The psychotherapist as the crucial factor in fostering the relationships in the triangle supporting the child: second audit and evaluation of the child psychotherapy service at the Randolph Beresford early years centre

ABSTRACT

Therapeutic programmes that offer early intervention may decrease the risk of developing emotional and behavioural difficulties in childhood and adulthood. This paper describes the Hammersmith & Fulham (H&F) Child and Adolescent Mental Health Service (CAMHS) Child Psychotherapy Service (CPS) that was established at Randolph Beresford Early Year Centre (RBEYC) in 2008. It presents the results of an audit and evaluation of the CPS. We used a Goal Based Outcome (GBO) measure to evaluate service-users’ (parents’ and caregivers’) perceptions of progress toward treatment goals, and structured interviews with eight caregivers and ten staff members to explore their views of the CPS. Thematic analysis was used to summarise these views. GBO ratings indicated that all caregivers felt they had made progress towards reaching treatment goals by the end of the intervention. Interview responses suggest that all caregivers and staff perceived the CPS positively and thought that the RBEYC was successful in nurturing the child’s overall development. The quality of relationships between staff, service-users and the CPS was perceived as central to the facilitative environment of the RBEYC. In particular, the psychotherapist was viewed as playing a critical role in facilitating this triangle of relationships supporting the child.

KEYWORDS:

• Early intervention
• vulnerable population
• audit and evaluation
• thematic analysis

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Inge-Martine Pretorius (PhD & DPsych) is Child and Adolescent Psychotherapist at the Anna Freud Centre National Centre for Children and Families (AFNCCF) where she is the Clinical Lead of the Parent-Toddler Service. She is a Clinical Tutor for Psychoanalytic Developmental Psychology at University College London and the AFNCCF where she organises and teaches the MSc Psychoanalytic Perspectives of Child Development course. She works part-time for the West London Mental Health NHS Trust, running a Child Psychotherapy Service in a Children’s Centre in a deprived area of London. She has published in the fields of molecular genetics and psychoanalysis and is co-editor with Marie Zaphiriou Woods, of “Parents and toddlers in groups: a psychoanalytic developmental approach”. Routledge: London and New York (2011). Together with Norka Malberg, she published, Anna Freud’s Legacy: The Revised Provisional Diagnostic Profile (2016): Historical Backdrop and Contemporary Integration, in a special edition (2017) of the Journal of Infant, Child, and Adolescent Psychotherapy, 16:2, 127-186.

Doron Batiste Harel holds an MSc from the Anna Freud National Centre for Children and Families (AFNCCF) in Psychoanalytic Developmental Psychology. Upon completing her graduate studies, she was joined the Parent-Toddler Service staff at the AFNCCF. She is currently completing her training in Clinical Psychotherapy for Children, Adolescents and Adults. She has specialised in psychotherapeutic work with deprived children at high risk in public institutions and in private clinical services.

Peter Martin is a Lecturer in Applied Statistics in the Department of Applied Health Research at University College London. He has been involved in studies in psychology, health care, and epidemiology, with a particular interest in mental health. His work has included life course research, survey methodology, monitoring and evaluation of health services, and psychotherapy research, using a variety of designs and types of data, including randomised controlled trials, cross-sectional and longitudinal surveys, and clinical records. Recent publications include:

• Martin, P., Cortina-Borja, M. et al. (2018). Timing of singleton births by onset of labour and mode of birth in NHS maternity units in England, 2005–2014: A study of linked birth registration, birth notification, and hospital episode data. Plos One, 13(6), e0198183. Available online: https://doi.org/10.1371/journal.pone.0198183

• O’Keeffe, S., Martin, P. et al (2018). Predicting dropout in adolescents receiving therapy for depression. Psychotherapy Research, 28(5), 708–721. Available online: https://doi.org/10.1080/10503307.2017.1393576

ORCID

Inge-Martine Pretorius http://orcid.org/0000-0003-4603-2051

Peter Martin http://orcid.org/0000-0003-4638-0638