In this brief paper, I aim to highlight the most significant aspects of the psychotherapy conducted with a 10-year-old child within a public service setting over a period of 2 years. The clinical work initially followed a weekly schedule for the first 10 months and subsequently increased to twice-weekly sessions. I believe that the most pivotal element of this therapeutic process was the possibility of reconfiguring an internal world inhabited by the presence of a ’dead mother’ (Green, 1980), a construct that relates to the profound depression experienced by the child’s mother. This process allowed the child to open himself more fully to both his inner world and his peers. I can affirm that he reached the threshold of adolescence with newly developed capacities for affective investment in his objects. I believe that the internal transformations he underwent facilitated an intense and engaged encounter with the relational experiences offered by reality.

The aim of this paper is to discuss the clinical rationale for designing a tailor-made board game as a therapeutic intervention in play therapy. Games are practiced in play therapy in directive and non-directive ways. Structured and directive approaches are used in individual and group therapy, and enable therapists to identify themes and work them through. A review of the literature concerning the use of games in psychotherapy is suggested in this paper, followed by a detailed rationale for a tailor-made rule-governed board game as a directive theme-focused intervention for short-term group psychotherapy. Such a board game, designed for processing termination in a group of severely deprived adolescent boys in their final year of long-term psychodynamic residential treatment is described. Therapeutic considerations for designing specific elements of the game are described in detail, as well as the symbolic language that served as a framework. Based on a description of clinical thinking used in the preparation of this board game, a discussion of the particular characteristics of designing tailor-made board games as a directive intervention in play therapy is suggested. The paper explains the need for a particular design of game for each specific therapeutic group, based on the identified needs of the participants, as well as on the aim of the intervention.

Click to increase image sizeClick to decrease image size Disclosure statementNo potential conflict of interest was reported by the author(s).Additional informationNotes on contributorsLaila Al-AttarLaila Al-Attar is a Psychodynamic Counsellor and Psychotherapist working in the NHS and in private practice.

The article aims to apply psychodynamic thinking in the context of psychological consultation to hostel staff, who were offering support to people experiencing homelessness in a residential hostel setting. The article focusses on how Rey’s claustro-agora-phobic dilemma was used to help staff to think about one resident and their dog, whose escalation in behaviour threatened the safety of everyone in the hostel. The article concludes with a reflection on the challenges and opportunities of offering psychological consultation in this sector, with some recommendations for commissioners and staff.