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any other member of the clinic staff, and had
given most valuable service.
Mrs Henry was appointed as part-time
psychotherapist and this appointment was most
welcome as there is an acute shortage of
psychotherapists and a great demand for their
services. Not more than twenty children could
receive once weekly psychotherapy. This meant in
fact that in many cases the emphasis had to be
on the difficulties within the families which were
dealt with by the psychiatric social workers.
The liaison with other agencies which Dr
Levinson started with the probation officers
was continued by closer co-operation with the
Children's Department, and the introduction of
seminars for school medical officers and health
visitors.
Mrs Lees took part in the persistent nonattenders
working party.

The psychiatrist is responsible for the selection
of children who require special educational
treatment for maladjustment and for the general
supervision of such children in attendance at
Busch House School.

The analysis of cases seen in 1966 shows that the
largest group are behaviour problems, but as
always in child psychiatry there is the problem of
a great deal of overlap in symptomatlogy. It will
be seen that only 19 cases were recommended for
treatment, and 16 for day maladjusted school.
These figures should be treated with great reserve
as it was felt unrealistic to make recommendations
for treatment or for maladjusted schools
where places were not available or likely to be so.
Intensive work in child guidance clinics can
only be carried on where there is a large staff.
As only four psychiatric sessions were available
throughout the year, very few children could be
seen more than once or twice by the psychiatrist
and this inevitably makes it difficult to serve a
role in prevention as well as treatment.
The primary task of a child guidance clinic
has never been made clear. The more successful
a clinic becomes in dealing with cases the more
referrals occur, which in time tends to lead to
considerable delays in treatment and dilution of
the services offered.
The Regional Hospital Board has been
requested to second more psychiatric sessions and
the borough council is being asked to approve
the direct appointment of a psychiatrist for two
sessions a week."
I am grateful to Dr Tyson BA BSc (Econ) PhD
for submitting the following report—
51