Background: There is growing interest in identifying changes in ways of practice associated with the growth of professional expertise. Research on highly experienced or expert teachers and therapists (i.e. occupational, physical and behavioural therapists) can provide insights into how they approach practice, providing guidance for new practitioners.

Purpose: The objective was to compare and contrast children’s mental health therapists’ and elementary/secondary schoolteachers’ perceptions of changes in perspectives and approaches related to the development of expertise.

Sample: Nine children’s mental health therapists and five teachers/principals took part.

Design and methods: Using a nested sampling design, therapists and teachers/principals were selected based on years of experience and peer reputation, and participated in two separate focus groups. Similarities and differences between the practice groups were examined qualitatively, using cross-group analysis.

Results: Common reported changes in perspective included the development of open, broad, flexible and relational perspectives. Changes in approach included a focus on children’s needs/desires, psychosocial issues/outcomes and realistic goals.

Conclusions: The findings indicated how expert practitioners viewed their practice as changing over time, contributing to a better understanding of the nature and development of expertise in children’s service practitioners. The findings suggest the importance of paying attention to children’s needs/desires, cultivating awareness of their motivation and psychosocial issues, and setting realistic goals. Practitioners linked these changes in perspective and approach to more positive life and learning outcomes for children, which may have implications for guiding the practice of more novice teachers and therapists.