Child and adolescent psychotherapists offer psychoanalytic treatment to children and young people with emotional or behavioural difficulties that include:
- development delay;
- gender dysphoria;
- consequences of child abuse;
- learning difficulties and disabilities;
- eating disorders;
- psychosomatic disorders.
Child and adolescent psychotherapists use a multidisciplinary approach and work within the context of the child's life, for example, the family or school.
They may see a child individually, in a group with other children, or with parents or other family members. They may see parents or carers without the child being present.
Psychotherapists also offer support and training to other professionals such as teachers, social workers and youth workers to help them with the children and young people that they have contact with.
Child and adolescent psychotherapy is a core profession within Child and Adolescent Mental Health Services (CAMHS).
Child and adolescent psychotherapists are trained to carefully observe children and young people and respond to what they might be communicating through their behaviour and play.
They tailor their approach to the individual child and work in an age-appropriate way, for example using play or drawing with younger children, but talking about feelings with teenagers. The relationship between the child and the therapist is central to treatment.
The work of a child psychotherapist can involve:
- providing assessment and treatment of children and adolescents as individuals or in a group;
- providing short-term and long-term interventions with children, young people and/or parents, from a few sessions to regular appointments over several years;
- working alongside other professionals in planning how best to help a child and the child's family, for example in schools, hospitals, children's services and child protection agencies;
- working as part of multidisciplinary teams comprising psychiatrists, psychologists, social workers, paediatric nurses, special educational needs coordinators (SENCOs), family therapists and community psychiatric nurses, most commonly in Child and Adolescent Mental Health Services (CAMHS);
- supervising trainee child psychotherapists and other therapists;
- offering training, consultation and supervision to other professionals who work with children and families in the community, including health visitors, social workers, teachers, midwives and nurses;
- planning service delivery in conjunction with commissioners and developing new services;
- keeping abreast of developments in theory and research and undertaking continuing professional development (CPD).
NHS pay scales apply to the majority of child and adolescent psychotherapists, who are employed in NHS Child and Adolescent Mental Health Services (CAMHS) or other mental health services.
- Psychotherapist trainees within the NHS earn £21,692 to £28,180 (Band 5).
- Qualified child and adolescent psychotherapists within the NHS can expect salaries in the region of £26,041 to £34,876 (Band 6). Working at a principal level, salaries of £39,632 to £47,559 (Band 8a) are earned.
Costs in private practice vary widely as there is no standard scale of fees. Charges can differ depending on the geographical area and level of experience. Some psychotherapists may provide low-cost therapy for unemployed or low-income clients.
Income data from NHS Agenda for Change. Figures are intended as a guide only.
Working hours within the NHS are generally regular. Extended working days occur if you attend meetings, run training sessions or take on additional private practice activities.
What to expect
- Child and adolescent psychotherapists employed within the NHS are very likely to be members of the The Association of Child Psychotherapists (ACP) or the UK Council for Psychotherapy (UKCP).
- Many child and adolescent psychotherapists have several part-time roles, such as working for the NHS, the voluntary sector, schools, social services or local authorities or in private clinics.
- Opportunities for work tend to be in large towns and cities. The amount of opportunities within the NHS varies from region to region.
- The work is emotionally demanding and a support framework is essential.
- Travel within the local area is necessary during the day if you work for more than one organisation, have consultancy commitments, are involved in training of other groups of professionals, or need to attend meetings.
- Experienced clinicians involved in research may present papers at national and international conferences, but overseas work or travel involving overnight absence from home is uncommon.
Training in child and adolescent psychotherapy in the UK is offered at training schools accredited by the ACP and the UKCP.
You must have an honours degree (or equivalent) to get onto one of the accredited training routes. It is also necessary for you to have considerable experience of working with babies, children, young people or families.
Child psychotherapy is a second career for many people, with entrants coming from:
- social work;
ACP accredited training takes around six years to complete and consists of two stages. The first stage is pre-clinical training, which lasts for two years and is based on infant observation. Trainees study to postgraduate diploma, Masters or equivalent level.
The second stage is a four-year clinical training scheme, which is based in various NHS Child and Adolescent Mental Health Services (CAMHS) or other suitable settings. It consists of:
- long and short-term psychoanalytic work with children, young people and parents;
- assessments and work with groups and families;
- consultation with other professionals;
- personal psychotherapy to help trainees experience a therapeutic relationship.
ACP officially recognises training at the following five schools:
- Birmingham Trust for Psychoanalytic Psychotherapy
- British Psychotherapy Foundation (London)
- Human Development Scotland (Edinburgh)
- Northern School of Child and Adolescent Psychotherapy (Leeds)
- The Tavistock and Portman NHS Foundation Trust (London)
More information can be found at ACP: How to Train.
The clinical training routes and personal psychoanalysis, as well as supervision throughout your career, develops the capacity to differentiate your personal feelings and emotions from those of the child or adolescent and the resilience to withstand being overwhelmed or burdened by your clients' problems.
Tuition fees for the pre-clinical training are usually funded by the trainees themselves, although NHS funding is provided in some areas. Bursaries may be available from some institutions. Contact individual institutions for information on fees and possible sources of funding.
Most clinical training posts are funded by the NHS, although training in some areas will have to be funded directly by you.
Personal analysis is an essential requirement of clinical training and it is expected that you will undertake a minimum of 12 months' personal analysis, which is generally attended outside normal clinic hours. How this is funded varies around the country, with some training posts offering full or part funding, while others ask trainees to meet the costs themselves.
You need to show evidence of:
- maturity and sensitivity, a broad mind and a genuine interest in the emotional problems faced by children, adolescents and their families;
- the ability to cope with the extremes of human emotion, ambiguity and vulnerability;
- the confidence to help children and adolescents explore difficult and painful aspects of their life.
Personal suitability is extremely important and this is judged on experience. A minimum of two years' work with children of varying ages or families, in a voluntary or professional capacity, is usually required.
The majority of child and adolescent psychotherapists work for the NHS in Child and Adolescent Mental Health Services (CAMHS), community-based clinics, such as the child and family consultation service, or in hospitals.
Other work environments both within and outside the NHS include:
- specialist and residential units;
- pre-school, primary and secondary schools;
- student health services;
- looked-after children teams within social services;
- youth justice services;
- voluntary sector.
Many therapists are employed by more than one type of organisation, for example the NHS, private clinics and voluntary organisations.
A small percentage of therapists are self-employed and work exclusively in private practice. Those who do must follow strict guidelines, organise their own insurance, provide practice premises, pay their own income tax and arrange clinical supervision.
A small number also work in training institutions or in universities as lecturers and clinical tutors.
Look for job vacancies at:
- British Association for Counselling and Psychotherapy (BACP)
- NHS Authorities and Trusts - for individual trusts' contact details.
- NHS Jobs
- NHS Scotland Recruitment
- National press.
Details of job vacancies are made available to members of the ACP.
Child and adolescent psychotherapists are required to undertake continuing professional development (CPD) in order to keep abreast of clinical and theoretical advances.
You are also expected to maintain and develop professional expertise through working with children and young people in a therapeutic setting for at least three sessions per week.
You must submit CPD records on an annual basis if you are a member of the AC) or the UKCP.
- engagement in CPD activities, such as regular attendance at conferences, training courses and meetings recorded in a log-book;
- a minimum of 12 hours' clinical work per month;
- time spent under clinical supervision (frequency varies according to grade and experience).
Recommended CPD activities include:
- work-based learning: supervision, in-service training, peer review and discussion with colleagues;
- professional activity: involvement in a professional body, lecturing and teaching, presentating at conferences;
- formal training and education: top-up courses, submission of papers to a journal, undertaking research;
- self-directed learning: reading professional journals and updating knowledge via the media;
- relevant short courses: in areas such as cognitive behavioural therapy (CBT), confidentiality and report-writing, special interest work and current child protection guidelines.
ACP organises regular meetings and lectures for members. ACP-accredited training schools also run a series of training programmes for child and adolescent psychotherapists at different stages of their careers, ranging from introductory lectures and discussion groups to post-qualification workshops.
UKCP also organises a series of events and conferences throughout the year. Organisational members also offer post-qualifying courses for psychotherapists already trained to work with adults who want to extend their knowledge and skills in order to work with children and adolescents.
Charities working with children and young people, such as YoungMinds, run short courses that may be of relevance to child and adolescent psychotherapists.
Child and adolescent psychotherapy is a small and highly specialised profession and opportunities for advancement vary depending on your interests and expertise, as well as your willingness to relocate.
It is likely you will work as part of a multidisciplinary team within a Child and Adolescent Mental Health Service (CAMHS) or other related setting. In this instance, you may develop a specialism within a team, taking the lead in areas such as:
- learning disabilities;
- looked-after children;
- neonatal work;
- parenting groups.
Career development and promotional prospects within the NHS are good and it is possible that you could be applying for more senior posts within a couple of years of qualifying. The career ladder is structured with trainee positions leading to qualified child and adolescent psychotherapist roles.
You may progress to take on managerial responsibilities within NHS mental health services, or you could carry out lecturing, research or clinical teaching in universities or training institutions.
Most child and adolescent psychotherapists choose to remain in supervision even when very senior. In addition to regular contact with their line manager at work, many go to their own external supervisor for clinical supervision and will fund this themselves.