Work processes in Mental Health of Speech, Language and Hearing Sciences in a Psychosocial Care Center for children and adolescents (CAPSi) are the theme of this study. Reflecting about the limits of the traditional Speech, Language and Hearing clinical approach for children with severe mental disorders in a public mental health service in Federal District, Brazil, we proposed the reorientation of the work process towards the de-institucionalization and the interdisciplinary care in a psychosocial clinic. The interdisciplinary perspective and the overcome of fragmented and isolated actions were the main changes observed. Receptiveness practices, group care, inter-sector actions, participation in therapeutic workshops and permanent education were inserted in the routine of the speech therapists. The access criteria were redefined from a collective management of the clinic. There was a large improvement in mental health care at the CAPSi reflecting on changes in concepts and health practices of the professionals. It is proposed that further research in Speech, Language and Hearing Sciences take into account not only the traditional clinic of pervasive development disorders but also the psychosocial clinic, embracing and strengthening it’s political role in the campaign for the implementation of psychiatric reform and in the defense of integral care for these children.