The Presence of the Therapist: Treating Childhood Trauma

By Monica Lanyado | Go to book overview

Chapter 6

Psychotherapy with children in transition from fostering to adoption: a question of technique 1

The clinical work in the first part of this book shows how difficult it is to help children recover from trauma where family circumstances have remained relatively constant. So it is no wonder that when faced with the enormity of the numerous traumas and grave neglect that 'looked after' children have experienced against an unstable external backdrop, recovery can seem like 'mission impossible'. Yet these children are taking up what seems like an ever-increasing proportion of child psychotherapeutic resources (37.5 per cent in one clinic audit-Fleming 2002), and against the odds do seem to be able to make some significant recovery. A great deal of thought and research is currently being undertaken within the child and adolescent psychotherapy profession around the clinical, technical and theoretical problems that these children present (see, for example, Journal of Child Psychotherapy 2000; Hindle 2001, Hunter 2001, Ironside 2002).

My particular interest in how best to help these children and those who live with them has centred over the past few years on thoughts about how the therapist might be able to convert a current potentially traumatic change in care into a creative transition in the child's life. This is most evident when there is a change of foster family, or a move from fostering to adoption. There are different points of view about the wisdom of working with children who are in transition as this appears to go against the therapeutic grain of only offering therapy to a child who is emotionally held within a secure home base. However, it soon becomes evident when working with looked after children that each poorly managed change of

1 Much of this chapter was originally published in 2000 as 'Fenomeni transizionale e cambiamento psychico: riflessioni sul ruolo del transfert e della relazione "attuale" nel passagio dall affidamento all adozione' [Transitional phenomena and psychic change: the role of transference and the new relationship as seen in the therapy of children moving from fostering to adoption], Studi Psicoanalitici del Bambino e dell Adolescente, 8(3). The paper was given at the third conference of the European Federation for Psychoanalytic Psychotherapy in the Public Sector (EFPP), Rome, Italy, October 1999.

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