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Hadley, D. (2011). Clinical commentary by David Hadley, recently retired as Head of a Child and Adolescent Psychotherapy Service in the West Country. J. Child Psychother., 37(3):354-356.

(2011). Journal of Child Psychotherapy, 37(3):354-356

Clinical commentary by David Hadley, recently retired as Head of a Child and Adolescent Psychotherapy Service in the West Country

David Hadley

Residential schools are not easy places to work in and I was concerned that the therapy was not safely held in its context. The school is described as a place where ‘the left hand does not know what the right hand is doing’ and I surmise that this may represent the splitting that can often occur between those responsible for care and those for education, or between care and control. The therapist gives no indication of the existence of a person or group in the school that might try to hold these elements together on behalf of this pupil or the therapist.

There is an unbounded timeless quality to the description of the setting, with no reference to the outside world, other than that it feels there are too many people in it. The therapy is introduced as taking place, ‘over several years at a residential school’ and it is a relief to get down to the structure of this being in the third year and in the second week after increasing to twice-weekly work. This is later undone when the session is described as ‘the first second session’.

The necessary identification with one's patient may be heightened by this sense of being in the same boat and may contribute to the benign attitude to Mark's personas in the introduction, which is at odds with my sense of them being representatives of a pathological organisation (Steiner, 1993). That said, the subsequent narrative demonstrates the therapist has a more robust grip on what might be going on.

The session starts with Mark in a world of his own in the school hall as he delays his entry to the room. He is clearly at home in this no man's land as the therapist comments.

[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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