You'll need substantial experience of working with children and adolescents in a social care, health or education setting to work as a child psychotherapist
As a child and adolescent psychotherapist, you'll offer psychoanalytic treatment to children and young people with emotional or behavioural difficulties, including:
- development delay
- gender dysphoria
- consequences of child abuse
- learning difficulties and disabilities
- eating disorders
- psychosomatic disorders.
You'll use a multidisciplinary approach to work within the context of the child's life, for example their family or school. Your relationship with the child is central to treatment.
You may see a child individually, in a group with other children, or with parents or other family members. You may also see parents or carers without the child being present.
Child and adolescent psychotherapy is a core profession within Child and Adolescent Mental Health Services (CAMHS).
As a child and adolescent psychotherapist, you'll need to:
- carefully observe children and young people and respond to what they might be communicating through their behaviour and play
- provide assessment and treatment of children and adolescents as individuals or in a group
- tailor your approach to the individual child and work in an age-appropriate way. You might use play or drawing techniques with younger children, but talk about feelings with teenagers
- provide short-term and long-term interventions with children, young people and/or parents, from a few sessions to regular appointments over several years
- work 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
- work as part of multidisciplinary teams made up of psychiatrists, psychologists, social workers, paediatric nurses, special educational needs coordinators (SENCOs), family therapists and community psychiatric nurses, most commonly in CAMHS
- offer training, consultation and supervision to other professionals who work with children and families in the community, including health visitors, social and youth workers, teachers, midwives and nurses
- supervise trainee child psychotherapists and other therapists
- plan service delivery in conjunction with commissioners and develop new services
- keep up to date with developments in theory and research and undertake continuing professional development (CPD).
- NHS pay scales apply to the majority of child and adolescent psychotherapists who are employed in NHS CAMHS or other mental health services. Psychotherapist trainees can earn £30,401 to £37,267 (Band 6).
- Qualified child and adolescent psychotherapists can expect salaries in the region of £37,570 to £43,772 (Band 7).
- Principal psychotherapists will be paid at Band 8 of the NHS pay scale, starting at £44,606 and rising to £86,687 for the most senior posts.
There is no standard scale of fees in private practice and the fees you charge can vary depending on your client base, experience and location, for example. Some psychotherapists may provide low-cost therapy for unemployed or low-income clients.
Income data from Agenda for Change (AfC) pay rates. Figures are intended as a guide only.
Working hours within the NHS are generally regular. You may need to work extra hours to attend meetings, run training sessions or take on additional private practice activities.
What to expect
- 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 cities and large towns. The number of jobs within the NHS varies between regions.
- The work can be emotionally demanding and a support framework is essential.
- You may need to travel locally during the day if you work for more than one organisation, have consultancy commitments, are involved in training or need to attend meetings. However, time spent away from home is uncommon.
Training is offered at schools accredited by The Association of Child Psychotherapists (ACP). You'll need an honours degree (or equivalent) and substantial experience of working with children and adolescents to get a place. This experience can be from a range of settings, including social care, health and education.
Before starting clinical training, you'll undertake pre-clinical studies and complete a course of observational psychoanalytic studies at postgraduate diploma, Masters or equivalent level. This usually takes around two to three years.
You'll then complete a four-year clinical training scheme, which covers theory, technique and clinical practice under supervision. For the clinical work, you'll be based in an NHS CAMHS team or other suitable setting. Areas covered include:
- long and short-term psychoanalytic work with children, young people and parents
- assessments and work with groups and families
- consultation with other professionals.
Personal analysis is an essential requirement of clinical training. It's usually begun at least one year before you start clinical training and continues throughout the training process. You'll typically undergo four sessions of personal analysis per week, which can add extra time on to your working week and involve a considerable amount of travel between your training school, clinical placement and the personal analyst's consulting room.
For more information and a list of training schools and pre-clinical courses, see ACP - How to Train.
The NHS provides a limited number of clinical training posts, offered by a small number of NHS trusts or as a partnership between a trust and a training provider. These posts will have varying levels of financial support. Check with individual trusts and training institutions about what grants, bursaries and training posts are available.
You'll need to have:
- sensitivity, empathy and a genuine interest in the emotional problems faced by children, adolescents and their families
- excellent communications skills
- the ability to cope with the extremes of human emotion, ambiguity and vulnerability
- the ability to work on your own and as part of a multidisciplinary team
- resilience, to withstand being overwhelmed or burdened by your clients' problems
- the capacity to differentiate your personal feelings and emotions from those of the child or adolescent
- 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. You'll usually need a minimum of two years' work with children of varying ages or families in a voluntary or professional capacity.
Child psychotherapy is a second career for many people who come from a range of backgrounds, including:
- social work
The majority of child and adolescent psychotherapists work for the NHS in 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. If you choose to work in private practice, you must follow strict guidelines, organise your own insurance, provide practice premises, pay your 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:
Details of job vacancies are made available to members of ACP.
In order to retain your membership of the accrediting body (the ACP), you'll need to undertake continuing professional development (CPD) to keep up to date with clinical and theoretical advances.
Relevant 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, presenting 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 your 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.
You'll also be expected to maintain and develop your professional expertise through working with children and young people in a therapeutic setting for at least three sessions per week.
Accredited training schools provide post-qualification courses and workshops. Charities working with children and young people, such as YoungMinds, may also run relevant short courses.
Most child and adolescent psychotherapists choose to remain in supervision even when in very senior positions. In addition to regular contact with your line manager, you may choose to have your own external supervisor for clinical supervision - but will have to fund this yourself.
Child and adolescent psychotherapy is a small and specialised profession, so opportunities for advancement will vary depending on your areas or interest, experience and willingness to relocate.
If you're working in the NHS for a CAMHS team or other related setting, there are opportunities to develop a specialism in areas such as:
- learning disabilities
- looked-after children
- neonatal work
- parenting groups.
There are opportunities 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.
If you're working in private practice, your success will depend on building a reputation and a network of contacts. You'll need a good head for business, as well as administration and marketing skills.