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Working life (CAP)

“I became a child and adolescent psychiatrist to help vulnerable young people reach their potential. It is fantastic to be able to engage with young people, see the world through their eyes and alongside them, their family and wider community, in order to help young people reach their full potential.” - Child and adolescent psychiatrist

Unlike some other specialties, child and adolescent psychiatrists have a high degree of autonomy and their days can be very varied and stimulating. Some examples of activities on an average day include:

• carrying out a one-hour cognitive behavioural therapy session
• assessing an adolescent in accident and emergency
• attending a school meeting about a child in difficulty
• assessing a child on a home visit to their foster placement
• running a multidisciplinary team meeting and discussing allocation of new outpatient referrals
• phoning social services to discuss a child protection matter
• hearing a case presentation from a colleague
• having a meeting about a new research project
• reviewing a child on medication
• seeing a family for family therapy alongside a co-worker, with a supervisor instructing from behind a one-way mirror
• teaching medical students

Working hours in child and adolescent psychiatry are reasonable and often quite flexible. The hours are usually 9am to 5pm, with some nights and weekends on-call covering local child and adolescent mental health emergencies. On-call duties vary across the UK, in terms of frequency and support arrangements. On-call demand is generally less frequent than in other specialties, but when called in, cases will typically take some hours to assess and manage.

The majority of work takes place in local community settings, such as clinics, schools and people’s homes.  Other settings include inpatient units, with specialist community teams or within acute hospitals.

A community child and adolescent psychiatrist may see between four and ten families a day depending on whether they are conducting detailed assessments, psychotherapy or more routine follow-up work such as medication reviews. Inpatient units often have around ten to twenty patients who are seen regularly.

Child and adolescent psychiatrists rate the importance of family life and emotional wellbeing very highly. Further, more than half of child and adolescent psychiatrists are women and so flexible working is well understood and accepted with many part time jobs being available.

Opportunities for research are good and span neuroscience, experimental psychology and sociology as well clinical outcomes and service improvement. There is a wealth of opportunities for research and teaching of medical students, and higher trainees, as well as staff from other disciplines.

Child and adolescent psychiatrists are employed in many different roles. They can be called as expert witnesses in court, or offer private consultation work.  Child and adolescent psychiatrists often move into consultancy and managerial roles as their systemic perspective on problems makes them well suited to these areas.

The EU Working Time Directive limits the working week to 48 hours. It is also possible to work part-time once you are consultant, or to train on a less than full-time basis (conditions apply).

• Who you will work with?

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  Child and adolescent psychiatrists work as part of multidisciplinary teams within a hospital or clinic.   

  They work with:

  • educational and clinical psychologists
  • paediatricians
  • mental health nurses
  • occupational therapists
  • teachers
  • family therapists
  • social workers
  • child and adolescent psychotherapists
  • speech and language therapists

• Attractions and challenges of the role

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  Child and adolescent psychiatrists consider it a privilege to be working with children and families, and enjoy the potential to improve children’s lives. It can be incredibly worthwhile and rewarding to join a child or young person on the journey through their difficulties. 

  The job provides plenty of job satisfaction. Factors such as the sheer variety of work available, the ability to combine therapeutic skills with medical knowledge, and great professional flexibility in how you work, combine to make the work very enjoyable.

  You will often be an advocate for vulnerable young people or for those who are too young to speak for themselves. Early identification of problems means that you have a better chance of successful treatment.

  Managing complexity, bearing with difficult emotional states and situations and seeing young people in distress, are all challenging aspects of the job.  Regular supervision throughout your career helps child and adolescent psychiatrists deal with this.

  Jobs in child and adolescent psychiatry generally involve working more regular hours than is possible in many other areas of medicine. This can allow for a career balanced with life outside work, as well as time for teaching and research.