Psychoanalytic Psychotherapy

About Child and Adolescent Psychotherapy

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About Child and Adolescent Psychotherapy

Child and adolescent psychotherapy is a core NHS profession with rigorously regulated standards and training, approved by the Department of Health and recognised as a component of comprehensive CAMHS in the Children’s National Service Framework. 

Child and Adolescent Psychotherapists work as part of multi-disciplinary teams in the NHS and other public services to assess and treat infants, children and young people and work with their parents, families and the networks surrounding them. Their in-depth training to doctoral level enables them to carefully observe what a child or young person might be communicating through their behaviour and play and work with complex states of mind that are not readily available to conscious thought. 

Child and Adolescent Psychotherapists may see children and young people individually or with other family members. The therapeutic relationship is developed through talking or play, depending on age. The child has an opportunity to work towards a better understanding of themselves, their relationships and their established patterns of behaviour.  Psychotherapists 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.

What does Child and Adolescent Psychoanalytic Psychotherapy offer?

Children and young people with severe and long-lasting problems may respond to people and situations in ways that they do not understand and cannot control. 

Their emotions can be extreme and powerful and are often expressed through their behaviour and in problematic relationships. These difficulties often extend to relationships with services and professionals.  This can prevent these children from benefiting from the care and opportunities that are available to them and is in part why many treatment approaches and interventions can struggle to meet the needs of the most vulnerable groups.

A Child and Adolescent Psychoanalytic Psychotherapist (CAPPt) can help a child or adolescent to understand himself or herself through their relationship together.  The problems identified in this relationship shed light on those in other relationships in the child’s life, whether in the past or present.  During a therapeutic session, younger children may be encouraged to play, while older children may be asked to draw or paint and teenagers to talk about their feelings.  Through the relationship with the therapist in a consistent setting, the child or adolescent may begin to know and to feel able to express their most troubling thoughts and feelings.

The extensive training of CAPPts uniquely enables them to work with these very disturbing thoughts and help the child make sense of their experience and develop their own individuality and potential.  Confused, frightened, hurt, angry or painful feelings can gradually be put into words rather than actions.  As a result the child can begin to express their emotions in less disturbed ways and begin to return to the normal process of child development.

They are likely to feel less anxious, more able to learn and better equipped to sustain friendships. It can also improve the quality of life within the family or in relationships with carers and professionals.  Significantly for the wider network, the CAPPts will also be able to represent the child’s experience in relation to his/her family, placement, special educational needs and therapeutic needs.

Where are Child and Adolescent Psychoanalytic Psychotherapists (CAPPt) most needed?

The areas where a specialist CAPPt approach is most needed include:

Co-morbid presentations particularly linked to early deficits, parental mental health difficulties and incremental developmental trauma

Developmental breakdown including psychotic-like symptoms, gender confusion and high risk “acting out” characteristically but not exclusively seen in adolescence

Families where there are complex trans-generational issues of mental health, deprivation and neglect

Moderate to severe impairments in personality development rooted in early infancy e.g. serious attachment difficulties  

Mind-body disturbances including somatisation, psychosomatic problems and the emotional/psychic impact of chronic medical conditions  

Depression – moderate and severe with suicidal ideation  

Severe, deep-seated anxiety states  

Underlying internal states in children and adolescents exhibiting challenging behaviour

Eating disorders

The emotional development of diagnosed ADHD and ASD children and young people