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(2011). Clinical Commentary: Clinical material. J. Child Psychother., 37(3):349-354.

(2011). Journal of Child Psychotherapy, 37(3):349-354

Clinical commentary

Clinical Commentary: Clinical material


Mark is a 14-year-old boy who attended for psychotherapy over several years at aresidential school. He has an early history of severe neglect and abuse, much of which was ill documented and lost to both official record and his own memory. There remain unanswered questions about what sexual activity Mark had been exposed to by his mother and sufficient evidence concerning his older brother's abuse of younger cousins that he became labelled as a Schedule One offender. On several occasions Mark has tried to initiate sexual activity with male peers and adults which has resulted in extra staff being employed to ensure his constant supervision. Mark is generally liked by the staff but avoided by other pupils who do not want to be associated with his infantile interests or his ‘weirdness’. Nevertheless, even staff find him intrusive and disconcerting as he will suddenly make an over familiar comment – “Your neck smells nice!” or slide from an intelligent discussion into incoherent baby babble. Mark functions well below his chronological age at school, but the legacy of his early abuse together with the amount of school he has lost and the disabling nature of at least two of his personas mean that it is hard to accurately assess his true cognitive ability. Certainly I meet a curious and quick witted young man as often as Imeet a very limited disabled Mark.

Mark's dramatic creativity encompasses a cast of thousands, he is a consummate mimic and a committed karaoke fan, and can be very entertaining.

[This is a summary excerpt from the full text of the journal article. The full text of the document is available to journal subscribers on the publisher's website here.]

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