101Careers in CounselingIn this weekly feature, the editors of SpringBoard highlight one career in the health care professions–including a basic description, educational requirements, core competencies/key skills needed, and related web sites and professional organizations where you can find more information!


Counselors working with children in outpatient settings make up a large percentage of professional counselors. Counseling at an outpatient clinic is patently different than at an inpatient clinic, and very different from counseling in schools.


Things to Know

  • Children in outpatient clinics, as opposed to inpatient clinics, are more likely to be healthier, live with their parents or guardians, and will not be at a residential center; counseling, then, will involve more standard individual and group therapy. Though children in outpatient clinics may have a stronger support system, this is not always the case.
  • For young children, counselors will need to be trained in alternative therapeutic methods such as play, art, and drama therapy. Readers interested in pursuing this part of the field need to understand that they will see many abused and neglected children and that it can be emotionally draining (Landreth, 2002). Alternative modes of therapy (e.g., play, art, and drama  therapy) are not recreation times for the child, but involve serious and methodical work and assessment on the part of the counselor.
  • Counselors working with children in outpatient settings also will need to become facile in addressing issues with parents and guardians. Healthy, involved parents can be a real asset to therapeutic treatment. Likewise, neglectful or abusive parents will complicate treatment and make it challenging to achieve optimal therapeutic results.
  • All counselors counseling children and adolescents must be aware that they are mandated reporters of child maltreatment and neglect. They will occasionally need to follow up with child protection services in their area in order to protect the child from suspected maltreatment.

Best Aspects of the Job

A former student of mine who became a counselor working in an outpatient clinic serving children told me that the best part of her job was seeing a child transition from depression and isolation to being joyful and connected to peers. It is likely that any counselor who chooses to continue working with children in outpatient settings enjoys this same reward. Many counselors who work with children in clinic settings also enjoy the fact that counseling children is very different from counseling adults. Counseling children will require a lot of patience and creativity that goes well beyond standard talk therapy.

Challenging Aspects of the Job

If readers were to poll a sample of counselors working with children in any setting, it is likely that the biggest challenge cited would be abusive or neglectful parents. Counseling with children will necessitate dialoguing with angry, disgruntled, overwhelmed, over-controlling, parents or guardians. To maintain a therapeutic mindset, counselors must find a way to engage such parents in meaningful dialogues (though in many cases, this may not be possible). As a counselor who has worked with children and adolescents, it is very disheartening to watch abused children return to the abusive environment that damaged them in the first place.

Occupational Outlook and Salary

The occupational outlook for counselors working with children is very good. Mental health counselors are the segment of the field providing most of the counseling to children in outpatient settings. The growth rate is projected at 24%, and the median salary is $37,590. Achieving licensure and becoming a clinical supervisor or clinic director would likely involve a significant increase in salary.