For many parents, navigating the various professional qualifications of clinicians offering therapeutic services can feel overwhelming. What does a Psychotherapist offer that a Psychiatrist does not? Are there different kinds of Psychologist? In this article we will clarify the different qualifications and different approaches to the treatment of mental health difficulty in children, and, most importantly, by doing so, help parents to think about what might be most suitable for their child.
Before getting in to the definitions of the terms above, a quick word on why these have been chosen. Within statutory services a number of professions are recognised as being crucial to the provision of thorough, evidence based services for the treatment of mental health difficulty in children and adolescents. Child Psychiatrists, Child Psychotherapists, and Clinical Psychologist are three such professions. They are all highly qualified clinicians, whose training is extensive and based within the NHS, and they are required to practice under strict codes of ethics. Part of their registration and chartered status depends on maintaining an up to date knowledge of research and treatment modalities. The Royal College of Psychiatrists, the Association of Child Psychotherapists and the British Psychological society are the respective governing bodies for the professions, and they maintain an up to date database of members, visible to the public.
So – how are these professions different from each other, and what does this mean for parents seeking help with their child’s mental health?
Psychiatrists are medically trained doctors, who will have completed basic medical training, and then specialised in the treatment of mental disorders. Training is extensive, and the longest of the three disciplines in the title. Psychiatrists can complete further specialisation in the treatment of mental health problems in children and adolescents. All NHS Child and Adolescent Mental Health (CAMHS) teams in the UK should have access to at least one Consultant Child and Adolescent Psychiatrist.
Psychiatrists are typically involved in the diagnosis of mental disorders (eg ADHD, Depression), and able to prescribe medication in the treatment of such difficulties. Psychiatrists are also likely to be involved in the care of young people who are very unwell, and might pose a risk to themselves and others.
A psychiatrist is likely to be involved in the logistics and overall management of a young person’s care. It is worth noting that relatively few psychiatrists provide psychotherapy, i.e. talking therapy, rather, they are extremely well qualified in the assessment, diagnosis, and pharmacological treatment of mental difficulty. However some psychiatrists may be trained in both psychiatry and psychotherapy, and offer this treatment as an option.
Child Psychotherapists are trained by the NHS to offer specialised psychotherapy for children and adolescents. Psychotherapy is a way of talking with a young person that seeks to get to the bottom of worrying behaviours, and to understand the specific emotional difficulty that a child may be struggling with. Child psychotherapists are trained to be particularly observant of a child’s play, or a teenager’s language, such that they are able to understand the underlying feelings and conflicts that young people struggle to put into words.
Following a relevant undergraduate degrees, child psychotherapists complete a 2 year MSc course in developmental psychology (the study of the developing minds of children), before going on to complete a 4 year clinical doctorate in child psychotherapy. Whereas psychiatrists and clinical psychologists have a much broader understanding of mental difficulty, child psychotherapists specialise early in their training, and so have considerable experience of a wide variety of childhood and adolescent presentations.
In Scotland and the wider UK, the term “psychologist” can describe a range of different professions. Educational psychology, sports psychology and counselling psychology are a number of such disciplines, however the kind that is most relevant to child and adolescent mental health, and is most frequently represented in mental health teams (including The Anchor Practice) is clinical psychology.
Clinical psychologists are trained to offer a wide variety of evidence based interventions, across a broad range of presentations. The work of clinical psychologists is informed by latest research, and clinical psychologists are well equipped to assess and treat many common conditions. Clinical psychologists complete a three year clinical training, and typically will have completed a Masters degree before this, though in contrast to child psychotherapists, this is not a compulsory part of the training route.
Typically a clinical psychology approach will often (though not always) be framed in behavioural terms. A clinical psychologist might look at a child’s behaviour and try to understand what form of intervention might change their behaviour, and ultimately their mood. In this way psychologists can work quite differently to psychotherapists: a psychologist may want to change behaviour, so that emotional states change consequently, whereas a child psychotherapist might want to address an emotional difficulty directly, with the understanding that this will facilitate a change in the child’s behaviour. No one method is better than the other, rather, the same aim is viewed from different perspectives, and one approach may be more suited to a particular child than another.
Whilst the term psychiatrist is protected under law, it is important to note that anyone can call themselves a psychologist or a child psychotherapist without the necessary training. This is at best disingenuous and at worst dangerous. Both child psychotherapists and clinical psychologists are required to register with governing bodies who have strict requirements for fitness to practice. You can check the register of child psychotherapists here and clinical psychologists here, to ensure that any professional you engage in your child’s treatment is appropriately qualified.
If you would like to discuss any of the above, or feel your child could benefit from talking with a child psychotherapist or clinical psychologist then please get in touch.