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This paper discusses the world of child and adolescent treatment today: How it is the same and different from what was described in an article by this author fifteen years ago. The article highlights issues presented by the pandemic, the growth of technology, and the omnipresence of global violence. There has also been an increased use of medication and substantial growth in the number of children and adolescents diagnosed with neurodivergences. The unique contribution of the psychoanalytic psychotherapist is explored along with the changed need for a coordinating function in the treatment, such that the therapist coordinates provision of multiple clinical and educational services for the child patient.