Individual psychotherapeutic interventions conducted at the UCT Child Guidance Clinic between 2000 and 2009 were investigated with a view to offering informed conclusions on the current nature of clinical practice at the Clinic. Assuming an ecodevelopmental perspective with regards to mental health that explicitly acknowledges the potential impact of social context on individuals’ lives the present research’s focus centres on the role of socio-economic class and sex differences specifically on work at the Clinic. The broader influence of shifting political, historical and pedagogical contexts on such work is also explored. The 156 individual case files that make up the sample were reviewed and a broad range of clinical information was collated including data on clients’ demographics, their presenting difficulties, the case formulations and intervention strategies employed as well as on clients’ apparent clinical outcomes. Results indicated that the Clinic has shifted to working predominantly with clients from lower socio-economic groupings, and that despite the often serious nature of presenting difficulties seen it appears therapy is for the most part of real help to clients.