It’s written everywhere—on clinic doors, websites, LinkedIn bios:
“Child and Adolescent Therapist.”

But as someone deeply committed to developmental neuroscience and therapeutic integrity, I’ll say this clearly:

Children and adolescents are not the same.
And pretending they are does a disservice to both.

The Brain Doesn’t Lie

A child’s brain and a teenager’s brain are not simply younger or older versions of each other. They are fundamentally different organisms in terms of structure, function, and regulation.

1. Myelination: Speed of Thought
In early childhood, the brain’s executive functions are still under construction. Myelination—the process that speeds up neural communication—is slow and uneven. Children live in the world of now, with limited foresight or inhibition. They don’t just need therapy; they need your nervous system as an anchor.

In adolescence, the emotional brain (limbic system) races ahead, while the prefrontal cortex (rational control) lags behind. This creates the infamous teenage turbulence: intense emotion with minimal regulation. Here, the therapist becomes a boundary-holder, not a co-regulator.

2. Synaptic Pruning: Jungle vs. Garden
Children’s brains are like a lush jungle—bursting with synaptic connections. They’re wide open, absorbing everything. Therapy must be sensory-rich, structured, and playful.

Teenagers, however, are pruning the excess. Their brains are streamlining—deciding who they are, what they care about, and what gets cut. Therapy here must honour identity exploration, autonomy, and cognitive sophistication. Clay and metaphor won’t reach a defended 16-year-old struggling with existential dread.

3. Limbic–Cortical Integration: Emotions vs. Reason
Children externalise emotion. Their regulation is social—dependent on attachment and sensory cues. Therapy must include the body, breath, symbol, and parent.

Adolescents internalise and intellectualise. They test boundaries. They want a witness, not a playmate. They need someone who won’t flinch at their rage, sarcasm, or silence.

The Therapist Must Choose

Of course, some clinicians do shift masterfully between child and adolescent work. But it’s rare. The posture, method, and energy required for each is distinct. Personally?

I am a co-regulator. I work best when I can meet a child in their emotional rawness, build symbolic bridges, and offer a nervous system steadier than their own.

Does that mean I don’t work with teens? Not necessarily. But it does mean I choose with intention—not branding.

Let’s Be Honest About Specialisation

The title “Child and Adolescent Therapist” may serve paperwork and marketing. But in practice, we owe our clients more precision. Children don’t need someone who tolerates play. They need someone who thrives in it. Adolescents don’t need someone who enjoys deep talk. They need someone who can survive the storm of separation and self-definition.

If we are to be ethically aligned with brain development, we must be willing to say:
“I specialise in children.”
or
“I specialise in adolescents.”
or
“I know where my skill ends—and I refer with respect beyond it.”


This is not about superiority. It’s about specificity. Children and adolescents are both sacred, sensitive stages. They deserve therapists who speak their language—neurologically, emotionally, and relationally.

Let’s stop selling ourselves short with generic titles.
Let’s claim who we truly serve—and serve them with everything we’ve got.

π