What is it like working with psychotic children and adolescents? A study of child and adolescent psychotherapists’ experience.

This study explores the lived experiences of a small sample of clinically experienced Child and Adolescent Psychotherapists regarding their work with psychotic children and young people. The research question is phenomenological in nature; the study seeks to understand what it feels like to work with these children. The method employed is IPA (Interpretative Phenomenological Analysis) owing to its compatibility with a small-scale qualitative study concerned with an idiographic approach, which aims to understand the ‘world view’ of individual participants. The following themes will be described: 1. Definition and Aetiology 2. Working with primitive states: the cost for the therapist, child, and family 3. Rival babies 4. What’s required – setting, technique, and personal qualities. The themes will be discussed in relation to psychoanalytic literature. The study concludes that a sub-group of overtly destructive psychotic children continue to be under-represented in the literature and require significant individual therapeutic support in addition to the active involvement of a wider network. Psychotherapists require considerable support to sustain the work with these children and intense emotional involvement ensues. Recommendations are made for further research.