Child and Adolescent Psychotherapist: Career progression and prospects

The Child and Adolescent Psychotherapy Training is one of the most rigorous and fascinating mental health trainings in the UK today. It is a training that offers quite extraordinary opportunities as well as challenges – and I think it fair to say that it is life changing. The training schools have been delivering high quality psychoanalytic teaching and support for the trainees for many years and are well established. The alumni become highly respected members of the mental health workforce, whose views and talents are sought after.

But, what distinguishes us from our colleagues in related disciplines? Well, I think most of us would immediately point to our focus on and interest in unconscious processes. The training takes you on a journey not just of understanding our fellow human beings, but of deeply understanding ourselves through the rigorous analysis that we undertake during the training. Please reflect for a moment on this: the training supports you, including financially, to undertake a psychoanalysis that will likely change you (for the better, we believe) and hone your understanding of these fascinating unconscious processes – and do so because the main tool of our work is our self. If my words have failed to convey to you what an extraordinary and wonderful opportunity this is, then I apologise!

The training begins with a pre-clinical phase during which you will undertake a two year infant observation. This develops in trainees a great eye for observational detail and is a core part of the related learning about human development in its earliest phases. The seminars that take place introduce psychoanalytic ideas drawn from some of the most fascinating minds of the last three centuries. The next phase of the training, usually after two years of the pre-clinical training, is a four year fully-funded training post based, usually, in a Child and Adolescent Mental Health Clinic (CAMHS). These posts are paid at Band 6 level. In the course of the training placement you receive a wealth of supervision and have the opportunity of learning from some of the most experienced practitioners in the profession. The work you will undertake in the placement will include 1:1 psychotherapy both short and long-term, consultation, conducting assessments, joining colleagues from other disciplines (e.g., Psychology, Psychiatry, Systemic Family therapy) offering supervision etc. To my knowledge, there is no similar training that supports such a long-term training placement, most seem to offer short stints in several places – but this is not the case in Child and Adolescent Psychotherapy.

But what about post training – what is life like as a qualified CAPT? I believe, as my psychotherapy colleagues do, that we are well prepared for working life in mental health services in the NHS as our profession is respected and our talents well known. Many newly qualified CAPT’s will take up band 7 positions either as Psychotherapists or as CAMHS Practitioners and practice their skills in the context of busy NHS services. I would add that the trainings usually provide learning about the psychoanalysis of groups, which is invaluable for work in teams and organisations. Within a few years many are looking towards a band 8a position, which is a senior grade in most locations. At 8a, clinicians will offering supervision to band 7’s and may be managing and also leading on service development. After several more years, CAPT clinicians may be looking towards Service Supervision of CAPT trainees - and supporting new trainees through their training placement is a wonderful experience (redolent with memory of our own trainings as you might imagine).

An 8b role is a senior role, of course, and you would likely be a core member of a leadership team in a CAMHS and be taking on wider management responsibilities and tasks. Throughout all of this progression our training helps us to keep the child central in our mind and able to mentalise his/ her emotional needs. Our understanding of processes of projection, splitting and projective identification and our understanding, too, of the developmental phases and unconscious life of children (and adults) enables us to advocate for children and communicate a deep sense of them. But, you may wish to travel further in terms of leadership and take up the role of Consultant at either 8c or 8d level. Then strategic challenges will be part of what falls on your desk and working within organisations to support awareness around the role the unconscious plays in working life could be part of what you try to do; as well as developing psychotherapy teams.

I have always been struck that so many in our profession choose to continue working to very significant ages (whether privately or in the NHS). This isn’t, I realised, because they had been neglectful of their pensions (!) but out of a never ending fascination with the human mind and especially its unconscious life. I hope in the future we can welcome you to our merry band!

Dominic Regan

Consultant Lead Child and Adolescent Psychoanalytic Psychotherapist

Check out the career map for CAPT here.