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76
The play-room contains various simple toys, models of objects used
in daily life, and opportunities for making a mess (sand and water trays).
Each child attends weekly for a period of 45 minutes, during which time
he or she is under constant skilled supervision.
The psychiatrist is responsible for the individual examination of all new
cases, for the regular treatment of a number of children suitable for psychotherapy,
and for the co-ordination of the work of all the other members
of the team. As regards children whom the psychiatrist treats personally,
it is less necessary to see all the mothers week by week, as the children are
older (usually in adolescence). In a number of cases, the parent is seen
at regular intervals by the psychiatrist, as it is not so necessary with
older children to observe the general rule that children and mother should
be handled by separate members of the staff.
The home environment of the children is an important factor in
causation of symptoms. It is the task of the clinic to modify this environment
where possible, just as it is to assist the child to make a better adjustment
to life. Success does attend these efforts, but all too often it is
clear that not only is the environment the cause of the child's difficulties
but also that continuance of that environment will so hamper the child as
to prevent any improvement from clinic treatment. Many and varied
are the factors in the environment which influence the child. Of these,
parental disharmony is a fruitful source of difficulties, whilst lack of
real affection never fails to produce problems. Personality disorders
in either parent may make the task of treating the child almost insuperable
whilst he remains at home. Vacancies are very difficult to obtain
at residential schools approval by the Board of Education for maladjusted
children. Open air residential schools meet the need occasionally when
the children's difficulties are not severe, and a foster-home (also very
difficult to find) provides an occasional solution. The establishment by
the County Council of a hostel or residential school of its own for maladjusted
children will fill a great need.
Statistics have been given in this report about numbers seen, types
of case, and so forth, but otherwise it is not possible in psychological
work to convey a true or satisfactory picture by means of figures of the
real work done.
The work of the clinic does not materially alter year after year, for
the type remains the same and the numbers with which any one clinic
can deal are always controlled by the factors of time and space ; in other
words, where, as here, a clinic of definite size is working to capacity,
further numbers could only be dealt with by increasing accommodation
and personnel.
Five lectures were given to groups of parents by clinic staff during the
year 1946. The aims and methods of child guidance have now become
much better known and a lively interest is shown by the public in all
aspects of the work.