I am sometimes asked, why can't just any psychotherapist or counsellor work with children

Why do I need to look for somebody with specialist training? My answer would be, whilst any fully qualified adult psychotherapist or counsellor may choose to work with children and young people, there are particular differences in therapeutic work with children and adults that require different skills and experience. 

Some differences between adults, children and adolescents are obvious, but the needs and expressions of these age groups are distinctly different. As well as child psychotherapy and child counselling trainings, there are specific trainings to work with adolescents as this is a time of great developmental change. A considerable body of recent research outlines the significant brain development that takes place during the teenage years.

Our knowledge and understanding of human development has moved well beyond the early ideas of a child being a “mini adult", not least in the significant advances in developmental neuroscience. 

As we gain increasing insights into the differences between an adult and a child, we also need to acknowledge the rights of children to access mental health support appropriate to their unique needs. Here are just some of the things any therapist working with children should have:

  • An understanding of child development


  • Training in assessment and diagnosis of childhood disorders (these can present in a quite different way to the way they present in adults)



  • An understanding of theories of neuroscience and how early trauma can affect the developing brain, even prenatally



  • An appreciation of the complexity of ethical issues and boundaries when working with children. For example, managing the limits of confidentiality when sharing information – with parents or carers, with social workers or teachers. Also, how to manage a disclosure, together with knowledge of safeguarding and child protection procedures



  • An enhanced DBS check (formerly CRB check)


In addition, children communicate distress in a different way to adults. Any therapist working with children should be able to understand non-verbal communication and how to make sense of the child's inner world through symbolic communication. Even the therapy room is likely to be set out differently when working with children and young people. How effective would it be to sit in a chair opposite a four year old, asking questions?

For that matter, how effective would it be to do this with a teenager?! What is also an essential difference to working with children is the potential power imbalance. However much one may imagine a power dynamic between therapist and client in adult work, the adult often has enough agency and economic power to make a choice about coming to therapy.

A child may be “sent" by somebody else, rather than making a choice to seek out therapeutic help. This needs to be considered in the context of the therapeutic relationship. 

If a child or young person has sought support, they may not have choice over how to effect change in their environment. They may also have no control over when therapy is terminated, either because a parent chooses this, or because a local authority deems that funding has run out or, in the case of a looked-after child, their placement may be subject to sudden change. 


If you care for a child who you think may benefit from child counselling, see our specialist directory.