Child and adolescent psychotherapy is a core NHS profession, recognised as an important component of comprehensive Child and Adolescent Mental Health Services (CAMHS).
Child and Adolescent Psychotherapists (CAPTs) work in NHS community and in-patient services, hospitals, early years centres, schools, social services and the youth justice system. They may be employed by statutory agencies or work in the voluntary and independent sectors. CAPTs accept that each human being has a unique combination of neurological, physiological, emotional, social, cultural, genetic and psychological factors, conscious and unconscious, which influence their relationships to people and events. Each child is seen and understood within the context of their family and their wider environment, and careful thought is given to the need for support for parents or carers, and other family members. CAPTs are trained to work with parents/carers, siblings and families as a whole when appropriate, in a way that is sensitive to their cultural and social environment.
Unlike some therapies offered to infants, children and young people, child and adolescent psychotherapy is not a single therapeutic modality, but rather a powerful combination of skills, knowledge and experience that can be applied to a wide range of patients, groups and work contexts.
Child and Adolescent Psychotherapists are dedicated to understanding the complex emotional lives of infants, children, young people, families and carers in depth; to look beneath the surface of problematic emotions, behaviours or relationships and to help children and adolescents, and their families, to understand themselves and their difficulties. They are trained to carefully observe a child or young person and respond to what they might be communicating through their behaviour and play. Their training enables them to develop and sustain relationships with children and young people whose difficulties may be long-standing and severe and whose levels of disturbance may make it hard for them to benefit from the care and opportunities offered them.
The Contribution of Child and Adolescent Psychotherapists
Unlike some therapies offered to infants, children and young people, child and adolescent psychotherapy is not a single therapeutic modality, but rather a powerful combination of skills, knowledge and experience that can be applied to a wide range of patients, groups and work contexts. This equips CAPTs with the capacity to work with the most complex cases characterised by severity of disturbance, co-morbidity and, often, multi-agency involvement. The cornerstone of the approach is an observational, reflective stance which, allied with an understanding of the unconscious mind and its manifestations, allows therapists to work with patients, their families and the wider systems around them.
In CAMH services CAPTs are often needed to work with cases where the patient has not responded to treatments. CAPTs are trained to focus especially on observing and reflecting on the relationship the patient makes with the therapist and the treatment, using this as a source of understanding of the patient’s difficulties. Child and adolescent psychotherapy is recommended as a treatment in NICE guidance for depression in children and young people and in NICE/SCIE guidance as a therapeutic intervention after abuse and neglect.
CAPTs can work with infants, children and young people across the age range from 0-25 years old, depending on the service context. They also apply their framework of thinking to work with parents, families and carers and to training and supporting other professionals who work with children, young people and families to encourage a deeper understanding of the child's perspective.