Abstract
A systemic approach to child and adolescent psychiatry involves not only the immediate family but also the wider environment in which the subject lives. Despite growing evidence confirming the effectiveness of systemic family therapy in child and adolescent psychiatry, this approach is not well represented in inpatient services in Greece. We present systemic principles as practiced at a child and adolescent psychiatric inpatient clinic embedded in a general hospital. We consider the competencies and strengths achieved by the team within a systemic epistemology, the difficulties of functioning in a biomedical-oriented environment, and the challenges faced during the 10-year socioeconomic crisis and the COVID-19 pandemic.