A CONCENTRATED THERAPEUTIC RELATIONSHIP WITH A PSYCHOTIC CHILD

Abstract

Child guidance clinics ar e frequently faced with decisions as to the most efficacious use of staff time and energy_ If severely disturbed child ren are inclu ded among those treated , questions arise as to who should treat th em and how often they should be seen . Should the sicker children be seen only by th e more experienced th erapists?What is the op timal frequency of sessions from the sta ndpoint of therapeutic and pra ctical consideration? The present paper describes an exper iment in wh ich a grossly distu rb ed six-and-a-half-year-old boy was seen in a psycho therapeutic relati onship for three hours a day, five days a week, over a per iod of twelve weeks with an untrained college student.' T he case is of interest because of the apparently posit ive results of th is contact and its im plications. T he decision to undertak e this exper iment was based mostly on a question of expediency. Our patient, Jimmy, had not mad e notabl e progress in th e two years he had been at our nursery school and the nursery school teachers conside red h im unmanageable except with excessive individual attention. On ce-a-week psychother. apy had been briefly tr ied and did not seem promising. The question arose as to whether Jimmy's needs coinc ided with wha t has been referred to by others as the need for a primary lore object . Alpert (1959) has tr ied a techn ique with three cases which