BJSW Advance Access published online on July 11, 2009
British Journal of Social Work, doi:10.1093/bjsw/bcp078
To Have and to Hold: Questions about a Therapeutic Service for Children
John Sudbery is Senior Research Fellow at the University of Salford. Originally qualifying in maths, physics and the philosophy of science, he is a registered social worker and psychodynamic psychotherapist. Now retired from his full-time post, he has extensive experience in academic research and in services for people who are dying, for families facing multiple and severe difficulties, and for sick children. He is chair of the Group for the Advancement of Psychodynamics and Psychotherapy in Social Work (GAPS). Professor Shardlow is Foundation Holder of the Chair of Social Work at the University of Salford, England, where he was until recently Director of the Institute for Health and Social Care Research. He has held academic appointments in Italy, Norway and Hong Kong. He is founding Editor-in-Chief of the Journal of Social Work. A previous chairperson of The Association of Teachers of Social Work Education (ATSWE) and UK representative on the Executive Committee of the European Association of Schools of Social Work (EASSW), he has worked as a social work practitioner and manager. He is a registered social worker in England and has worked extensively in international social work, through research, consultancy and development work. Current research interests are in the following areas: welfare and social capital; evidence-based policy and practice; professional ethics; comparative practice in the social professions; professional education. He has published widely in these fields, including fourteen books, and his work has been translated into several languages. Dr Huntington is a principal lecturer at the University of Central Lancashire (UCLAN). She has a worked for over twenty-five years in the statutory and independent sector. During that time, she has been employed as a nurse, youth worker, social worker, group therapist and educationalist in a range of health and social care settings. She has a particular interest in working with survivors of childhood maltreatment. Her most recent practice experience has been as a psychotherapist facilitating groups for people who have been dependent on drugs and/or alcohol. She has been a subject specialist reviewer for the QAA; is a member of the Higher Education Academy, the British Psychodrama Association Professional Conduct Committee and the National Children's Bureau Board of Management.
Correspondence to Professor Steven M. Shardlow, Chair of Social Work, School of Social Work, Psychology and Public Health, The University of Salford, Allerton Building, Salford, Greater Manchester M6 6 PU, UK. E-mail: s.m.shardlow{at}salford.ac.uk
 |
Abstract |
|---|
Therapies for children and young people that using ‘holding’ as an intervention for severe difficulties with attachments are controversial and raise many questions. At least one major professional organisation has stated that these therapies should be banned. This paper discusses the implications of a study of a service for children (and their families where appropriate) described as having attachment difficulties or a diagnosis of attachment disorder and where ‘holding’ techniques are employed as part of the therapeutic intervention. The views of a range of stakeholders (including children, young adults who had previously used the service, purchasers, outside professionals, and staff) about this service were collated directly by interview. The article identifies how this study can refine and inform the broader questions about ‘attachment and holding’ therapies. Proponents argue that the service offered provides effective assistance for some of the most hurt and difficult children in society. Opponents state that some of the techniques involved have not been evaluated, are ethically questionable and are not based on a validated theoretical mechanism. This paper highlights a number of core questions about attachment and ‘holding’ therapy and the findings of the study provide a commentary on these questions.
Keywords: Social work, children and young people, attachment, holding therapy, residential care