The Clinical Practicum, the name for my class on child psychotherapy for UCLA Child Psychiatry Fellows, is, as the name implies, a “practical” class about how to begin treatment with children. My seven students are licensed physicians, able to practice as an adult psychiatrist, but wanting, for various reasons, to pursue further training in child psychiatry. The group hovers around thirty, which, of course, is the new twenty, or so people say. “So, what should your seven-year old patient call you?” I ask, somewhat to the shock of my students. “Dr. Sarah” (not her real name, of course), said, making sure that the child knows she is a doctor, but that he/she should use her first name. Another student got passionate. “Oh no, I am Doctor Green. I think it is essential that the child use my last name so that they understand that we are not just playing together.” She says with conviction. “What do they call you?” Another student asks me. “Shirah,” I said. “Over the years, I have become the most comfortable with that,” I say, trying to encourage the students to do what feels right for them, rather than look for the ‘right answer’. “My goal is to make you guys more conscious of your choices. The idea is that whatever they call you is going to set up a frame on the relationship which may or may not add meaning to the treatment. Deciding how you want to be addressed is a very serious matter.” I say, highlighting the idea that every decision, every interaction with the child and his/her parents, is, to use an overused expression, grist for that therapeutic mill. The end of the class was very similar to how it began. There were questions. No conclusions were drawn. I like that.