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Service is unique in that it is not entirely either a medical and
educational or a social service, but combines all three aspects and
has evolved its own special method of team-work to fulfil the special
task of such a complex service.
On the medical side the Child Guidance Service has two major
functions:-
(i) It is a consultant service for other doctors whether they
are doctors of the Local Authority or the general practioners of the
neighbourhood.
(ii) It is a treatment service for children suffering from
emotional instability or psychological disturbance.
On the educational side it is also a diagnostic and consultative
service for the educational authorities and teachers, in providing
intellectual and educational assessments of individual children;
and also a treatment service, in that children who are educationally
retarded more than in proportion to their intellectual retardation,
can be helped to regain their rightful level in the school.
On the social side the same two functions are fulfilled. Social
workers in other fields want advice and assessment of children and
their families and also hope for treatment of social problems, this
is the least easy to supply. There are many problems referred to
us which are virtually insoluble.
The special and complicating factor in Child Guidance work is
that every case presented tends to have all three aspects and is
rarely confined to one category. Moreover, although the service is
called Child Guidance, no child exists in a vacuum and few children
have problems without a corresponding problem in their family.
Therefore, Child Guidance is a not very accurate name for what is
pre-eminently a service to families. In any given case several
members of a family may be involved and will have to be considered
in diagnosis and in treatment.
We have abundant evidence of the association between the
disturbance in the child and the disturbance in the home: the more
unsatisfactory the home, the more severe the problem in the child.
Families attending the Child Guidance Centre are drawn to a large
extent from among the psychologically disturbed and the emotionally
unstable, with a far higher incidence of the severely neurotic
and psychotic, than in the population as a whole.
Apart from the consultative and therapeutic work that is done
with the patients actually referred to the clinic, an important
function is to be a preventive service. It is with this idea that most
Child Guidance Services are set up. It is no doubt true that
treating individual cases in childhood is in itself a substantial
contribution to prevention, in that many will be saved from an
adult life of mental illness. Nevertheless, by the time the children
have been referred to the Child Guidance Clinic from the schools,