The Training Council of the Association of Child Psychotherapists sets out the minimum requirements for training in child psychotherapy, as follows:
1. Pre-training requirements
Child psychotherapy is a graduate-entry profession. The pre-training qualifications of each trainee must be approved by the Membership Committee of the Training Council.
The criteria are:
- An enhanced Criminal Records Bureau check
- An honours degree or equivalent
- Pre-clinical studies: Before commencing the clinical training, students must have completed a course of observational psychoanalytic studies leading to a Postgraduate Diploma, MA or equivalent qualification. Candidates who do not have an honours degree must complete the course to MA level.
- Work experience: Trainees are required to have substantial experience of working with children and adolescents of varying ages. This experience may have been gained in a number of settings, including health, education and social care.
- Personal suitability: The pre-clinical studies provide an opportunity for assessment of suitability for working in psychotherapy and an opportunity to discuss with tutors the appropriateness of applying for clinical training.
- Personal analysis: This is optional in the pre-clinical phase but an essential component of the clinical training. Trainees must have completed sufficient analysis to be competent to commence intensive casework. The responsibility for making this decision lies with the training school in consultation with the analyst. The expected minimum is 12 months' personal analysis.
2. Clinical training
The clinical training in child psychotherapy is an intensive course covering theory, technique and clinical practice under supervision for a range of ages, disturbances and clinical settings. The theory and technique elements will be delivered through a variety of teaching methods. The clinical work under supervision will be gained through the clinical placement in a Child and Adolescent Mental Health Service (CAMHS) team or other other suitable setting. Through the use of individual and group supervision and clinical seminars the trainee will be enabled to integrate theory and practice. The training period is usually four years.
The key elements of the clinical training are detailed below.
a) Theory and technique
The academic elements of the training cover:
- Human growth and development
- Disturbances of development and psychopathology
- Psychoanalytic theories
- Research methodology and practice
- Psychotherapeutic techniques
- Knowledge of forms of adult mental illness and impact of parental mental illness on children
- Structure and management of NHS
- Current relevant legislation and guidance
- Child protection procedures
- Report writing including court reports, letters to GPs and other health professionals, social services assessments
b) Clinical work under supervision
i) Intensive psychotherapy with children. This includes intensive therapy with three patients: one pre-latency; one latency; one adolescent. Each patient will be seen between three and five times per week. One case must be seen for a minimum of two years and the other two for a minimum of one year. There must be a mix of girls and boys. Each case is supervised by a different senior child and adolescent psychotherapist to give the trainee experience of a range of approaches. The intensive case supervisors are likely to be external to the Trust.
ii) Less intensive psychotherapy with children. Once and twice-weekly psychotherapy on a long-term basis (usually one year minimum) must be undertaken with at least six children or adolescents. Instead of a non-intensive case, a trainee may substitute running a children's group, treating a mother and young child on a long-term basis, participation in longer-term family therapy or undertaking some time-limited treatments.
iii) Work with parents. Trainees must gain competence in working with parents: either those whose children are in treatment or those where the work is focused on the child or adolescent. This is not adult psychotherapy.
iv) Assessments/Experience of multi-disciplinary working. This includes making appropriate recommendations based on initial assessment and diagnosis of a range of children, adolescents and their families; working with other professionals involved in the assessment process involving both generic assessments and those for psychotherapy; joint working with other members of the multi-disciplinary team.
v) Application of psychoanalytic understanding. It is essential for trainees nearing the end of their training to obtain experience of applying their psychodynamic knowledge to at least two of the following:
- Brief interventions and time-limited psychotherapy with adolescents and young adults
- Brief interventions and time-limited psychotherapy with parents of babies and very young children
- Family work
- A Tier 2 CAMHS settings
- Group work with children and adolescents
c) The context of work with children, adolescents and their families
i) Adult mental health experience: Knowledge of the forms of adult mental illness and the impact of parental mental illness on children.
ii) Working in the NHS: Structure and management of NHS; current relevant legislation and guidance; child protection procedures; report writing including court reports, letters to GPs and other health professionals; social services assessments.
iii) Multi-agency working: Trainees need to have knowledge of the variety of settings across health, education, social services and forensic provision within which children and young people are at higher risk of mental ill health. These include paediatric wards, child development centres, residential children's homes, special schools and off-site educational units, and young offender units. Training schools and work placements should liaise together to ensure that such knowledge is provided.
iv) Consultation to other professionals: Consultation to professionals in other tiers of CAMHS and in other agencies that work with children and adolescents.
v) Research: Students should be given opportunities to contribute to clinical research projects.
d) Recommended further training
Further training could include:
- Dynamics of groups and institutions
- Teaching courses of other professionals and care-givers
- Understanding of other forms of treatment e.g. cognitive and behavioural methods, family therapy, medication
- Experience of consultation to other professionals
e) Personal analysis
Trainees will be in their own psychoanalysis for a minimum of four times a week. In circumstances where there is a scarcity of analysts, at the discretion of the Training School and in consultation with the analyst, this may be reduced to three times a week. This is an essential and central requirement of training.