Child and adolescent psychiatry

In child and adolescent psychiatry (CAP), doctors work with children, young people (up to the age of 18) and their families. They treat a range of mental health problems and conditions including autism spectrum disorders, depression, anxiety, substance misuse and eating disorders.

This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you. 

Watch a video of Ajit Kumar talking about child and adolescent psychiatry:

Note: this video is part of a longer film that can be watched from the psychiatry introductory page.

Nature of the work

Child and adolescent psychiatry is a specialty within psychiatry working with children and young people up to the age of 18, and their families.

Working as a child and adolescent psychiatrist provides an opportunity to make a significant difference to the lives of the next generation.  It is an interesting and challenging specialty which has seen tremendous developments over the last two decades and is continuing to make great strides forward.

Working with children and young people means that early intervention at this critical period is possible with the potential for making a lifelong difference to those being seen. 75% of adult mental health problems have started in before the age of 18, and there is evidence that early interventions can reduce the likelihood of mental disorders in adulthood.

Child and adolescent psychiatry combines the rigours and science of medicine, with the art and creativity of therapy.  The ability to advocate for young people and improve public mental health, both add dimensions to the work that mean the possibilities are bountiful.

Working in child and adolescent psychiatry is both varied and rewarding.  There are many approaches to treatment, ranging from cognitive behavioural therapy to family therapy.  Medication and admission to an inpatient unit may occasionally be used, but this is less frequent than for adult mental health services.

Child and adolescent psychiatrists believe in the importance of family and community and this is reflected in service provision.  The work emphasises a multidisciplinary and multi-agency approach.  This means collaborating with colleagues with skills in different areas, or with partners from other organisations such as schools, social services, hospitals, or the police.   Consultation with other agencies is an important part of the work, to ensure integration of interventions at all levels.

Child and adolescent psychiatrists see a great variety of patients from all walks of life.  Young people present with many different problems, including:

Neuro-developmental problems arising in childhood:

Emotional and behavioural problems:

Other significant mental health problems:

Sometimes work is carried out with other professionals or carers of young people, rather than directly with the young person themselves.  For example, child and adolescent psychiatrists may work with teachers, foster carers, paediatricians, siblings or others involved with a young person in difficulty.

Consultant psychiatrists often provide specialist advice, leadership and support to the wider mental health team.

A good understanding of legal frameworks is also important, since child and adolescent psychiatrists may need to intervene by suggesting a particular care arrangement, educational provision or ensuring the safety of young people through legal means.

“Early intervention can make all the difference, even to potentially serious illnesses such as psychosis”.  Rory Conn, Child and Adolescent Psychiatist, Whittington Health NHS Trust.

Read Rory’s story

Common procedures/interventions

Most interventions involve talking to children and young people and their families to gain an understanding of difficulties and to find a way forward, within a child development perspective.

An example of a “talking therapy” used with children and young people is cognitive behaviour therapy (CBT). CBT enables the patient to look at how they think and feel about a particular situation and to see how this might influence their behaviour. It can be used to help change unhelpful thinking patterns and behaviours.

Alongside many other non-drug treatments, child and adolescent psychiatrists may prescribe medication where necessary, such as anti-depressants and drugs for ADHD.

Child and adolescent psychiatrists often liaise with professionals from many other agencies to improve care for young people.

Associated sub-specialties

There are no formal General Medical Council recognised sub-specialties within child and adolescent psychiatry. However there are a number of growing special interest areas including the following:

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