[Treatment center staff and the children referred by DDASS for specialized foster home care].

Many children placed in foster families chosen by the local administrative authorities need an intensive and complex treatment, which would well justify their case being handled by the Specialized Psychiatric Unit responsible for a number of selected foster families. The foster family, which is often chosen hurriedly, is generally unprepared to deal with the child's psychological problems. Moreover, the child's links with his own family have not always been maintained. Soon social workers and the foster mother will be expecting the local Child Psychiatry Outpatient Unit to provide them with massive aid, which this unit is not properly equipped to give. It happens frequently that members of this team will have to face particular counter-transfer difficulties. However certain aspects of this medical structure are helpful for the treatment of these children: the Child Psychiatry Unit offer specific facilities, like therapeutic groups, and as the members of its team have no part in the factual decisions concerning the fate of the child, they feel more neutral and can be considered so by the different actors involved, including the child him- or herself. We discuss two clinical cases, and then touch upon the fundamental issue involved, that of the organizing power of psychiatry in a given environment.