Many psychological talking treatments are available, but most have been developed for individuals who choose to ask for help, and are fully willing and able to cooperate with a clinician. In these circumstances, and where problems are not complex or entrenched from an early age, CBT or behavioural therapy may well offer the best chance of speedy success in alleviating symptoms.

However, there are client groups that cannot consciously acknowledge the need for help or cooperate in treatment. Many families in this country struggle with long-term, generational histories of deprivation, loss, trauma and abuse. As a consequence of early, damaging experiences, the children of such families may become delinquent, disturbed, hard-to-reach or hard to manage. As teenagers and young adults they may turn to self-harm, abusive relationships, drugs or alcohol or to the gang culture of the streets. Few of them will be in a position to choose to co-operate with formal counselling.

A psychodynamic training equips the practitioner to understand feelings that are unspoken, and that may not be easy to name or acknowledge.

For instance, it may be too shaming for a teenage boy to let himself know about his own feelings of terror or his longing for a loving relationship with his father.

A psychodynamic training equips the practitioner to understand unconscious meaning behind bizarre or worrying behaviours.

For instance, a young woman who threatened to cut her stomach open with a kitchen knife was expressing her fury with her mother for becoming pregnant by an abusive lover.

A psychodynamic training equips the practitioner to explore and deepen the quality of their relationships with clients and colleagues.

For instance, a boy consistently kicked and swore at his teacher until she was able to talk to him about how her ethnicity reminded him of his mother, who had abandoned him.

Vulnerable client groups may not find it easy to trust anyone who is trying to offer them help or has a position of authority.

Psychodynamic practitioners are trained to understand how childhood experiences may have led to an attitude of distrust and cycnicism. They learn to build relationships with their clients that can withstand hatred, suspicion and prejudice.

For this reason, psychodynamic practice requires substantial commitment and self-discipline.

Psychodynamic practitioners must offer:

emotional availability

emotional honesty

open-mindedness

integrity

reliability

a capacity to remain consistently self-reflective and self-critical