Exploring ‘Clinical Judgement’: How Do Child and Adolescent Mental Health Professionals Decide Whether a Young Person Needs Individual Psychotherapy?

This article reports on a small-scale, qualitative study based in a single CAMHS team, exploring the decision-making process used by mental health professionals when deciding whether or not to refer a child for one particular modality of treatment--individual psychotherapy. Building on an initial audit of child psychotherapy referrals within the team, this study analyses a small number of in-depth interviews with members of the multidisciplinary CAMHS team. Three themes emerged from the analysis, suggesting that referral-making decisions depend on wider conceptions of the particular modality of therapy, particular features of the child and family referred (but not reducible to diagnostic categories), and the stage at which therapeutic work with the family has reached at the time of referral. The implications of these findings are discussed specifically in relation to child psychotherapy, and more generally in relation to evidence-based practice. The authors conclude by arguing for the use of more clinically relevant research methodologies within evidence-based research.