ABSTRACT
Children may lose continuity of care within the family they entered at birth for a variety of reasons. In this chapter, the focus will be on children who have experienced severe losses. Such children are those whose families have been unable to provide an ongoing home and who have entered the system of child-care administered by the state. Either because of requests for help in taking care of a child from overwhelmed families or because of state intervention to remove a child from an abusive home, these children become the responsibility of social work agencies and are in residential homes or foster-placements, and some ultimately in adoptive homes. Within this group, the children referred for psychotherapeutic assessment are not usually those for whom there are hopes and plans for rehabilitation within the family of origin, but those for whom long-term alternative plans are being or have been made. They are the children who have not been helped enough by being offered alternative care, and whose psychological distress is evident either through their own visible unhappiness and difficulties in living, or through the disturbing effect they have on their carers and the wider world.
