Our highlights

The Tavistock and Portman has a history of innovation, thought-leadership and excellence in what we do. Our highlights include pioneering infant observation and collaborating in creating a framework for delivering mental health services for children, young people and their families.

Attachment theory

John Bowlby had been one of the original members of staff at the Portman Clinic, but at the end of World War 2 he joined the Tavistock and became the Head of the Children’s Department. It was here that he carried out work that would eventually lead to his three volume treatise on attachment. Bowlby’s ‘trilogy’ – Attachment, Separation, and Loss – had, by 2010, been cited over 12,000 times. By this measure at least, John Bowlby is the most influential psychoanalyst of all time, establishing a new developmental paradigm.

A two-year-old goes to hospital

This film classic, made in 1952, drew attention to the plight of young patients at a time when visits from parents were severely restricted. Laura, aged 2, is in hospital for 8 days to have a minor operation. She is too young to understand her mother’s absence. Parents and carers are now welcome to stay with their child for as long as they wish. This film, made by the Tavistock’s James Robertson changed the way that children are treated in hospitals all over the world.

Play and observation

When the Tavistock Clinic moved into its new building on the corner of Torrington Place and Malet Place in November 1932 we made a number of innovations. When it was founded, the Tavistock was probably the first psychotherapeutic clinic in the UK to have a Children’s Department. When we moved, we took this a step further with a purpose built play room for children. This even included a primitive one way screen for observation – a completely new innovation.

A two-year-old goes to hospital

This film classic, made in 1952, drew attention to the plight of young patients at a time when visits from parents were severely restricted. Laura, aged 2, is in hospital for 8 days to have a minor operation. She is too young to understand her mother’s absence. Parents and carers are now welcome to stay with their child for as long as they wish. This film, made by the Tavistock’s James Robertson changed the way that children are treated in hospitals all over the world.

A two-year-old goes to hospital

This film classic, made in 1952, drew attention to the plight of young patients at a time when visits from parents were severely restricted. Laura, aged 2, is in hospital for 8 days to have a minor operation. She is too young to understand her mother’s absence. Parents and carers are now welcome to stay with their child for as long as they wish. This film, made by the Tavistock’s James Robertson changed the way that children are treated in hospitals all over the world.

Family Drug and Alcohol Courts

Family Drug and Alcohol Courts (FDAC) were pioneered by the Tavistock and Portman NHS Foundation Trust, in partnership with several government departments, Camden Council and Coram, the children’s charity. Established in 2008, instead of the usual care proceedings, a family chosen for the FDAC programme goes through a very different therapeutic process co-ordinating a range of services around the family to help tackle drug and alcohol problems. At the same time it redefines the role of the judge within a problem-solving approach. There are now 15 FDACs serving 36 local authorities across the UK.

A recent report says that parents involved with the Family Drug and Alcohol Courts during care proceedings are more likely to beat their addiction and be reunited with their children.

Factors that supported FDAC’s success include the package of high-intensity, wraparound, multidisciplinary support flexibly tailored for each individual, the role of FDAC judges in overseeing the process, and having direct contact with parents, encouraging them to make and sustain changes.

A celebration of excellence

Over the years, the outstanding work of our clinicians has been recognised by the Department of Health in its annual Clinical Excellence Awards. Past recipients include:

• Robin Anderson
• Tony Garelick
• Rob Hale
• Peter Hobson
• Sebastian Kraemer
• Caroline Lindsay
• Anton Obholzer
• Michael Shaw
• Nick Temple
• Judith Trowell
• Jessica Yakeley

Separation

This year the NHS celebrates its 75th birthday. It is also the 50th birthday of John Bowlby’s second volume of his attachment trilogy: Separation Anxiety and Anger . Where Volume I is perhaps the most theoretical, introducing attachment as a fundamental motivation and spelling out the ways Bowlby’s position is different from Freud and other psychologists; Volume 2 moves into a more particular focus on the anxiety (along with the protest and ambivalence) observed to result from separation or threats of separation.

Find out more about attachment and the Tavistock.

i-THRIVE and the THRIVE Framework

The THRIVE Framework for system change (Wolpert et al., 2019) is an integrated, person-centred and needs-led approach to delivering mental health services for children, young people and their families. It was developed by a collaboration of authors from the Tavistock and Portman NHS Foundation Trust and the Anna Freud National Centre for Children and Families.

It is now used widely across the country in various forms, and has been cited as a model of good practice in national NHS strategies, green papers and in the 2019 NHS Long-Term Plan.

The THRIVE Framework provides a set of principles for creating coherent and resource-efficient communities of mental health and wellbeing support for children, young people and families.

It aims to talk about mental health and mental health wellbeing help and support in a common language that everyone understands. The Framework is needs-led which means that mental health needs are defined by the children, young people and their families, alongside professionals, through shared decision making. Needs are not based on severity, diagnosis or care pathways.

The THRIVE Framework thinks about the mental health and wellbeing needs of children, young people and families through five different needs based groupings: Getting Advice and Signposting, Getting Help, Getting More Help, and Getting Risk Support.

Emphasis is placed on the prevention and promotion of mental health and wellbeing across the whole population. Children, young people and their families are empowered through active involvement in decisions about their care, which is fundamental to the approach.

Thinking Space

Thinking Space was developed by Frank Lowe and draws on therapeutic principles and methods to create a space where people can reflect safely with others about ‘the self ‘and ‘the other’, and learn from this experience. Thinking Space was created to help staff learn how to talk about race and racism with the depth and sophistication that they can on other subjects. Then, following the 2011 riots, it was made available to the public and taken to Tottenham. The Haringey Thinking Space was a radical approach to community mental health inspired by a community therapy model developed in Brazil. These groups acted as very powerful catalysts for change.

Beryl Gilroy

Beryl Gilroy was a pioneering black woman. A writer, a teacher, an ethno-psychotherapist and one of the most significant members of the ‘Windrush generation’. Born in what was then British Guiana, she moved to Britain in the 1950s, where she became the first black headteacher in London. She also worked at the Tavistock Clinic and may have been our first black clinician. Beryl Gilroy is one of the most extensively published Caribbean writers of her time. Gilroy’s early work examines the impact of life in Britain on West Indian families and her later work explores issues of African and Caribbean diaspora and slavery.

Infant observation

How better to learn about the development of the individual than to observe from the early beginnings. Infant observation involves observing a baby from as near to new-born as possible, in an ‘ordinary’ family, for an hour a week. The approach is to try to see the world from the baby’s point of view as they struggle to make sense of their own bodies, interact with and grow in relation to the important people in their young lives, their hunger, their joy and the rest of life’s rich pattern. Infant observation was developed at the Tavistock Clinic in the 1950s by Esther Bick. Infant observation was developed at the Tavistock Clinic in the 1950s by Esther Bick, and is her best-known contribution to psychotherapy Infant observation still underpins child psychotherapy training not just at the Tavistock and Portman, but around the world. Watch our talk by Dilys Daws and Alexandra de Rementaria ‘In the footsteps of Bick: Continuing the legacy of infant observation’.

A unique NHS environment for study, with a vibrant student community and expert clinician-tutors

The Tavistock and Portman NHS Foundation Trust is also an internationally-recognised centre of world-class education.

The staff that treat our patients also teach our students. This means that students receive the most up-to-date, relevant and real-time education that prepare and empower them for careers in mental health, social care and management and leadership.

One of the unique things about our approach is that we provide teaching and training from a variety of theoretical perspectives – systemic, psychoanalytical and developmental, for example. These perspectives can both complement each other and sit in creative tension with each other.

We believe people learn differently when they live through and experience things for themselves as well as through reading and lectures. Many of our courses have an experiential learning component in the teaching, such as a regular experiential group, attending a group relations conference, a work discussion or reflective practise group or live supervision.

In 2021 the Tavistock and Portman became the first NHS Trust to be registered with the Office for Students – the body that monitors Higher Education providers to ensure that all students succeed in higher education.

The Leaderless Group

By 1941 in World War 2 the Army were having trouble finding officers. Most foreign armies were already using psychological testing. The British Army was behind the curve, relying on ‘old boy’s networks’. The trouble was there were no longer enough ‘old boys’. The solution put forward by Wilfred Bion was the ‘Leaderless Group’, a radical departure from traditional methods of testing. It replaced lengthy individual tests with one twoand-a-half hour exercise that included several candidates simultaneously, reproducing the kinds of interpersonal conflicts and stresses of a wartime situation. The radical side of it was the way that it prioritised the examination of the quality of interpersonal relationships rather than individual qualities. Find out more about Leaderless Groups and how our concept of discipline has changed.

Balint Groups

Balint Groups, which are now common across the NHS, grew out of research at the Tavistock Clinic in the 1950s. By placing the detailed exploration of individual doctor-patient relationships at the centre of his enquiry, Michael Balint initiated a radical challenge to conventional medical practice. Balint’s great masterpiece for GPs is The Doctor, His Patient and the Illness, published in 1957 based on the work of the first GP research group which he created at the Tavistock in 1951. The essence of Balint groups has remained the same – no teaching, no case notes, mutual exploration of professional work within a clear framework to facilitate free association and observation of shifts in feeling – a profoundly psychoanalytic structure. Find out more about Michael Balint.