Sally is tall and well-built, facially unprepossessing with hair that is not quite short, glasses, and pudgy features. She goes to her local Comprehensive school and seems to be bright, with no trouble with her school work and a number of interests outside school like Kung Fu and Conservation Work. Her parents love her dearly but are in despair. She is miserable, constantly complains and lies to her friends to make herself more interesting. I’ve seen Sally four times so far, and spoken at length with her Mum – as with some other families, Father tends to leave this sort of stuff to his wife. Sally is unhappy. Her size makes it hard to remember that she is only in Y8 but she talks like someone of that age. Except she also shows some insight. Sally is friends with a group of three girls, but feels she is always the optional add-on, the one the others don’t always tell things to, the one sometimes not invited to sleep-overs. She doesn’t share their musical taste, though she tries, and they don’t make fashionable clothes in her size which she knows makes her different. Being cleverer than most of the others in her class seems to be isolating too.  We have tried a number of strategies to help develop her self-esteem, and at times, things have seemed better. Sally was filling in a diary of Things to be Glad About every evening, to remind her of all the things that go right in her life. She took more of an interest in her appearance and put a mild colour on her hair which looked better. Sally began to tell me of how she was trying to eat differently in order to lose weight and it seemed sensible.  We talked about her Mum too and she complained that her Mum was always having ‘that time of the month’. She claimed that her mum was always ‘in a mood’. Obviously this is only one side of the story, but Sally’s perception is a very important starting point. She feels that her mother constantly interferes – a common complaint at 13 – that when she is trying to not eat because she is not hungry [and there is no suggestion that she has any signs of an eating disorder] her mother insists that she eat and usually gives her crisps and chocolate. Similarly, her mother complains that she is insolent particularly in front of other girls, and Sally feels that she tries hard not to be, pointing out that one of the other girls has cat fights with her mother. Sally loves her Dad, but he seems to leave it all to his wife. Any attempt to talk with Mother privately and suggest that she tries a slightly different tack, has failed. Mum seems determined that the problem lies within Sally – had there been more paternal involvement, I would have tried to encourage him to give Mum the confidence to let go a little. There is a younger girl, and she is sociable and popular, not like Sally at all. In many ways, Mum seems very like this older daughter, constantly complaining and miserable. I don’t feel very successful with Sally. She appears to try many of the suggestions I make but says the efforts she makes are generally not supported by Mum. Today, Mum said she could see very little point in Sally coming back since things weren’t changing sufficiently quickly. If she did as we agreed, it is much more likely that things would improve. Sally cried a lot during our session and she needs some sort of emotional outlet. Perhaps I need to talk to Mum without Sally and see what we can come up with. Ultimately, Mum is with her for much of the time, I am not.