Working with vulnerable children: therapeutic observation and Watch Me Play

Watching a child play, describing the play, and providing undivided attention for short periods of time can do no harm. Trainings in clinical observation and child development may be helpful and reflective supervision is always important in work with children who have experienced trauma and disrupted care. It is likely to be helpful to observe alongside a clinician or to discuss what is seen in the child' s play with another interested adult, but the Watch Me Play! approach is not a brand. It is a flexible approach that can provide a helpful first stage before further more intensive treatment such as video-interactive approaches, parent-infant psychotherapy or individual child psychotherapy, if they are needed, and available.

Where possible we offer around six sessions with foster carers and children together, often with telephone support to the carer between sessions, but the approach is flexible enough to be used in briefer interventions of just one or two sessions with telephone follow-up. It has also been possible to follow a child from foster placement to foster placement and to the adoptive home, providing an extra layer of continuity for the child, with the same approach being used by each caregiver.

Conclusion

Making sense of observations and feelings -- Freud's 'observing thought' -- seems to create a potential space in which something new can develop. Bringing professionals together with a focus on making connections with the child's experiences reflects the gathering and binding function that Freud ascribes to the life instinct. This approach can be particularly helpful in situations where it is difficult to maintain a focus on the child or to feel hopeful for the child.

Observational work with young children in temporary foster care can be both rewarding and harrowing, bringing closer contact with realities in the lives of infants and young children whose families of origin have broken down, always painfully. Working together, focusing on meaning and seeking out life-seeking energy through the power of attention helps to make it possible for painful experiences to become known and provides a frame in which vulnerable children can be seen and heard.

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