ABSTRACT
Maria Emilia Pozzi discusses two issues, regarding assessment, that are closely linked. The first is the range of patients who can benefit from psychoanalytic psychotherapy and the second is the therapeutic alliance or consent for psychotherapy treatment. In the past, children with mainly neurotic disturbances, good verbal skills, internal conflicts, and supportive parents were part of the group to whom psychoanalytic psychotherapy would be offered. Nowadays, the spectrum has broadened to include children with autism and developmental delays, psychopathic disturbances, learning disabilities and mental handicap, severe abuse, and neglect. Under fives' counselling can turn into an assessment for further psychotherapy for either the child or the parents, individually or as a couple. The second issue of the therapeutic alliance is an essential ingredient for treatment to take place. Children with severe learning disabilities and developmental delays often communicate it to the therapist in puzzling or subtle ways.
