The role of child psychiatrists is evolving. Economic and psychosocial factors such as marital breakdown, inner city decline, unemployment, plus increased awareness of conditions such as Substance Abuse and all forms of Child Abuse have led to stress for children and their caretakers. There is also increasing recognition that with help many troubled children and their families can emerge better able to function. Child psychiatrists occupy a pivotal position in the child mental health team and need to be familiar with all the treatment options available to ensure their effective use. This paper presents examples of current work being undertaken by child psychotherapists and discusses the implications of this for the training of child psychiatrists as well as for clinical work.