ABSTRACT
Issues of risk in Short-Term Psychoanalytic Psychotherapy, as with other approaches to therapy with severely depressed young people, usually focus on deliberate self-harm, such as cutting, and on expressions of suicidal ideation and actual suicide attempts. A persisting negative therapeutic reaction is one way of describing an impasse arising from destructive forces within the patient. One might suggest that the negative transference was being held in the patient–therapist relationship, leaving more space for something better in the external world. Where there has been a trauma or multiple traumas in the immediate or wider family, these will have a bearing not only on the young person’s therapy but also, inevitably, on the parent work and will need to be sensitively handled. While admitting a young person to an inpatient unit can seem like a safe alternative, and is sometimes clearly necessary, there are also risks associated with admission.
