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107
Child Guidance Service
Dr. James Hood, Consultant Psychiatrist, North West Metropolitan
Regional Hospital Board, to Harrow Child Guidance Clinic, reports and
comments as follows.
The number of new cases seen by the Psychiatrist fell from 101 to 81
as compared with 1970.
The number of new cases referred by general practitioners fell,
probably as a result of the opening of the new Paediatric Department at
Northwick Park Hospital, to which some family doctors preferred to
refer children in the first instance. After paediatric assessment, some of
these children were referred on to the clinic for psychiatric opinion and
treatment.
The figures otherwise reflect not so much a fall in demand for the
clinic's services—this increased, if anything, during the year—but rather,
an intake policy which is affected by such factors as the following:-
(1) The difficulties in staffiing the clinic on the social work side,
referred to in detail in the report for 1970. These continued.
Only two out of the three established posts were filled during
the year, and for a short time there was only one social worker on
the clinic staff. One exceptionally talented worker resigned on
her appointment as casework organiser for a large Social
Services Department.
(2) The new Children's legislation and the setting up of a Social
Services Department in Harrow were leading to the development
of work with children and their families which overlapped with
that formerly undertaken mainly by the Child Guidance Service
Staff. Consequently, an increasingly selective intake policy
could be pursued, with the object of taking on for investigation
and treatment only those children and parents who were most
likely to make good use of the specialised resources of the clinic.
(3) A higher proportion of time was spent by the psychiatrist in case
consultations with workers from other agencies, especially the
Department of Community Services.
(4) Individual child psychotherapy (in conjunction with casework
with parents), therapeutic consultations with children, and family
therapy with intact families—these continue to be the main areas
of clinical concern for the psychiatrist. Numbers of cases were,
by these criteria, inappropriately referred to him, but communications
and discussion with referring agents led to clarification,
and usually, referral elsewhere. In this way, the clinic's functions
as a link and meeting ground between the general medical
services for children, the educational services, and the Social
Services Department (which has potentially so much more to
offer emotionally and socially deprived children than the clinic
itself) were demonstrated.