ABSTRACT
Winnicott described in his book Therapeutic Consultations how a diagnostic assessment of a referred child developed into a fruitful therapeutic intervention when he was able to discover the unconscious fantasy that underlay the child's symptoms. Because these were children who were, essentially, developing normally, he used the word "knot" to depict the obstacle the child had met. Any conflicts the parents might have were not explored in that context. The chapter presents cases in which child and parents are seen together for the diagnostic assessment. The child's feelings about his world and his difficulties are explored through a variety of techniques, including drawings. From a psychoanalytic perspective, it is quite logical to offer individual treatment to a child or adolescent who has a problem, but other schools of thought would consider this situation quite differently. Family therapists consider the child's symptom as a sign of family pathology and address themselves to the whole family.
