The child psychotherapist Mary Boston, who has died aged 96, was one of the first generation to be trained to work in the NHS in this new profession, which came into being as the health service was launched. She worked with John Bowlby on the development of attachment theory and went on to establish a clinical research specialism working with seriously deprived children, at the Tavistock Clinic in London (now the Tavistock and Portman NHS foundation trust).
In 1948, as the Tavistock became part of the new NHS, she had begun to train as an educational psychologist there when she learned that a new training in child psychotherapy was planned for the following year, under the guidance of Bowlby, chair of the children’s department; Esther Bick, a child psychoanalyst, had been invited to organise the course.
The new training was intended to equip non-medical staff to become psychoanalytic child psychotherapists, who could treat emotionally disturbed children and adolescents, an initiative in tune with the ambitions of the NHS to respond to concerns in the postwar period about the unmet psychological needs of young people. Impressed by Bowlby and Bick’s thinking in clinic case conferences, Mary knew at once that this was what she wanted to do. She and two others were offered places.
Mary combined the three-year training with work as a member of Bowlby’s research team, alongside James Robertson and others, work which was laying the foundation for Bowlby’s theories about the impact on young children of separation from their parents. She was thus involved at the start of the new understandings of patterns of human attachment, a hugely significant shift in developmental psychology. She proved to be a sensitive and imaginative clinician and a talented researcher, displaying her intelligence and warmth in equal measure.
In her psychotherapy training she was taught not only by Bick, the originator of infant observation (now practised worldwide) but also by the pre-eminent psychoanalysts Hanna Segal, Marion Milner, Melanie Klein and Donald Winnicott, among others.
After qualifying, Mary worked in several different London hospitals, including Paddington Green, where Winnicott was a senior paediatrician, and was then appointed head of child psychotherapy at Great Ormond Street hospital for children.
In 1977 she returned to the Tavistock as a senior tutor for the much larger training programme that had grown from its small beginnings. There she expanded the teaching of child development research and developed the research activity of child psychotherapists themselves.
She had herself earlier attempted the treatment of a child with a history of early deprivation and loss, challenging the received view that such children were not suited for psychoanalytic therapy and publishing an account of her work, Psychotherapy With a Boy from a Children’s Home, in the Journal of Child Psychotherapy in 1972.
She then led the formation of a multidisciplinary clinical research workshop in studying a large cohort of such children, eventually a total of 80, living in children’s homes or, rather less likely at that time, in foster care, who were seen for long-term psychotherapy at the Tavistock.
Support was offered in parallel to their carers, and liaison was maintained with their schools and social workers. The children often posed extreme challenges to their therapists, some displaying violent and sexualised behaviour, others very withdrawn and passive, most having little capacity for play and limited verbal skills.
What became shockingly clear was the intense level of psychic pain underlying their modes of being. To make any real difference to the children, their therapists had to get close to their extreme states of distress and the work was thus stressful and upsetting.
A book, Psychotherapy With Severely Deprived Children (1983), edited by Mary and her colleague Rolene Szur, emerged from this workshop, and the clinical approach at its heart set the scene for the future of child psychotherapists’ work with children in state care; this has turned out to be an expanding aspect of the profession’s profile ever since. Mary’s workshop nurtured new approaches to clinical technique, thus making possible the treatment of children with histories of maltreatment and early trauma.
Mary was born to Christine (nee Carver) and Harold Flanders, both teachers, in Enfield, north London. Her mother became very ill when she was only two and a half, and she went to live with her aunts. She did very well at Enfield county school for girls and went to read psychology at Bedford College, University of London, which was evacuated to Cambridge when the second world war broke out. Starting on a PhD at Birkbeck, she discovered Bowlby’s work and decided to put aside pure academic research in favour of professional training.
Mary’s personality combined a certain shyness and a great deal of modesty with a strongly independent sensibility and intelligence. She was never “tribal”, despite being in a professional world rife with competing tribes, and she enjoyed her talent for working across boundaries.
In 1977 she co-edited, with Dilys Daws, the first overview book about child psychotherapy, The Child Psychotherapist and Problems of Young People. It was a model of inclusive fairmindedness and heralded a golden era of book publication from the talented early generations of child psychotherapists. In moving beyond professional journal publication to books intended for a wider public, Mary was a pioneer.
In 1951 she married David Boston, an electrical engineer. After her retirement from the NHS in 1988, she and David moved to Westward Ho! to enjoy the coast and Devon countryside and to be near family, but Mary remained professionally active, serving as an external examiner for child psychotherapy doctorates and joining the local psychotherapy community as both a therapist and supervisor. She dealt with the losses and personal limitations of growing old with admirable grace and practicality.
David died in 2008. Mary is survived by their children, Lynette and Paul, four grandchildren and four great-grandchildren.
• Mary Boston, child psychotherapist, born 27 May 1923; died 14 January 2020