ABSTRACT
This brief chapter sets out to describe the Under Fives’ Counselling Service at the Tavistock Clinic, to outline some of our practice and its origins, and to link it with assessment, including that kind of assessment which never moves towards long-term treatment but stays at the level of what Winnicott called a ‘therapeutic consultation’. The Under Fives’ Service is a much-used service in our Child and Family Department which was set up to answer the frequent need for brief work with parents and their baby or small child. This service has been running for some years, and we have developed our own way of working. We offer up to five sessions (all five may not be needed or wanted) with one of our team of professionals drawn from all the four department disciplines in psychiatry, social work, child psychotherapy and psychology. This work needs to be undertaken by experienced workers, because in brief work you need to have some resources to draw on, to have some capacity for quick thinking and to have developed some resilience in the face of sudden strong projected anxiety. Nowhere are these qualities more necessary than in work with infants and very young children when one is constantly urged on by the inner awareness that every week counts at a time when development is proceeding at such a pace. Less experienced workers have ample opportunity both for co-work with a senior person and for supervision. Indeed, for all kinds of briefer work, and certainly for assessment too, support and discussion times are not just desirable but essential.
