How do child and adolescent psychoanalytic psychotherapists understand treatment review meetings?

Objective Treatment review meetings are a routine part of clinical practice in NHS Child and Adolescent Mental Health Services (CAMHS), yet they remain largely unexamined within psychoanalytic literature. This study explores how child and adolescent psychoanalytic psychotherapists understand and experience reviews. It aims to illuminate the emotional, relational and institutional meanings of these meetings, considering how psychoanalytic thinking can contribute to understanding their complex dynamics. Methods A qualitative design was adopted, grounded in Braun and Clarke’s Reflexive Thematic Analysis (RTA). Six ACP-registered child and adolescent psychotherapists, all practising within NHS CAMHS, participated in semi-structured interviews. The interviews invited participants to reflect on their experiences, feelings and theoretical understandings of treatment reviews. Data were analysed inductively and interpretively, with particular attention to transference-countertransference dynamics and the researcher’s reflexive position as a trainee psychotherapist. Results Four overarching themes were identified: (1) Tensions inherent in ‘Bringing things together’ (2) Reviews as a site of ambivalence (3) Feelings of exclusion and intrusion abound (4) ‘Being aware of what parents can tolerate’. The findings reveal that reviews evoke deep anxieties about judgment, responsibility and therapeutic progress, yet also offer opportunities for linking and containment when handled reflectively. Conclusions Treatment review meetings, though often perceived as administrative necessities, can be understood psychoanalytically as spaces where clinical, parental and institutional states of mind intersect. Recognising their emotional significance allows psychotherapists to use these meetings more creatively, fostering shared thinking and collaboration across the therapeutic system. The study highlights the value of psychoanalytic reflection within NHS settings and calls for greater attention to such dynamics in clinical training and research.