Child and adolescent psychotherapists offer psychoanalytic treatment to children and young people with emotional or behavioural difficulties, including:
Other psychotherapeutic approaches and methodologies based on a range of traditions, including integrative, integrative arts, humanistic, transactional analysis and systemic psychotherapies, may also be used.
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 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) (http://www.dcsf.gov.uk/everychildmatters/healthandwellbeing/mentalhealthissues/camhs/) .
Child and adolescent psychotherapists are skilled in the assessment and treatment of children and young people, and are trained to carefully observe them 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. Younger children, for example, may play with the toys provided or draw, whilst teenagers might talk about their feelings. Infants and parents are seen together so that their patterns of interaction can be considered. To a trained eye, play is a powerful form of communication which may express how children feel and the difficulties they may be experiencing. The relationship between the child and the therapist is central to treatment.
Tasks typically involve:
Trainings in child and adolescent psychotherapy in the UK are offered at training schools accredited by two organisations: The Association of Child Psychotherapists (ACP) (http://www.childpsychotherapy.org.uk) and the UK Council for Psychotherapy (UKCP) (http://www.ukcp.org.uk) .
Entry to accredited trainings is at graduate (honours degree or equivalent) level and those wishing to train must already have substantial experience of working with infants, children, young people or families. Trainees often come from other professions including psychology, psychiatry, medicine, nursing, social work, academia and teaching.
Details of UKCP courses and Standards of Education and Training as well as entry requirements can be obtained from the UKCP website or the UKCP office (tel: 0207 014 9955). UKCP accredit trainings in child and adolescent psychotherapy in several organisations across several psychotherapy traditions. The trainings are at a minimum four years part time and it usually takes five to seven years to reach accredited status as a practitioner. UKCP psychotherapists and counsellors registered to work with children and young people make a major contribution to working with children in educational settings and some trainings specialise in this field.
ACP-accredited trainings take around six years and involve two stages: a part-time, two- or three-year pre-clinical training course in infant observation and a four-year clinical training. Trainings are offered at the ACP’s five accredited training schools:
The Masters level pre-clinical training includes close observation of infants and young children in order to gain an understanding of child development and attachment theory. Once trainees have successfully completed the pre-clinical training, they can apply for a doctoral-level clinical training based full time in a multidisciplinary NHS Child and Adolescent Mental Health Services (CAMHS) (http://www.dcsf.gov.uk/everychildmatters/healthandwellbeing/mentalhealthissues/camhs/) or other setting. This helps them to develop skills in a multidisciplinary setting from the outset.
Entry on to the pre-clinical training for candidates who do not have a degree or equivalent may be possible for those with relevant experience. Contact individual institutions for details.
Clinical training includes long- and short-term individual psychoanalytic work with children, young people and parents, as well as assessments, work with groups and families, and consultation with other professionals. A central feature of this stage of training is personal psychotherapy, which deepens self-knowledge and enables trainees to experience first-hand the impact of a therapeutic relationship. The four years of hands-on clinical training and personal psychoanalysis, followed by supervision throughout your career, develops the capacity to differentiate your personal feelings and emotions from those of the child and the resilience to withstand being overwhelmed or burdened by clients' problems.
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 required.
Candidates need to show evidence of the following:
Tuition fees for the pre-clinical training are around £1,500 to £3,000 per year and trainees usually meet these costs 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.
Clinical training takes place in a full-time child and adolescent psychotherapy training post within an NHS CAMHS or equivalent. Most posts are NHS funded, although trainees fund the clinical training themselves in some areas. Personal analysis during the clinical training may cost between £6,000 and £8,000 per year. Again, how this is funded varies around the country: some training posts offer part funding; in other cases trainees meet these costs themselves. Contact individual institutions about the availability of partial funding in the form of loans or bursaries. See NHS Careers (http://www.nhscareers.nhs.uk) or contact individual NHS trusts for more details.
For more information, see work experience (www.prospects.ac.uk/workexperience) and find courses and research (www.prospects.ac.uk/pg).
Child and adolescent psychotherapists are required to undertake continuing professional development (CPD) in order to keep abreast of clinical and theoretical advances, and are expected to maintain and further professional expertise through working with children and young people in a therapeutic setting for at least three sessions per week.
Members of The Association of Child Psychotherapists (ACP) (http://www.childpsychotherapy.org.uk) and the UK Council for Psychotherapy (UKCP) (http://www.ukcp.org.uk) must submit returns on an annual basis detailing their CPD activity. Requirements include:
Recommended CPD activities include:
Relevant short courses in areas such as cognitive behavioural therapy (CBT), confidentiality and report-writing, special interest work and current child protection guidelines are provided by professional organisations, employers and NHS trusts.
The ACP organises regular meetings and lectures for members, which are advertised in The Bulletin, the monthly members’ magazine, and documented in the Journal of Child Psychotherapy, the official scientific journal of the ACP. 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.
Similarly, the UK Council for Psychotherapy (UKCP) (http://www.ukcp.org.uk) publishes a quarterly magazine, The Psychotherapist, and organises a series of events and conferences throughout the year. UKCP 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 young people.
The Society of Analytical Psychology (http://www.jungian-analysis.org) publishes its own journal and lists books written or edited by its members.
Charities working with children and young people, such as YoungMinds (http://www.youngminds.org.uk) , also 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 interest and expertise, as well as your willingness to relocate.
Child and adolescent psychotherapists usually work as part of multidisciplinary teams within NHS Child and Adolescent Mental Health Services (CAMHS) (http://www.dcsf.gov.uk/everychildmatters/healthandwellbeing/mentalhealthissues/camhs/) or other settings. They may develop a specialism within a team, taking the lead in areas such as:
Career development and promotional prospects within the NHS (see NHS Careers (http://www.nhscareers.nhs.uk) ) 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, while lecturing, research and clinical teaching in universities or training institutions prove more attractive to some practitioners.
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.
The majority of child and adolescent psychotherapists work for the National Health Service (see NHS Careers (http://www.nhscareers.nhs.uk) ) in Child and Adolescent Mental Health Services (CAMHS) (http://www.dcsf.gov.uk/everychildmatters/healthandwellbeing/mentalhealthissues/camhs/) , community-based clinics (like the child and family consultation service), or in hospitals.
Other work environments both within and outside the NHS include:
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 wholly 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.
Search graduate jobs (www.prospects.ac.uk/links/jobvacs).
Recruitment agencies do not handle vacancies.
See also job hunting tips (www.prospects.ac.uk/links/jobhunt) and applications, CVs and interviews (www.prospects.ac.uk/links/appsinterviews).
The following Case studies are also available on prospects.ac.uk:
© Content copyright of or licensed to AGCAS (www.agcas.org.uk)
Written by Sarah Nichols, AGCAS, November 2009.
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