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The Average Working Day of a Child Psychotherapist

Being a therapist has it’s ups and downs, like every job I guess. The real buzz for me is the daily dose of hope I get and the sheer privilege of working with other humans in such a beautifully intimate way. Since I’ve written quite a few articles on voiceBoks about some of my thoughts, theories and experiences, I’ve been asked to expand on what I do exactly. So I’ll just jump right into it …

Training and Qualifications (because it’s different from the U.S.)

I work as an accredited Counselling Psychologist, Psychotherapist & Supervisor in a full-time private practice. Accredited in Ireland means licensed.

In Ireland, one can train as a Psychologist – and specialise in clinical counselling, educational, straight-up clinical or organisational psychology by doing a Masters degree. Getting your PhD is offered, but normally only psychologists who are interested in pure research with a view to an academic career that do that. Most practitioners here do not have PhDs for that reason.

Having a Masters Degree means you’ve completed at least five to six years of full-time training in both academic and clinical practices. This is followed by post qualification experiences where we work towards ‘accreditation.’ Once we are accredited, we must complete a minimum amount of continuous training annually (CPD) in order to hold onto our status.

Psychotherapy requires different and usually less (in both time and academic content) training. One is not superior to the other though I think. Each individual has their own unique skill and personality which they bring to their chosen practice.

Supervision means working with practitioners to help them work more effectively and safely with their clients. In Ireland, it is considered unethical and bad professional practice to work without regular supervision. In fact, if you don’t attend a supervisor, you will most likely lose your license.

Why do practitioners need supervisors?

Sasha catIf my cat died and my client’s cat also died, I might be too triggered to work in a helpful way with them until I work through my own grief. And that would be a LOT if my cat died because I love the bones of him!! Anyway, you get the picture.

It’s all a part of good quality control, because physicians are people too and they too would need time to heal, etc. etc. Supervision requires extra training and experience, but it’s a super rewarding work – particularly when I get to supervise therapists and psychologists from different academic backgrounds to my own. There’s so much to learn!!

Who are my clients?

I work in private practice exclusively now, which is great. It means I have time to write and run (my two therapies) and see clients in my own time and at my own pace. I did seven part time years with Barnardos – Ireland’s largest charity for children – you may have heard of them. There I worked with children and families who were affected by bereavement. The children ranged in age from anywhere between 18 months (yes) up to 18 years of age. So it was a pretty varied job.

Children who went through the bereavement process were usually there, because of the death of a parent, or sometimes a sibling or close relative. And sometimes this death would be by suicide or murder. So a lot of the work was around trauma, which required extra training. This is how Babette Rothschild became something of a hero to me. 

Children express themselves differently from adults and tend to be much more creative and imaginative in the way they communicate. Often, they will express themselves through game-playing, painting or stories. So that work was different from my private work with adults. And I’m a big fan of variety!

I concurrently worked in secondary schools (known in the U.S. as high school) with 15-17 year olds where I developed personal growth and entered a sexual health education programme, which was actually really great fun! I started that in 1995 when I was just as old as some of the students I work with now …

My longest stint was in a private school for 17 years. I loved that place dearly. At times though, working in this setting is very, very sad. Sad because I get to really know these kids and their weekly trials and challenges. And let me tell you, they are facing things we didn’t conceive of in our worst nightmares. They have a lot going on, but their resilience is astounding and working with this age group is, for me, hugely energising and motivating. I still work with this age group privately – about half, maybe over half of my current clients are teenagers.

Once you give children and teens permission to express themselves freely and help them feel understood, it’s amazing how quickly they begin to heal after difficult or traumatic events. It is a true privilege to witness. I’m keenly aware as well that the trust these kids’ parents place in me is enormous, and I value that immensely.

While a lot of therapists fear working with teens, I relish it and I actively encourage other supervisees to consider this work too. We are, us adults, quite terrified of teenagers and tend to make whopping assumptions about how judgmental they are, how disinterested they are in our support – how ‘grown-up’ they are –  but the opposite is true.

Perhaps we are still traumatised from our own experience of BEING teens – #triggercity. And with regard to their need for guidance, support and boundaries I believe their need is greater than ever.

How do people come to me?

The kinds of referrals that come my way vary greatly. I get a lot of word of mouth referrals at this stage, as well as GP, social worker and psychiatrist referrals. And Dr. Google of course.

The age range of people I help varies. At the moment, the youngest person I’m working with is 4 and the oldest is 79.

The concerns vary with anxiety from school, home, marriage, divorce, grief, work, self esteem, body image, bullying, dysfunctional families, addiction. I often get calls asking me for assessments for schools but this is not a service I provide so I refer to educational or clinical psychologists for that.

And then there’s the saying no. I spend a lot of time teaching and supporting people in saying “no” and still struggle with it myself sometimes! We, as therapists need to know when our books are full and when we cannot take on any more work! It’s pretty basic self-care, it’s a choice, and I am lucky that I am fully independent and can do that. I enjoy my work a lot, and choosing to say no is a real challenge. I’m sure many of you can relate! (Right???!!)

saying no

Modern therapy:

I’ve really noticed these last few years that there’s far less stigma, or sense of shame attached to the idea of therapy, which is very heartening. People are using online therapy, skype, self-help sites. Sites like this are a great example of how normalised help-seeking behaviours have become. While it isn’t a substitute for therapy of course, it is still helpful and valuable.

Not everyone needs or wants therapy. We can land on a site like voiceBoks.com and know for sure that there are other people struggling with the same stuff and some of them might have come up with solutions. It’s how society has always evolved of course – but now it’s right at our fingertips!!

The sooner we can equip children and each other with the skills and knowledge to deal with difficult or traumatic events, the better and happier it will be for all of us as a world of cohabiting citizens. That’s the dream anyway and I’m busy dreaming!!!

Sally O'Reilly

Sally O'Reilly

Sally O’Reilly is an IAHIP, ICP and EAP accredited Counselling Psychologist, Psychotherapist and Clinical Supervisor with nearly twenty years of professional experience. Her particular area of expertise and interest is work with teenagers. She enjoys a busy full-time private practice and has developed and facilitated a personal development, substance misuse and sexual health programme for teenagers for over 15 years. She is a regular contributor to national print and radio media.
Sally is also the co-author of Two Wise Chicks.
Feel free to follow Sally on: Facebook | Twitter | Linkedin


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  • You are a wonderful person! It takes a certain type of person to be able to help people! I’m glad that you found a job you love!

  • Finding something you truly love to do – is so important! I’m so glad you found that. It sounds like a tough but rewarding job, and that’s really all you can ask for. So awesome – this was great to learn about!

  • I love that you work in mental health. It’s so important for people, especially children to be able to express themselves and seek help when they need it. My sister is a child psychologist and she works at an elementary school and she loves it. It’s such a great field.

    • Hi Lavanda, yes indeed having my own schedule is great! Have to be disciplined though, which I’m used to now thankfully! And I agree, mental health is about every, single, one of us. Thanks for reading, warmly, Sally.

  • It’s so true that over the last few years there is more openness about mental health and seeking help. Here in Canada, there are a few campaigns that encourage people to talk about it. It’s great that you’re largely able to set your own schedule and see clients at your own pace. That’s the dream right!

    • Right!! Yes, my co- wise chick from twowisechicks is Canadian and so I’ve been privy to some of the work done there. Impressive place! And very beautiful of course… thanks for reading, warmly, Sally.

  • It’s nice to know that psychotherapy is now (widely) accepted, and we have professionals like you whom people can turn to for help. I have a friend who is currently undergoing therapy, and I am glad she is making progress. 🙂

    • Hi Karissa, Thanks for reading and for commenting. Y’know, I wouldn’t do anything else and I’m really, really fortunate to have found a path that I love and want to stay on! Warmly, Sally

  • It’s nice to know that over the years there’s far less stigma. Kudos to what you do, not everyone can do it. I’m not a good listener and I’ll be very affected if I’m the one on the listening end. Keep doing what you’re doing.

    • Hi Kathleen and thanks for reading the piece. Yes, there is definitely a reduction in stigma – it’s great to see and will continue I believe. Things are certainly improving for our society in many, many ways. Warmly, Sally

    • Hi Allison and thanks for reading! Thank you for your awesome compliment but I want to assure you I’m no super woman! Therapists are a mess too at times – hence the supervision! Because yes, it can be hard but oh so so SO rewarding. Warmly, Sally

  • You have an amazing role, helping kids and families all around. You improve quality of lives of so many and help so many. Crucial job and I am glad you are able to let people know how hard but rewarding your job is.

  • It can be really difficult to listen to other peoples problems without trying to solve them but a great therapist knows how to let people get everything out. I have went to therapy before as a kid and it was kinda helpful in some ways but no matter what it is a nice way to get some things off of your chest in a private way.

    • Hi Melissa, I’m glad it was helpful – I did hear the ‘kinda’ and the ‘some’ – everyone’s experience of therapy is different and every therapist is different. It can be a little like shopping – not everything os going to fit, and shopping isn’t everyone’s cup of tea, even if it’s the only way they can get what they need. You also nailed a difficulty that a lot of (esp ‘starting-out’) mental health workers have – trying not to fix or provide solutions – doing so is ultimately disempowering, even though the goal is the opposite! Thanks for reading, warmly, Sally

  • You are a truly awesome person! Your skills and talent are so vital and important to the lives that you serve. I commend you, as I can only imagine the restraint necessary to do what you do! I would want to cry and hug client!

    • Hi Sapphire – well you too have just named a thing that naturally can arise in therapy for therapists – the wanting to hug and make better. This is why the supervision and supports and ingoing training is so vital – we must take care of ourselves in order to take care of others. And figure out things like – if I want to hug / resuce this person, is it for them or is it really my need? These are issues that therapists everywhere grapple with daily. Thanks so much for reading! Warmly, Sally

About Author

Sally O'Reilly

Sally O'Reilly

Sally O’Reilly is an IAHIP, ICP and EAP accredited Counselling Psychologist, Psychotherapist and Clinical Supervisor with nearly twenty years of professional experience. Her particular area of expertise and interest is work with teenagers. She enjoys a busy full-time private practice and has developed and facilitated a personal development, substance misuse and sexual health programme for teenagers for over 15 years. She is a regular contributor to national print and radio media.
Sally is also the co-author of Two Wise Chicks.
Feel free to follow Sally on: Facebook | Twitter | Linkedin