Working with children can be very challenging, and in practically all cases, great care must be taken by both the therapist and the parents in the processes involved. Children are very quick to react, and tend to show their emotions, their thoughts and their opinions quite graphically and "matter-of-fact". This directness should not necessarily be taken as offensive – even if it appears ot be so.

In a lot of cases, a child’s agression and shortness of temper is a manifestation of something more deeply concerning to them, and it can be quite challenging to get to the root cause of these issues. problems in the home – such as difficulties in the relationship between parents – are a major cause of difficult behaviour in children, so often it is a case of trying to deal with these issues first, so that the environment in which the child is living, is changed for the better.

Children are increasingly exposed to challenges in their own lives and relationships with peers, because of increasing demands on them academically and socially. Sensitive children can become the victims of bullying and teasing, and in many cases, they keep quiet abot this for fear of being ostracised by their peers.

And peer pressure can be a major cause of problems that young people face today. Apart from being more vulnerable to influences of their peers, children often measure up against each other by comparing what they have with what others have. The latest toy, computer game, electronic gadget, fashion item are all symbols of status and position in the peer-group. Children feel very pressured to obtain material goods in order to demonstrate their "qualification" to be part of the crowd.

Fortunately, professionals such as teachers and medical practitioners are trained to spot situations where children are having difficulties, but it is very important that the underlying cause of these problems is identified quickly. A shy child may be very reluctant to discuss the fact that they are being bullied or teased, for fear of being excluded from the group. Today "cyber-bullying" is a growing threat to children, whose "virtual" friends are just as real as their physical ones. In a lot of cases, parents and teachers remain unaware of the nature, or the extent, or their childrens’ social contacts on internet sites, so evidence of bullying and peer-pressure remain largely hidden from view and scrutiny.

Children who are highly aggressive and short-tempered are particularly challenging to work with – moreso if their behaviour has been "tolerated" by adults around them, or dealt with in a similarly aggressive manner. Children will mimic the behaviour of adults close to them – because that is how they learn – and if the adults behave aggressively, then the children may believe that that is the way disagreements or conflict is handled.

Therapy for children almost always requires a detailed knowledge of their environment, their social groups (their friends), their activities both in and out of school and the home, so it is often necessary to obtain input from teachers, other adults and (in some cases) the child’s friends and acquaintances.

While it is usually not possible to radically alter the environment in which a child has to participate within, helping them deal with some of the big challenges they face is a key strategy in getting them to cope with their environment.