Paranoia or adaptation? The implications of a kings fund review on a psychotherapy department

SUMMARY

This paper examines the impact of a Kings Fund Review on an established psychotherapy clinic during a period of major change in NHS mental-health services resulting from government initiatives. Some of the political, social and personal pressures on psychotherapists and their effects on the structure and process of the Clinic are considered. The benefits of the Review in helping Clinic staff to identify and distinguish between those initiatives to ‘fight’ and those where ‘adaptation’ is appropriate are illustrated. Through an understanding of the unconscious processes involved, strategy and tactics employed to maintain the identity, core values and therapeutic integrity of the Clinic are discussed.