Choosing a private therapist for a child can be surprisingly difficult. Terms such as therapist, counsellor and psychotherapist may sound as though they describe a consistent level of training, but in the UK anyone can legally call themselves a counsellor or psychotherapist, regardless of their qualifications or experience. Parents therefore need to look beyond a practitioner’s title, website and directory profile. [1]
The most important things to check are independently verifiable professional registration, specialist training in children and adolescents, experience relevant to your child, a careful assessment process, appropriate supervision and safeguarding, and whether your child can develop a workable relationship with the therapist.
Registration with the Association of Child Psychotherapists, or ACP, provides one particularly clear indication of specialist child mental-health training. It should not be treated as a guarantee that a particular therapist will suit every child, but it gives parents a substantial and externally verifiable starting point.
What is an ACP-registered Child and Adolescent Psychotherapist?
An ACP-registered Child and Adolescent Psychotherapist is a psychoanalytically trained mental-health professional qualified to assess and treat infants, children, teenagers and young adults up to age 25, and to work with their parents, carers and professional networks. Full ACP registration is awarded after successful completion of an ACP-accredited clinical training. Qualified members must renew their registration annually. [2] [3]
The ACP maintains a public register on which parents can check a therapist’s name, membership category and registration status. This matters because a logo on a website is not sufficient evidence of current registration. Parents should establish that the practitioner is a registered Full Member, rather than assuming that trainee membership or attendance on a psychotherapy course is equivalent to qualification. [3]
The ACP Register is accredited by the Professional Standards Authority for Health and Social Care. PSA accreditation means that the organisation holding the register has met standards covering areas such as education, governance, professional conduct, public protection and complaints. It does not mean that the PSA has personally assessed or endorsed every individual therapist, or that it guarantees the effectiveness of a particular therapy. [4]
How extensive is ACP child-psychotherapy training?
ACP qualification involves considerably more than completing a general counselling course and later deciding to work with children.
The usual pathway begins with postgraduate pre-clinical education at Level 7. Required elements include extended observation of an infant and family, work-discussion seminars, psychoanalytic theory and research into child development. These studies normally take two or three years and are undertaken alongside substantial experience of working with children and young people. [2]
This is followed by a four-year, full-time clinical training embedded in child and adolescent mental-health services. The training includes academic teaching, clinical supervision, research, personal psychoanalysis and a salaried NHS training placement. Trainees gain direct clinical experience across the 0–25 age range. [2]
A defining part of the clinical training is sustained intensive work. Trainees treat three children or young people of different ages at a frequency of three sessions per week under close supervision. They also undertake once-weekly psychotherapy, assessments, brief interventions, consultation, parent and family work, and work with professional teams and wider networks. [2]
Personal psychoanalysis, usually several times each week, is another compulsory element. Its purpose is not to suggest that therapists must be psychologically flawless. It is intended to help them recognise their own reactions, anxieties and blind spots; tolerate difficult emotional states; and distinguish what belongs to the therapist from what a child may be communicating within the relationship. [2] [5]
Why does specialist child training matter?
Children do not necessarily communicate distress in the way adults do. A younger child may communicate through play, drawing, movement, silence, bodily symptoms or behaviour. A teenager may appear oppositional, detached or highly capable while privately experiencing shame, fear, exhaustion or hopelessness.
A presenting problem may also sit across several systems. School avoidance, for example, might involve anxiety, bullying, sensory overload, family stress, physical illness, learning difficulties, neurodivergence or experiences of failure and exclusion. Effective assessment therefore requires more than matching a visible symptom to a technique.
NICE recommends that psychological therapies for children and young people should be delivered by therapists trained in child and adolescent mental health and competent in the particular therapy they provide. It also advises that treatment choices should follow a full assessment of developmental level, family and social circumstances, comorbidities, neurodevelopmental differences, communication needs and the context in which treatment will take place. [6]
This is one of the principal advantages of ACP training: it prepares clinicians to understand a child developmentally and relationally, while considering parents, school, physical health and the wider professional network rather than treating the child as an isolated collection of symptoms.
Does ACP registration guarantee that someone is the right therapist?
No. Registration establishes a substantial professional floor; it does not prove that one practitioner, one personality or one therapeutic approach will suit every child.
Different difficulties may call for different forms of help. A child may benefit more from specialist CBT, systemic family therapy, psychiatric assessment, medication, occupational therapy, educational psychology, neurodevelopmental assessment, changes at school or work undertaken principally with parents. A trustworthy therapist should be able to explain why their approach is being recommended and recognise when another professional should lead.
The research evidence for psychodynamic child and adolescent psychotherapy is encouraging but should not be overstated. A 2021 synthesis brought together 82 studies and found evidence of benefit across several clinical presentations, particularly internalising difficulties, adversity and some complex problems. The authors also identified methodological limitations and called for more high-quality research. [7]
In the large UK IMPACT trial involving 470 adolescents with depression, short-term psychoanalytic psychotherapy, CBT and a brief psychosocial intervention produced comparable longer-term depression outcomes. This supports psychodynamic psychotherapy as a credible treatment option; it does not establish that it is universally superior to CBT or other therapies. [8]
The therapeutic relationship matters as well. A meta-analysis of 99 child and adolescent psychotherapy studies found small but meaningful associations between therapeutic alliance and outcomes, including the alliance between parents and therapists. Training matters, but so does whether the child feels understood and whether the adults can work constructively together. [9]