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Abstract

This study explored how prepared clinical child psychologists feel they are to support children with mental health issues, given the global increasing prevalence of these disorders and the need for skilled, empathetic and evidence-based care. Semi-structured interviews with ten clinical child psychologists were analysed using thematic analysis, following the DIPEx methodology, to explore their professional preparedness in working with children with mental health issues. Participants were recruited via social media and direct contact with organisations across the Czech Republic using email and phone. The following key themes were identified: school preparedness and lifelong learning, professional competencies and forming a professional identity, and supervision and collaboration. Participants reported that their university education was insufficient in preparing them for their work with children facing mental health challenges. They emphasised the value of informal practices, such as peer intervision, collegial consultations, and knowledge sharing, which were seen as complementary to formal supervision. These informal interactions played a crucial role in supporting professional development and fostering a collaborative work environment. The findings underscore the importance of enhancing training pathways for psychologists by incorporating more practical experience. Informal support systems, such as peer consultations and intervisions, are very important for professional development of clinical child psychologists. Addressing these areas may better support clinical child psychologists to meet the mental health needs of children.

Keywords

child mental health universities mental disorders education continuing professional competence

Introduction

Increasing prevalence of mental health issues faced by children worldwide highlights the need for competent, well-prepared clinical child psychologists. According to the World Health Organization,¹ approximately one in every seven children worldwide aged 10 to 19 suffers from a mental disorder, constituting 13% of the overall global burden of disease within this age group. The consequences of unaddressed mental disorders in adolescents extend into adulthood, exacerbating both physical and mental health and constraining the ability to lead a fulfilling adult life.^1,2 Children and youth experiencing mental health issues require specialised support and intervention to navigate their challenges effectively. For this study, mental disorders means clinically diagnosed conditions recognised by healthcare professionals, typically based on DSM-5 criteria.¹ Mental health issues are broader concerns that may not meet diagnostic criteria but still manifest in observable symptoms affecting emotional, social, and cognitive functioning.³

The professional preparedness of clinical child psychologists working in the area of the clinical practice is a key factor for treatment success,⁴ but the care in European countries is heterogeneous and often not applied consistently.⁵ Professional preparedness is defined as the combination of knowledge, skills, attitudes, and behaviours necessary to effectively perform job roles and adapt to evolving professional demands.⁶ In clinical child psychology, this means being adequately trained and competent to provide effective, evidence-based, and empathetic care to children experiencing mental health challenges.

Professional preparedness refers to the ability and competence of specialists, particularly clinical psychologists, to effectively address the mental health needs of children and adolescents. It encompasses the necessary skills, knowledge, ethical understanding, and the development of a well-formed professional identity, all of which are essential for delivering high-quality care and intervention.^7,8 Given the significant prevalence of mental disorders among young people globally, professional preparedness is a critical factor for successful treatment outcomes.⁴ It ensures that psychologists are not only equipped to diagnose and treat these conditions but also capable of managing the specific challenges that come with working with children and adolescents in diverse settings.⁵

In essence, professional preparedness in this context involves more than just having the necessary expertise, training, and professional identity to engage in clinical child psychology. Being professionally prepared means not only implementing successful interventions but also adapting to the evolving landscape of youth mental health, ensuring that care is both relevant and effective across various settings.^9
–11

In general, this concept relates to how prepared the professional feels to be for the challenges associated with his/her work and defines professional preparedness as the perceived ability to provide care, where having appropriate knowledge, training, and confidence is perceived as being “prepared.” Moreover, professional identity can be described as an internal sense of belonging to a particular community, leading someone to “think, feel, and act” like a member of that profession.¹² Professional preparedness incorporates pre-service and continued learning and work experiences to prepare for the demands of a specific job.¹³ Previous studies have shown a limited preparedness of clinical child psychologists in several topics, such as trauma,¹⁴ suicide risk assessment,^15,16 the Covid-19 pandemic response,^17,18 or interprofessional collaboration.¹⁹

Certain authors use the term “professional preparedness” interchangeably with “professional readiness”.²⁰ Po-Yan Leung (2018) distinguishes between the terms “readiness” and “preparedness,” emphasising the importance for psychologists to promptly identify problems and respond accordingly.

Development of an individual’s professional identity is a complicated, continuous, and long-lasting process that takes place in contextual settings. Professional identity formation represents a multifaceted and dynamic process through which individuals assimilate the fundamental knowledge, skills, values, and beliefs inherent to a specific profession. This transformative journey culminates in the development of a professional identity, wherein individuals adopt the mindset, behaviour, and emotions characteristic of the professional community to which they belong. It is a comprehensive process that encompasses not only cognitive aspects but also behavioural and affective dimensions.²¹ In recent years, children’s mental health has gained increasing recognition and attention. The professional preparedness of clinical child psychologists, psychotherapists, and psychiatrists is essential for ensuring quality care for youth.²²

This study aimed to understand the subjectively perceived professional preparedness among clinical child psychologists. By examining the developmental trajectory and key factors influencing preparedness, the research sought to enhance our understanding of the current state of mental health care for children and the readiness of professionals in this field. Despite the growing recognition of its importance, there is a lack of a understanding of professional preparedness, which leads to inconsistencies in practice and training. This study is important for addressing these gaps and establishing a clearer framework for ensuring effective care and interventions for children with mental health needs.

Methods

Measures and Procedures

This qualitative study was conducted using the Database of Individual Patient Experiences (DIPEx) method developed by the Health Experiences Research Group at Oxford University. This research design has been applied in studies examining the experiences of individuals with various illnesses and disabilities.²³ In the present study, the interviews with clinical child psychologists focused on mental health issues of children were conducted. This study followed the guidelines of the Standard for Reporting Qualitative Research (SRQR) to present the methodology and findings. This approach ensures the transparency, rigour, and clarity of qualitative research.²⁴ The method involves the rigorous analysis of narrative interviews from individuals with specific conditions, selected to represent a broad range of experiences.²⁵ The methodology was adapted to the context Czech Republic.²⁶

Ethics

The research adhered to ethical guidelines following the Oxford University’s DIPEx methodology and was approved by the Ethics Commission of the Sts Cyril and Methodius Faculty of Theology in Olomouc (2022/8). The team received ethical training and supervision. Participants provided informed consent, were aware of their right to withdraw, and approved anonymised transcripts. All data were stored in compliance with GDPR and personal data regulations. All the participants signed the written consent.

Design

Between November 2022 and April 2023, interviews with ten clinical child psychologists were conducted. The study analysed their preparedness and expertise in carrying out interventions with children and youth experiencing mental health problems.

Participants

The study involved ten clinical child psychologists working with children aged up to eighteen years old from various regions of the Czech Republic; see Table 1. Participants were selected through purposive sampling, ensuring a diverse range of clinical child psychologists.

Table 1.

Sociodemographic Factors.

Pseudonym	Gender	Age	Length of practice (in years)	Specialisation
Michael	m	59	20	CAN, relationship violence, bullying, domestic violence, crisis
Anna	f	34	3	depression, eating disorders, borderline disorder
David	m	37	10	the full spectrum of mental health diagnoses
Samuel	m	30	5	the full spectrum of mental health diagnoses
Peter	m	43	5	trauma, ADHD, anxiety, conflict, parenting difficulties
Sofie	f	23	1	the full spectrum of mental health diagnoses
Lea	f	N/A	1	the full spectrum of mental health diagnoses
Thomas	m	29	2	the full spectrum of mental health diagnoses
Vanessa	f	30	1	anxiety, self-harm, depression
Tobias	m	36	1	the full spectrum of mental health diagnoses

Inclusion Criteria

Inclusion criteria included: to be clinical child psychologists who provide care for children under eighteen years old with mental health issues, work as a clinical child psychologists for at least one year.

Exclusion Criteria

Participants were excluded: if they worked in a profession other than clinical child psychologist, had less than one year of practice, or primarily worked with individuals older than eighteen years or declined to provide informed consent.

Data Collection Procedures

Nine interviews were conducted online, and one interview took place by telephone. The interviews lasted from 26 min to 52 min (average 40 min) and followed a set scenario, which included two parts – a narrative part and a semi-structured part. The researcher began the interviews by asking the same open question: “Please tell me about your experiences working with children (or families of children) facing mental health challenges,” which focused on listening to the story that participants shared in their own words. The second part consisted of semi-structured questions, which gathered information about these topics:

(a) work experiences,

(b) professional identity development,

Data Analysis

Reflexive thematic analysis was used for the data analysis process. Transcripts were tagged with thematic codes and subcodes (names of main topics and subtopics), such as “professional preparedness,” “professional competence,” and “mental health disorder of children,” among others. NVivo software was used to facilitate the analysis process by organising and managing the data, and the follow-up analysis was performed manually by the researchers. In this phase, the researchers systematically sorted the text from the transcripts, assigning codes and subcodes. They also explored new partial subcodes, enriching the existing subcode tree. Following this, the “One Sheet of Paper” (OSOP)²⁵ technique was employed. Researchers read and coded the transcripts, labelled participant interviews for identification, identified thematic clusters and connections, and organised the statements into a mind map to illustrate their interrelationships.

Findings

Through analysis and careful examination of the data, the following key themes emerged where viewpoints were identified: school preparedness, lifelong learning, professional competences and forming professional identity, and supervision and collaboration.

Professional Competences and Forming a Professional Identity

Participants emphasised the importance of personal development, whether achieved through experiential training, professional experiences, or personal life events.

Thomas stated:

I definitely don’t have enough experience to say, ‘I'm done, I don’t need anything else.’ And I think no one can really say that, you know, in the world because, yeah, I believe I could develop anything; it’s just that the work is never completely routine. . .

This participant’s statement highlights that professional development is a continuous process, with individuals recognising that constant growth is essential. The idea that work is never entirely predictable or monotonous reinforces the belief that continuous learning and improvement are necessary components of professional development.

Moreover, some participants mentioned specific turning points that propelled their professional growth, while others described a gradual increase in their competencies:

Sometimes, there are cases that occur directly in our work that open up new horizons for us. We discover interesting facts gradually, you know; it’s not like some groundbreaking discovery or anything, but there are definitely small shifts and improvements. – Anna.

This participant’s observation underscores the incremental nature of professional development, where small shifts and improvements contribute to overall advancement. The acknowledgment of gradual discovery and improvement further emphasises the dynamic and evolving nature of professional competencies.

In summary, participants expressed the importance of ongoing personal development in their professional journeys. They recognised the necessity of continuous learning, irrespective of one’s level of experience.

School Preparedness and Lifelong Learning

While some participants appreciated the practical training provided during their university studies, many professionals felt that their education fell short of adequately preparing them for the demands of child psychology work.

Certain participants positively highlighted their university education, pointing out that they had gained applied knowledge and skills through practical training during their later years of study. These experiences allowed them to engage in diagnostic work, couples counselling, and therapy sessions, helping them to discover their interests and preferred target groups.

The first three years were more focused on theory, and then the next two years were really hands-on with a lot of practical experience. I got to try out diagnostics, like working with couples or being present in marriage counselling. Of course, I also had opportunities in therapy settings, maybe to figure out what suits me better, which target group resonates with me more. – Anna.

However, the majority of professionals expressed reservations about the sufficiency of their higher education. They felt that their studies lacked practical subjects relevant to their professional practice and included unnecessary topics. Some participants mentioned the need for more practical experiences and emphasised the importance of meaningful interactions and real-world scenarios during their studies.

One participant shared his perception that university education alone was insufficient to fully prepare them for their future practice. He stressed the importance of gaining practical experience and real-life exposure, as he believed that true professional preparedness comes from first-hand encounters and learning on the job.

Tobias emphasised the urgency of strengthening education in psychiatry, mental health, psychology, and related fields, particularly concerning children. He expressed that his university education did not adequately prepare him for the challenges he encountered in his work and highlighted the value of real-life experiences in building practical skills and knowledge.

Sure, university didn’t prepare me for that. Even though we had psychiatry, we visited a children’s psychiatric clinic only once during the entire six years, so it was very marginal. . . I feel like everyday life prepared me more, you know. – Tobias.

The participants reported the importance of recognising the dynamic nature of their roles and the necessity for ongoing self-improvement. All research participants actively pursued diverse forms of continuing education, such as courses, internships, seminars, and psychotherapeutic training courses, to enhance their professional skills. These educational opportunities were widely acknowledged as being highly beneficial for their overall professional growth.

In summary, the participants recognised the limitations of their university studies in preparing them for working with clients with mental disorder. The need for further professional education to enhance their competence and meeting the demands of their profession. Overall, the research findings highlighted the importance of diverse continuing education opportunities for practitioners’ professional growth.

Supervision and Collaboration

The development of professional expertise in child psychology extends beyond formal education and training, being profoundly influenced by collaboration with peers and multidisciplinary teams. This highlights the transformative impact of peer support, the contributions of multidisciplinary teamwork, and the integration of formal and informal methods in advancing professional growth.

Participants reported that their university education was insufficient for their future work with children. According to the findings, graduates from various universities did not feel adequately prepared to work with children experiencing mental disorders. They emphasised the need for more practical training in their curriculum, including hands-on experience through internships or placements, courses focusing on child development and mental health disorders, and opportunities to engage in real-world diagnostic and therapeutic practices. Additionally, participants highlighted the value of incorporating interdisciplinary collaboration exercises and more exposure to case studies to better prepare for the complexities of professional practice.

Participants reported that the process of enhancing professional competencies and preparedness was effectively facilitated through communication channels and the support of fellow professionals. Formal mechanisms, including specialised supervision, methodological consultations, and case-study seminars, played a pivotal role in this regard. These structured platforms provided individuals with opportunities to seek guidance, exchange insights, and delve into complex scenarios.

Participants reported that informal practices, such as peer intervision, collegial consultations, and knowledge sharing, were equally valued as complements to formal avenues. These informal interactions fostered an environment of mutual support and engagement. In situations where uncertainties arose or intricate cases were encountered, professionals united their efforts to provide assistance and collectively sought solutions. In the workplace, a sense of cohesion was cultivated through collaborative sessions, where professionals gathered to exchange ideas and explore alternative approaches.

In the moment when one of us, let’s say, is unsure or encounters a more difficult or challenging case, or let’s say, diagnostically something that is not entirely clear or simple, we always try to support each other, help each other, put our heads together to find some kind of answer that we are seeking at that moment. So, in our workplace, we actually try to do that; so we have these sorts of consultations, or supportive, like mutual sitting-together sessions, you could say. – Samuel.

The benefits of working within a multidisciplinary team of a child psychiatrist, physicians, social workers, and teachers were particularly emphasised:

The multidisciplinary team works really well here, because when we, from different professions, are not entirely familiar with a certain topic, we can study it on our own to some extent, but it will never be as comprehensive as the knowledge possessed by the experts. . . – Anna.

Such teams provided a rich platform for cross-pollination of expertise and knowledge. Child psychologists highlighted the importance of consulting with experts from other disciplines. Transformative supervision allowed professionals from diverse fields to recognise the limitations of individual study when facing unfamiliar topics and appreciate the unique insights of experts in each domain. This multidisciplinary approach enabled the team to achieve a comprehensive understanding, receive valuable guidance, and effectively address complex situations. Through embracing supervision and collaboration, participants recognised the collective wisdom present within their professional networks. Through these collaborative endeavours, professionals fortified their skills, refined their approaches, and remained adaptable in the face of evolving challenges.

In summary, the experiences shared by professionals underscored the transformative impact of supervision and collaboration in professional development. The fusion of formal supervision structures and informal discussions with colleagues supported the growth, mutual assistance, and knowledge exchange. By harnessing these synergistic elements, professionals fortified their capabilities, navigated intricate scenarios, and delivered enhanced outcomes within their respective domains.

Discussion

This study understands the level of perceived professional preparedness among clinical child psychologists working with children facing mental health challenges. The qualitative analysis revealed three central themes that illuminate the experiences and perspectives of these professionals: diverse experiences from undergraduate education, the shared recognition of the importance of ongoing training for professional development, and the critical role of supervision in enhancing professional competence and confidence.

These findings underscore the necessity for educational institutions to enhance their training programmes to better prepare future child mental health professionals. Furthermore, there is a clear need for structured pathways for lifelong learning to ensure that practitioners remain competent and confident in their ability to support children facing mental health issues. By addressing these concerns, we can improve the overall standard of care for vulnerable populations and enhance outcomes in child mental health. Our findings emphasise the need for educational systems to take a more active role in preparing future professionals. By integrating both foundational and adaptive skills into their curricula, institutions can better equip students for the complexities of working in the field of child mental health.

The findings suggest that professional preparedness develops gradually rather than through specific milestones. This supports Shön's “The Reflective Practitioner” model, which views professional growth as an ongoing process of learning and adaptation rather than a single event.²⁷ Through continuous experiences, professionals deepen their understanding and refine their skills. Reflective practice is widely recognised across fields such as health care,²⁸ social work,^29,30 and psychotherapy,^31
–33 including infant mental health.^34
–36 Reflective practice, as described in Schön’s model, is reinforced here as a continuous process. This view suggests that professional preparedness is not an endpoint but rather an evolving journey that incorporates constant learning and adaptation.

The perception of preparedness varied greatly among the participants, highlighting the diversity of experiences and perspectives gained through their academic journey. Likewise, Kocken mentioned that when assessing the risk of mental health issues in adolescents, experts highlighted obstacles such as professionals’ insufficient knowledge or skills.³⁷ Specialised training and clinical placement of psychology students also hold significant importance in their preparedness.³⁸ Interestingly, education shapes the professional identities of aspiring professionals, with the curriculum playing an essential role in this process. The link between what is taught in the curriculum and its practical applications underscores its paramount importance. The design of curricula holds considerable sway over the development of students’ identities, as highlighted by.³⁹ When it came to professional development and competence, all participants emphasised the importance of ongoing professional development, recognising its potential to enhance their expertise. The diversity of experiences among the participants highlights the fact that academic journeys are not linear, and preparedness is shaped by various factors, including the educational system, personal experiences, and clinical practice. This suggests that the process of becoming professionally prepared is more nuanced and individualised than it may initially appear.

The study underscores both formal and informal supervision as vital elements of professional development, integral to enhancing preparedness and strengthening professional identity. The study highlights the importance of peer support and intervision in refining practice. Recognised across various fields, supervision not only aids in preventing burnout but also fosters continuous growth and skill refinement.^40,41 It facilitates both the acquisition of clinical knowledge and the evolution of professional identity.⁴² Twivy et al⁴³ advocates for structured care arrangements, resource packs, and peer collaboration to better prepare for the conclusion of treatment, recommending end-of-treatment reviews and follow-up discussions to address emerging needs. This topic has received relatively limited attention in previous studies, and it would be beneficial to explore it further in greater depth. The study underscores the value of both formal and informal supervision in fostering continuous professional growth. By facilitating ongoing reflective practice, supervision supports the development of both technical skills and professional identity.

Practical recommendations for clinical psychologists include fostering informal interactions among colleagues to complement formal supervision structures. Peer collaboration and resource-sharing sessions, as advocated by Twivy et al,⁴³ provide opportunities for collective problem-solving and professional growth. Structured end-of-treatment reviews and follow-up discussions are also recommended to address emerging needs and ensure continuity of care. Interestingly, Porter et al⁴⁴ observed that while clinical training boosts students’ confidence in their skills, it may simultaneously reduce their perceived preparedness for clinical placement. This underscores the importance of striking a balance between theoretical learning and practical exposure in training programmes.

Strengths and Limitations

This study provides valuable insights into the professional preparedness of clinical child psychologists working with children and adolescents with mental health challenges. Qualitative methods enabled a rich understanding of their experiences and identity development.

However, limitations include a small sample size, which may cause limited data saturation, partly due to the potential high workload of other participant. Recruitment bias is also possible, as those with particularly strong experiences may have been more likely to participate.

The considerable time elapsed since graduation may have contributed to recall bias among some participants. Moreover, the wide range of participants’ professional experience – from one to over twenty years – may reflect significant differences in their training and practice. Future studies would benefit from broader sampling, increased data saturation, and prospective designs.

Conclusion

The study underscores the importance of focusing on the professional preparedness of clinical psychologists working with children with a mental disorder, starting from higher education. It identifies themes highlighting participants’ views on professional preparedness in child psychology, stressing the importance of undergraduate training, ongoing development, personal growth, supervision, and collaboration. In conclusion, lifelong learning – whether through formal courses, self-directed study, or practical experience – plays a pivotal role in maintaining professional competence and continuously enhancing the skills required for working with children in the field of mental health. Systematically advancing educational programmes, supporting ongoing professional development, and emphasising practical training, can ensure that professionals are well-prepared to deliver high-quality care and contribute to the improvement of mental health outcomes for the most vulnerable populations.

Supplemental Material

sj-docx-1-inq-10.1177_00469580251376922 – Supplemental material for Informal Collaborative Engagement Supports Professional Preparedness in Clinical Child Psychologists: A Qualitative Study

Supplemental material, sj-docx-1-inq-10.1177_00469580251376922 for Informal Collaborative Engagement Supports Professional Preparedness in Clinical Child Psychologists: A Qualitative Study by Nika Totova, Kristyna Gabova, Peter Tavel and Radek Trnka in INQUIRY: The Journal of Health Care Organization, Provision, and Financing

Footnotes

ORCID iDs

Nika Totova

Kristyna Gabova

Radek Trnka

Ethical Considerations

This study was approved by the Ethics Commission of the Sts Cyril and Methodius Faculty of Theology in Olomouc (Approval No. 2022/8), dated April 4, 2022. This research was conducted ethically in accordance with the World Medical Association Declaration of Helsinki.

Consent to Participate

All participants provided written informed consent prior to enrolment in the study.

Authors Contributions

Nika Totova developed research design, conducted data acquisition, data analysis, drafting of the paper. Kristyna Gabova worked on analysis and interpretation of data, drafting of the manuscript and final approval of the manuscript. Peter Tavel worked on general conception and design of the study, revising the article and interpretation of data. Radek Trnka worked on design of the study, interview guide and provided supervision. All authors have given their final approval for the version to be submitted and agreed to take responsibility for all aspects of the work. The authors declare no competing interests.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The work was supported from ERDF/ESF project DigiWELL (No. CZ.02.01.01/00/22_008/0004583) and institutional grant of Palacky University Olomouc (IGA_CMTF_2025_008).

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data Availability Statement

The data used in this study are available upon request.

Supplemental Material

Supplemental material for this article is available online.

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