Winnicott's therapeutic consultations and squiggle game

Domain I · Psychodynamic & depth psychology · D. W. Winnicott · 1964 · Paddington Green Children's Hospital

What it is

A therapeutic consultation is a full, open first interview, or a small number of them, with a child (sometimes a parent alone). Winnicott used it at Paddington Green Children's Hospital for children who did not need analysis or could not get it. He called it applied psychoanalysis, not…

Format

• Session count. One to three consultations is the norm. 1971 presents about 21 cases, some with follow-up meetings.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Breaches of trust. Always ask first.
• Limited privacy in group or medical settings.
• Feeling infantilised. Frame it as adult exploration.
• Too many toys or materials, which dilute the exchange.
• Embarrassment. Respect a refusal and offer talk instead.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.