Simona Revelli - psychoanalyst based in London SW2
Simona Revelli - psychoanalyst based in London SW2 - Therapeutic, educational and support services
Psychotherapist based in london SW2 Simona Revelli - innovative contributions to psychotherapy

In 2000 I contributed to the ideation of the Psychotherapy Support Team, and that same year King’s College Hospital NHS Foundation Trust agreed to fund the project. I was offered a position as Psychotherapist, and for the following eight years I worked with colleagues to establish, promote and develop the team’s services.

The Psychotherapy Support Team (subsequently renamed Counselling and Psychotherapy Team) was a highly regarded innovation. The rational for its creation was the recognition that patients, relatives and staff, who experience illness and hospitalisation, often find themselves in uncertain, fragile, powerless and difficult situations, facing painful and challenging questions about their own and other people’s existence. A culture of health, well-being, cure, competence and scientific objectivity, together with powerful defensive mechanisms at both individual and institutional levels, often have silencing effects on these experiences. In turn, this can have considerable consequences for service users, professionals and organisations alike. In view of this, the overarching aim of the team was to provide Trust-wide opportunities to acknowledge and address precisely these experiences and questions. Consequently, whereas many general hospitals provide counselling or psychotherapy in some of their departments, this was the only team in the UK and probably worldwide delivering therapeutic services to in-patients, outpatients and relatives across all wards and departments of an inner-city general hospital, as well as a range of Trust-wide supportive and developmental services for staff-teams and professionals at all levels.

The team was designed to maximise the cost effectiveness, responsiveness and sustainability of its services. To this end, each year three part-time senior clinicians managed and supervised a substantial placement for trainee counsellors and psychotherapists from a range of training institutions. This gave trainees an opportunity to gain the necessary clinical experience for their professional registration within an unusual, challenging, supportive and well organised structure. The innovative nature of the team’s work rendered its placement highly desirable and the competition to gain access to it very high.

Whenever possible, practitioners from the team carried out their clinical work within conventional professional boundaries. Nevertheless, since hospitalised patients are often unable to leave their beds, in order to respond to their psycho-somatic needs, work would be undertaken often at a patient’s bedside. This required considerable thoughtfulness, creativity, flexibility and responsiveness, careful attention to questions of boundaries and ethics, and a capacity to work with constantly shifting frames, tailoring, adapting and responding to these according to individual needs and circumstances.

The clinical contribution made by trainees allowed senior clinicians to also engage in a number of other important activities. They designed and delivered corporate and local training on topics such as communication, listening, death, bereavement, communicating difficult news and working with difference; promoted and facilitated reflective practice for individual staff members and staff-teams; offered debriefing to staff who had experienced critical incidents; contributed to the formation and implementation of organisational policies and procedures, for example, in relation to the care of older patients, patients diagnosed with cancer and dying patients.

In 2005 my contribution was recognised by the Trust with a Commendation Roll of Honour. In 2007 I was appointed Consultant Psychotherapist and took up the management and leadership of the department until 2008, when I left the Trust.


Simona Revelli - psychoanalyst based in London SW2 - Therapeutic, educational and support services
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