23rd December, 2021.  So, after around just ten minutes, Mark Birbeck made his excuses and withdrew from the first of the two scheduled ‘review’ meetings leaving Meg and I with Sally Mungall. It was the first time that Meg had actually met Sally and she would meet her just once more on the 13th January, 2022. Looking back it seems remarkable that Sally met with my daughter on just two occasions, both at the dog-end of therapy with Mark Birbeck. Revelations made available through access to records a full two years later revealed that Sally Mungall was, in fact, the lead practitioner involved in Meg’s case. The responsibilities of a lead practitioner working within a CAMHS setting primarily include the assessment and treatment of children and young people who present with a wide range of mental health problems. They are expected to be responsive to the needs and views of the children, young people and their families, carers or guardians, ensuring that the best evidence-based care is available in line with clinical guidelines such as those laid out by the National Institute for Health and Care Excellence. I would have expected Sally to have carried out regular face to face assessments with Meg throughout the course of her mental health treatment. Indeed, the Code of Practice to the Care Act says that, in England, all assessments of people with mental health problems should take place face-to-face. This would be especially important considering what I believe to be Mark Birbeck’s very inexperienced position. As already mentioned, Sally had carried out mental health assessments of my daughter through second hand account via Mark. Medical records suggest that Sally struggled to get a grip on understanding Meg’s mental health presentation, especially around her autism. I would have expected a lead practitioner to have sought face-to-face meeting with all children and young people under their managerial care. The fact that Sally did not take such opportunities seems reprehensible. But it was, apparently, far worse than that. I now understand that CAMHS, Bramblys Drive, did not even have a Team Leader in charge throughout much, if not all of the time that Meg was receiving therapy.

I settled back in my chair and adopted a spectator role, thinking it best not to interfere with Sally’s review of Meg and wait until I was invited to contribute opinions. I remember things well. It was a joy to see my daughter open up and I marvelled at Sally’s easy therapeutic attitude, her nurturing and motherly tone. I had, myself, often been the beneficiary of that warm and earthy attention except that here it was consistent and unwavering. There was never going to be time, or even inclination to change therapeutic approach. Meg was never going to experience the unforgiving, spiteful, counter-transference inflected demeanour or disdainful disposition that Sally could be capable of. It was bearing witness to this exchange that convinces me that Sally Mungall was, in all likelihood, an excellent child and adolescent therapist. Maybe it was only men that carried the potential to provoke Sally’s own negative counter-transference, the redirection of her feelings shaped by her own history that impeded objectivity, and limited therapeutic effectiveness. I am reminded of the enigmatic last line written in my blog entry posted on the 5th September, 2024 which I will unpack in a much later blog post.

It was within the span of less than a quarter of an hour that Meg actually broke down in tears. I found that to be especially remarkable. Meg wasn’t given to exposing her emotions to complete strangers. In fact, by her own account at the time, she had never broken down so completely during any of her therapy sessions with Mark Birbeck. ‘Well done, Sally,’ I said, softly under my breath. ‘Good work.’ I was acknowledging the empathy, the connection, the interplay of therapeutic presence and therapeutic authority.

Meg was encouraged to acknowledge her feelings, to give a good account of her day to day lived experience while coping with her mental health issues, particularly the truly debilitating OCD while Sally countered the revelations with practical advice and suggestions.

Sally then manoeuvred the conversation so as to focus upon Meg’s relationship with me while I maintained a low profile in the bleachers, a quiet bait-breathed observer, my actual presence momentarily forgotten. Sally started posing questions that gently probed at my role as a dad and carer, eliciting responses that painted an overall picture of the father daughter relationship. Gradually the questions steered towards the more personal. The questions moved from ‘What is your dad like at cooking?’ , ‘What does your dad cook for you?’ and ‘What are your favourite meals that you like your dad cooking?’ to a whole new subject of enquiry centred around questions like ‘How do you feel about dad having ‘new’ friends come to visit him at home?’ There was obvious utility in this line of questioning as I had fallen into semi isolation and needed to reclaim my own social life but there was also something in the way that the questions were presented that led both Meg and I to suspect Sally had an ulterior motive. The impression was formed in each of our minds, simultaneously, at the time and without corroboration, that Sally wasn’t asking Meg a generalised question. It seemed certain to both of us that Sally was fishing on her own behalf. Sally appeared to be gauging Meg’s receptivity to this idea because Sally was considering becoming one of these ‘new’ friends.

Meg and I talked about this line of questioning during the following days and while she now has little recollection, the conversations we had together are lodged firmly and forever in my own memory. Those conversations are filed in my brain adjacent to my memories of Sally’s first meeting with Meg and they have often been cross-referenced over the intervening years.

The first review wound to a close. We were looking forward to the Christmas holidays and then to the second and final review scheduled for the 13th January, 2022. Before we said our actual goodbyes I handed over my art therapy ending ‘gifts’ to Sally. She asked if she could open them there and then but I wanted her to open them later, in private. Meg was aware that I had gifted Sally a draft manuscript of a children’s story that I had been writing and had seen the concept art of the principle characters that I had also included. The third of those gifts was ‘that letter’, the same one that I posted to this blog on 3rd November, 2024. ‘That letter’ was private back then and I wanted Sally to read it quietly and without interruption. Sally held onto her anticipation and we said goodbye.

As Meg and I were making our way across the CAMHS car park she turned to me and said, ‘I know why you love Sally. I love her too.’