Finding new clinical pathways in the changing world of district child psychotherapy

Abstract

This paper discusses the changing working environment of child psychotherapists in the public sector in the UK whose responsibility is to play a part in providing a general service to a local community. It suggests they operate with a kind of dual citizenship, owing allegiance both to the psychoanalytic community and to the public sector. Transitions between one and the other are demanding, requiring careful thought and management. This has become more demanding because of changes occurring within the public sector as a whole and within multidisciplinary, multi-approach child and adolescent mend health tams. The nature of these changes is outlined. It is suggested that their cumulative effect is radical and irreversible and that, if district child psychotherapy is to be sustained, it will need to adapt to them in ways that are understood by and are acceptable to both the psychoanalytic and the public-sector communities. Hard thinking will be needed to carry forward into the next fifty years the achievements of district child psychotherapy in the UK in its first fifty.

Key Words:

• District child psychotherapy public sector;
• child and adolescent mental health services;
• multi-disciplinary teams; multi-causal approach.