Developing a clinical seminar on difference and identity within a psychoanalytic training institution Institutional development from within, London, UK, 2016–2021

In the mid-2010s, working as a tutor and seminar leader within the child and adolescent psychotherapy training programmes at the Tavistock and Portman NHS Trust, it became apparent that questions of race, culture, gender, class, sexuality, and other dimensions of difference and identity — while present in the clinical work — were not being adequately held within the training itself. These are not simple institutional failures: the challenges of thinking clearly about social identity, historical injustice, and their intersection with clinical practice are genuinely difficult, and the discomfort they generate is real on all sides. But the gap was becoming visible in the clinical work trainees were bringing, and in the conversations that were and weren't happening in seminars and staff meetings.

Working from within — as a tutor on both the master's and doctoral programmes — and in close collaboration with a colleague, a new clinical seminar was designed and offered to trainees across both programmes: the Difference, Identity and Diversity workshop. It was carefully structured to triangulate between theory, clinical practice, and an experiential dimension — bringing together psychoanalytic and developmental thinking around race, culture, gender, sexuality, class, and religious identity with the trainees' own clinical material, and working with what emerged in the group itself as live data. The seminar was deliberately bounded — capped at twelve trainees, meeting weekly, held closely by two facilitators who met separately each week to reflect on the process. The aim was to keep the work grounded in its primary task: the development of child psychotherapists who could think clearly and openly about difference in the consulting room.

The seminar ran for several years in its original form, adapting year on year in response to what emerged. It was consistently one of the most valued elements of the training for those who participated. It has since taken on a life of its own in new hands, becoming a core and compulsory component of both programmes — a recognition that what began as an initiative from within had identified something the training could not do without. These challenges do not disappear when they are named; they continue to evolve, and so must the institutional responses to them.

Institutional development — difference and identity — professional formation — working from within — clinical training