann Horne was Head of the Child and Adolescent Psychotherapy training at the British Association of Psychotherapists. She works at the Portman Clinic, London, where she is co-editor of the Portman Series. Contributors: Chriso Andreou; Dilys Daws; Sira Dermen; Judith Edwards; Denis Flynn; Barbara Gaffney; Viviane Green; Trevor Hartnup; Jill Hodges; Juliet Hopkins; Ann Horne; Carol Hughes; Margaret Hunter; Monica Lanyado; Meira Likierman; Sheila Melzak; Niki Parker; Marianne Parsons; Pat Radford; Sandra Ramsden; Susan Reid; Paulina Reyes; Margaret Rustin; Valerie Sinason; Elizabeth Urban; Peter Wilson. The handbook of child and adolescent psychotherapy Psychoanalytic approaches Edited by Monica Lanyado and Ann Horne London and New York First published 1999 by Routledge 11 New Fetter Lane, London EC4P 4EE Simultaneously published in the USA and Canada by Routledge 29 West 35th Street, New York, NY 10001 Routledge is an imprint of the Taylor & Francis Group This edition published in the Taylor & Francis e-Library, 2001. Editorial matter and selection © 1999 Ann Horne and Monica Lanyado; individual chapters © 1999 individual contributors All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloguing in Publication Data The handbook of child and adolescent psychotherapy/[edited by] Monica Lanyado and Ann Horne. p. cm. Includes bibliographical references and index. 1. Psychodynamic psychotherapy for children. 2. Psychodynamic psychotherapy for teenagers. 3. Child analysis. 4. Adolescent analysis. I. Lanyado, Monica, 1949– . II. Horne, Ann, 1944– . RJ505.P92H36 1999 618.92′8914–dc21 98–48880 CIP ISBN 0–415–17258–6 (hbk) ISBN 0–415–17259–4 (pbk) ISBN 0-203-13534-2 Master e-book ISBN ISBN 0-203-18296-0 (Glassbook Format) Contents Contributors ix Foreword xiii MARY BOSTON AND DILYS DAWS Acknowledgements xvi 1 Introduction 1 ANN HORNE AND MONICA LANYADO PART I Theoretical foundations 17 2 The roots of child and adolescent psychotherapy in psychoanalysis 19 MEIRA LIKIERMAN AND ELIZABETH URBAN 3 Normal emotional development 31 ANN HORNE 4 Some contributions on attachment theory 43 JULIET HOPKINS PART II The child and adolescent psychotherapist in practice 53 5 The therapeutic relationship and process 55 MONICA LANYADO AND ANN HORNE 6 Some intercultural issues in the therapeutic process 73 CHRISO ANDREOU vi Contents 7 The child and adolescent psychotherapist and the family 81 (a) The family context JULIET HOPKINS (b) The place of consultation with parents and therapy of parents in child psychotherapy practice 87 MARGARET RUSTIN 8 The therapeutic setting: the people and the place 93 TREVOR HARTNUP 9 Research in child and adolescent psychotherapy: an overview 105 JILL HODGES PART III The child and adolescent psychotherapist in different therapeutic environments 125 10 The child and adolescent psychotherapist in the community 127 MARGARET HUNTER 11 The child and adolescent psychotherapist in a hospital setting 141 SANDRA RAMSDEN 12 Therapy and consultation in residential care 159 PETER WILSON 13 The challenges of in-patient work in a therapeutic community 167 DENIS FLYNN 14 International developments 183 JUDITH EDWARDS PART IV The diversity of treatments 197 15 Traditional models and their contemporary use 199 (a) Intensive psychotherapy VIVIANE GREEN Contents vii (b) Non-intensive psychotherapy and assessment 215 MARIANNE PARSONS WITH PAT RADFORD AND ANN HORNE 16 Brief psychotherapy and therapeutic consultations: how much therapy is ‘good-enough’? 233 MONICA LANYADO 17 The group as a healing whole: group psychotherapy with children and adolescents 247 SUSAN REID 18 Brief psychotherapy with infants and their parents 261 DILYS DAWS PART V Special clinical interests 273 19 The treatment of traumatisation in children 275 MONICA LANYADO 20 Deprivation and children in care: the contribution of child and adolescent psychotherapy 293 CAROL HUGHES 21 Delinquency 311 PETER WILSON 22 The violent child and adolescent 329 MARIANNE PARSONS AND SIRA DERMEN 23 Sexual abuse and sexual abusing in childhood and adolescence 347 ANN HORNE 24 Gender identity dysphoria 369 BARBARA GAFFNEY AND PAULINA REYES 25 Eating disorders 387 NIKI PARKER viii Contents 26 Psychotherapeutic work with child and adolescent refugees from political violence 405 SHEILA MELZAK 27 Autism: clinical and theoretical issues 429 JUDITH EDWARDS AND MONICA LANYADO 28 The psychotherapeutic needs of the learning disabled and multiply disabled child 445 VALERIE SINASON Appendix: Further information 457 Index 461 Contributors Chriso Andreou is a founder member of Nafsiyat, an intercultural therapy centre in London. She has undertaken clinical research into sexually abusive behaviour in young adolescent boys at Great Ormond Street Hospital, and worked at the Adolescent Unit in Wandsworth, London. Dilys Daws is a consultant child psychotherapist at the Tavistock Clinic, London, where her work includes being part of the Under Fives Counselling Service. She has also for the last twenty years visited weekly the Baby Clinic at the James Wigg Practice in the Kentish Town Health Centre, London. She was Chair of the Child Psychotherapy Trust and is founding Chair of the Association for Infant Mental Health. Sira Dermen is a child psychotherapist and a Member of the British Psycho-analytical Society. She has a private psychoanalytic practice, and also works at the Portman Clinic, London, where her special interest is in violence. Judith Edwards is a consultant child and adolescent psychotherapist in a Family Centre and teaches child development at the Tavistock Clinic. She is currently joint editor of the Journal of Child Psychotherapy. She has published in professional journals and contributed chapters to books including Autism and Personality (Routledge 1999). Denis Flynn has worked as Head Child Psychotherapist at the Cassel Hospital, London, and is now Head of the Adolescent In-patient Unit at the Cassel Hospital. He is a psychoanalyst in private practice. Barbara Gaffney trained as a child psychotherapist with the British Association of Child Psychotherapists having previously worked with deprived and abused children at the Mulberry Bush Residential School. She worked at the Gender Identity Development Clinic, St George’s Hospital, South London (which subsequently moved to the Portman Clinic) from 1992–7. She currently works in the Child and Adolescent Mental Health Service within Pathfinder NHS Trust, London.