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Cases re-opened
Still open 20
Under investigation 3
Under treatment 17
Closed 16
Diagnosis only 10
Psychological test only 3
Improved 1
Never attended 2
During the year 1954, the activity of the Child Guidance Clinic was almost entirely
taken up with meeting the diagnostic and treatment needs of a full case load. Although the
total number of cases dealt with showed little increase in the figure for the previous year,
practically the entire resources of clinic time and effort were devoted to the various aspects
of this case work. In consequence, prophylactic and educative work with the other agencies
concerned with the care of children received little attention. The neglect of this important
aspect of Child Guidance Service was partly offset by some of the benefits derived from the
greater concentration of effort on case work. Social histories became at once snore valid
and useful by being taken in the patients homes. The high standard of psychological assessment
which characterises the work of the Educational Psychologist and which requires an
unhurried atmosphere and often more than one interview, was maintained without any overburdening
of the waiting list, Where treatment or remedial coaching was undertaken, it was
sustained for as long as seemed clinically desirable in each case irrespective of the claims
of others awaiting treatment. Clinical summaries were prepared at the time of closure in
every case, and subsequent progress was ascertained by letter or interview during the
succeeding six months.
The adoption of this procedure as a routine was immediately satisfying to the clinic
team, and of benefit to the children and parents. In less direct ways, it also had some
prophylactic value. In families where the emotional maladjustment seems to be fashioned
and fostered in each succeeding generation by mothers who were maladjusted in their childhood,
adequate treatment of the pathological situation in one generation, may break the chain of
neuroticlsm and prevent the perpetuation of maladjustment. On occasions, the follow-up
enquiries also had some prophylactic value. Minor difficulties in other members of the
family were often volunteered by parents of a child who had been helped by treatment. Timely
discussion of the problems usually encouraged their spontaneous resolution, and restored an
equable balance in intra-family tensions.
The table of statistics calls for little comment. The gratifying increase in the
number of home visits by the Psychiatric Social Worker, has already been noted. The
predominance of boys over girls in the new referrals was more marked than ever. Among the
re-opened cases, there were six times as many boys as girls. The increase in the number
of re-opened cases was more a reflection of parental confidence in the clinic than of an
increased relapse rate. Ten of these cases were referred by the Children's Officer on
behalf of the Juvenile Court. Many of the remainder were direct referrals from parents.
The general trend apparent in the sources of referral, was a falling off of cases
from the school medical officers and an increase in the referrals from hospitals. In this
connection, the clinical impression is, that referrals from hospital, family doctor and
from the parents, were co-operative from the outset, and became quickly sensitive of the
manner in which they could be helped.
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