Bringing psychoanalytic consultation to the table: experiences of CAMHS clinicians and practitioners who engage in a 1:1 consultation with a child psychotherapist about their work with adolescents with a history of intergenerational trauma

Objective: This study explores the experiences of clinicians/practitioners (N=7) working in CAMHS, who sought 1:1 consultation with a child psychotherapist to support their work with adolescents impacted by intergenerational trauma (IGT). The project extends the current literature by exploring the specifics of child psychotherapy consultation taking place within a trauma-focused pathway. Method: Semi-structured interviews were used to collect the data, which were transcribed verbatim and then analysed using Reflexive Thematic Analysis (RTA); no prior hypotheses were applied. Results: From the qualitative analysis of participants' narrative accounts, five central themes emerged: ‘Psychoanalytic Markers’, ‘Digestion, Processing and Container-Contained’, ‘Consultation Through the Lens of IGT’, ‘Who’s the Expert’, and ‘The Impact of Consultation’. A distinctive contribution of this research was that these themes captured participants’ perceptions about the outcomes of child psychotherapy consultation, defined as the gains made by staff (micro-gains) and gains made for the patient and the organisation (macro-gains). Conclusions: Consultation emerged as a vital support to staff groups in CAMHS working with traumatised children and families. Findings evidence that in IGT cases, staff are motivated to seek consultation as a valuable intervention of choice, helping them better understand their patients. Slowing down, containment, and digestion are indicated as essential ingredients to consultancy work. A key finding of consultation with a child psychotherapist is the unique contribution where negative feelings stirred by IGT cases can be endured, tolerated, and eventually understood within a psychodynamic collaboration, widening the lens of sustainable practice and protecting against staff burnout. Parallels between the findings and the existing literature on child psychotherapy consultation were found. This study warrants further consideration of the specialist contribution child psychotherapists make through joint consultation with NHS staff. It is argued that there is a need for a consultation offer to be made more readily available when working in trauma-focused services.