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Home arrow Psychology arrow Time-limited Psychodynamic Psychotherapy with Children and Adolescents: An interactive approach

The place of the double task

The organisational consultant and psychoanalyst Harold Bridger (1990) has described the process of building in a review as ‘the double task’. He states that all organisations need to carry out a dual task; the first of which is to carry out the task and do the work, and the second is to review the task. The process of review is essential to assessing the continued relevance of the work, including what changes need to take place. Time-limited psychotherapy with children, parents and young people if it is to be a dynamically alive process committed to change, must do the same.

The review offers the opportunity to re-address the formulation that was made at the outset of the therapy. By carrying out a review, one is not advocating trying to please the patient or client, or pull up the roots of the therapy to see how it is growing. Rather, it is a process that acknowledges that children, parents and young people have come into therapy because of a genuine desire for change and improvement in their emotional and relational circumstances. It follows that they can be trusted to engage in a review halfway through the therapy, in order to evaluate how things have gone, and what needs to be attended to in the next part of the therapy. Stepping back into ‘role’ for both the therapist and patients, following the review, becomes an accepted part of the process because of the relationship of trust that has been established, that enhances the therapeutic alliance and anchors the therapy.

Carrying out the review in the spirit of Bridger’s ‘double task’ should not be confused with some of the current directives in some government- run child and family mental health services, to check the usefulness of each session with the patient, whether child, adolescent or adult, at the end of each session. We would be advised to be cautious about such a directive which constitutes a commodification of the therapeutic relationship, under the guise of democratic participation. Our understanding of the transference elements in the therapeutic relationship, as well as sheer common sense, would inform us that the therapeutic engagement can have its ups and downs, and that the overcoming of resistance is one of the most significant challenges in therapeutic work. Additionally, the fact that therapy is time-limited does not in any way detract from, or minimise our attention to the sense of continuity that is intrinsic to the process.

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