Young People's ( <scp>YP</scp> ) Experiences and Perceptions of Psychotherapy: A <scp>PRISMA</scp> Scoping Review

ABSTRACT Aim To scope the literature articulating YP experiences and perceptions of psychotherapy across all modalities and settings. Background The COVID pandemic precipitated a crisis in the mental health of YP, creating an urgent need for relevant, fit‐for‐purpose psychotherapeutic interventions. Objectives To undertake a literature search of YP experiences and perceptions of counselling and psychotherapy; to identify helpful and unhelpful aspects of YP counselling and psychotherapy provision; to pinpoint YP unmet needs. Eligibility Criteria Literature that met our definitions of ‘young person’ and ‘psychotherapy’; published/pre‐printed 2013–2023; primary research that documented client‐reported experiences and perceptions; a range of settings, modalities and interventions. Sources of Evidence Database searches included CINAHL, ProQuest and PubMed, supplemented by forward and backward citation tracking, manual journal searches and subject‐specific websites. Charting Methods We adhered to the PRISMA checklist for Scoping Reviews, using an a priori protocol. We screened 1712 titles/abstracts, full‐text reviewed 233 papers with blind voting and extracted data from 71 articles. Results Findings were synthesised around three mastercodes ‘engaging in therapy’, ‘exercising my own autonomy’ and ‘relating to my therapist’. Findings are illustrated by a novel conceptual map and narrative description. Conclusions Implications for practice : personalised treatments that meet individual needs; relationships that allow YP to feel seen/heard; importance of trust/confidentiality, agency/autonomy; inclusion of creative/multi‐modal/non‐verbal approaches; acknowledgement that silence and pressure to talk can increase anxiety; practitioner sensitivity to developmental needs/lived experiences of older adolescents, marginalised groups and LGBTQIA+ YP. Implications for policy : YP Mental health policy that champions flexible, personalised approaches; services that balance safeguarding with YP need for privacy/trust; adaptation of policy to be age‐appropriate regarding parental participation; commissioning of longer‐term interventions where funding/resources allow; supporting wider availability of services, including school‐based provision; workforce development centring on age‐sensitive/LGBTQIA+ supportive practice, relational approaches and cultural awareness; future policy for service design, evaluation and commissioning to be developed with YP participation/co‐production.