Thinking about judgement in psychoanalytic assessment and consultation

The role and nature of clinical judgement in psychoanalytic consultation are discussed and illustrated with clinical material from psychoanalytic consultations. The considerable and inevitable pressures that act on 'judgement' and 'judgementalism' are considered. A model for psychoanalytic consultation that takes these pressures into account is described, showing how the subjectivity of clinical judgement is an essential element in understanding and decision-making. Internal as well as external pressures on the formation and proper valuation of psychoanalytic clinical judgement are noted.