ABSTRACT
Child psychotherapists usually work as part of a team, either within the NHS or the voluntary sector. The challenges of therapeutic work within a multidisciplinary team are considered, the tensions that can develop, as well as the value of shared thinking. Complex cases can lead to complex team dynamics if each worker identifies with their own patient rather than seeing the overall picture. The work of Isca Wittenberg showed how systems develop within the workplace to protect professionals, like nurses, from the pain and anxiety of their child patients’ suffering. A parallel is made with professionals working with distressed children who can benefit from a regular reflective meeting to share ideas and avoid the splits and tensions that can develop. The strain on a team of constantly dealing with risk is also considered, and the danger that workers can react defensively, either overact or minimise the risk rather than struggle to achieve a more thoughtful response. The need for clear procedures, supervision and working together is emphasised to contain the anxiety that complex cases create. If therapists work independently, it is important to link with professional networks involved with a referred child, and where possible find local colleagues for support.
