Praxis der Kinderpsychologie und Kinderpsychiatrie

Summary From Pretending to Play to Playing Pretend: The Role of Epistemic Trust in Mentalization-Based Therapy with Children Although all forms of psychotherapy encourage the patient to focus on their mental states and those of other people, it is a distinguishing characteristic of Mentalization-Based Therapy (MBT; Fonagy u. Bateman, 2006; Bateman u. Fonagy, 2016) to place such focus at the center of treatment. In MBT-Child there is the added element of play, which is considered a primary vehicle for enhancing mentalization (Midgley, Ensink, Lindqvist, Malberg, Muller, 2017). However, pre-mentalizing modes during play are developmentally normative in children. Thus, it can be difficult to distinguish between play as a goal of treatment, and the psychic equivalence and pretend modes. This paper presents some thoughts about how we can unravel the relationships between restoring mentalizing and the process by which children in therapy “learn to play”. We begin by introducing the theoretical principles that underlie MBT and MBT-C, with particular focus on defining the pre-mentalizing modes. Then, we discuss recent innovations in thinking about the role of epistemic trust in psychotherapy and present a possible use of this concept in understanding pre-mentalizing modes during playing. We suggest ways in which mentalization-based techniques used when children are in pre-mentalizing modes may restore epistemic trust and act as a mechanism of change in child psychotherapy, opening up the child’s capacity to both play and mentalize in relation to their social environment. Finally, we present a clinical case of a mentalization focused treatment with a 9-year old child to illustrate our views.

Jordan Bate

Sophie Hauschild

Alessandro Talia

Vom Tun, als würde man spielen, zum Spielen, als würde man tun: Die Rolle epistemischen Vertrauens in der Mentalisierungsbasierten Therapie mit Kindern

从行动如游戏，到游戏如行动：认知信任在基于心理化的儿童治疗中的作用

Rainer Thomasius

Prax Kinderpsychol Kinderpsychiatr

Zur Diskussion / Up for Discussion. Entgegnung zum Beitrag von Nadja Gaßmann

讨论/供讨论。回应纳贾·加斯曼的文章

Sexual Risks in Young Patients in Inpatient Child and Adolescent Psychiatric and Psychotherapeutic Addiction Treatment Engaging in fulfilling and low-risk sexual relationships is a developmental task in adolescence and young adulthood. At the same time, sexual contact is associated with risks, including early and/or unwanted pregnancies, sexually transmitted infections (STIs) and negative sexual experiences. In the present study, n = 84 inpatients in child and adolescent psychiatric and psychotherapeutic addiction treatment aged between 13 and 19 years were examined. The aim was to determine how many participants had experienced sexual risks due to (1) sexual contact under the influence of alcohol and/or drugs, (2) sexual contact without a condom outside of a committed relationship and (3) regretted sexual contact. It was also checked whether there was a state of intoxication during the situation in the three risk situations. 69.7 % of adolescent SUD patients stated that they had had sexual contact under the influence of alcohol and/or drugs. 46.1 % of SUD patients reported unprotected sexual intercourse in the last 12 months. A total of 53.6 % of female and 12.5 % of male adolescent SUD patients reported regretting sexual contact. 90 % of cases occurred while intoxicated, regardless of gender. No connection to comorbid disorders was found, but there was a clear connection to the impulsivity factor urgency. The figures indicate that young SUD patients are at considerable risk of having unwanted sexual experiences. Preventive measures should take into account aspects of managing urgency.

Christiane Baldus

Sabrina Kunze

Julian Harbs

Tanja Legenbauer

Originalarbeiten / Original Articles. Sexuelle Risiken bei jungen Patient:innen in der stationären kinder- und jugendpsychiatrischen und -psychotherapeutischen Suchtbehandlung / Sexual Risks in Young Patients in Inpatient Child and Adolescent Psychiatric and Psychotherapeutic Addiction Treatment

原创研究 / 原创文章。住院儿童和青少年精神病学及心理治疗成瘾治疗中的年轻患者性风险 / 住院儿童和青少年精神病学及心理治疗成瘾治疗中的年轻患者性风险

School Absence as Functional Impairment of Juveniles with Personality Disorders Based on ICD-11 This longitudinal study focused on the question whether specialized treatment with applied transference focused psychotherapy in a day hospital program can improve school dysfunction in adolescents with borderline and other personality disorders (PD). Moreover, we investigated influential factors for the improvement of school attendance. Among the 175 juvenile patients, before treatment 60 % showed school absence. Our results indicate that the treatment could improve school attendance significantly. At the same time, we could show that some psychological variables can be considered essential predictors for the development of attending school regularly. More conduct problems and dissocial behavior diminished the likelihood to attend school increasingly regular; the higher borderline and avoidance PD criteria were fulfilled, the higher were the odds to improve school attendance. With respect to the changes regarding functional impairment of PD in the upcoming ICD-11 our results could generate knowledge that school dysfunction in adolescents with PD can be improved significantly with applied transference focused psychotherapy in a day hospital program, especially in juveniles with borderline and avoidant PD. The alteration in ICD-11 with its focus on functional impairment enables to assess and treat this problem earlier in adolescence. A specific focus for future research based on ICD-11 should address the issue how juveniles with pd, school dysfunction and conduct problems can benefit more from treatment.

Sebastian Hoffmann

Johanna K. Loy

Sandra Färber

Maya Krischer

Originalarbeiten / Original Articles. Schulabsentismus als Funktionsbeeinträchtigung von Jugendlichen mit Persönlichkeitsstörungen gemäß ICD-11 / School Absence as Functional Impairment of Juveniles with Personality Disorders Based on ICD-11

原创研究 / 原创文章。基于ICD-11的人格障碍青少年学校缺勤作为功能障碍 / 基于ICD-11的人格障碍青少年学校缺勤作为功能障碍

Assessment and Treatment of Attachment-Related Aspects in Adolescents with Personality Disorders In recent years the relevance of attachment-related aspects in psychotherapy research has increased. This approach offers an opportunity to test the effectiveness of specific psychotherapeutic procedures for personality disorders in adulthood. Although there are a number of novel psychotherapeutic interventions for personality disorders that were adapted for adolescents, there is still a lack of research on studies that consider attachment-related characteristics. The present study demonstrates attachment-related aspects in a large sample of in-patient adolescents with personality disorders. Therapeutic implications of these findings will be outlined and discussed in the context a new attachment-based intervention tool. This tool might be particularly useful to help patients facing individual aspects of their attachment trauma and to develop more adaptive emotion regulation strategies in interpersonal contexts.

Manuela Gander

Originalarbeiten / Original Articles. Diagnostik und Behandlung bindungsbezogener Aspekte bei Jugendlichen mit Persönlichkeitsstörungen / Assessment and Treatment of Attachment-Related Aspects in Adolescents with Personality Disorders

原创研究 / 原创文章。人格障碍青少年依恋相关方面的诊断与治疗 / 人格障碍青少年依恋相关方面的评估与治疗

Does Cannabis Legalization Endanger Children and Adolescents? The Cannabis Act (CanG) came into force on April 1, 2024. It regulates the "controlled supply of cannabis to adults for recreational purposes". In the USA, legalization has contributed to a decrease in the risk perception of the health hazards of consumption and an increase in risky consumption patterns, including among adolescents. The use of cannabis-related emergency and addiction treatment has risen sharply. Similar developments are now to be feared for Germany. For children and adolescents with cannabis-related disorders, a high standard of quality is maintained in the addiction departments of child and adolescent psychiatric and psychotherapeutic clinics with qualified withdrawal treatment and the subsequent treatment of comorbid mental disorders. However, the number of hospital beds is not sufficient to meet demand. This also applies to the medical rehabilitation measures for children and adolescents with the indications of cannabis abuse and addiction, which are too limited. There is a risk that children and young people will suffer in two ways as a result of the change in drug policy. Conclusion: The CanG sends the wrong signal for addiction prevention. Just a few months after the CanG came into force, the cannabis industry is already expanding. International evidence indicates that legalization endangers the health of the younger generation. Instead of a CanG, the better path for young people would have been to strengthen cannabis-related education and prevention in Germany.

Zur Diskussion / Up for Discussion. Gefährdet die Cannabislegalisierung Kinder und Jugendliche? / Does Cannabis Legalization Endanger Children and Adolescents?

讨论 / 值得商榷。大麻合法化是否危及儿童和青少年？ / 大麻合法化是否危及儿童和青少年？

Abbreviation	Prax. Kinderpsychol. Kinderpsychiatr.
Journal Impact	0.58
Quartiles(Global)	PSYCHOLOGY, DEVELOPMENTAL(Q4)

ISSN	0032-7034, 2196-8225
h-index	22

Publication Information	Publisher: Vandenhoeck and Ruprecht GmbH and Co. KG，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1961，Proportion of original research papers: 83.33%，Self Citation Rate:25.00%， Gold OA Rate: 21.90%

Praxis der Kinderpsychologie und Kinderpsychiatrie

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Vom Tun, als würde man spielen, zum Spielen, als würde man tun: Die Rolle epistemischen Vertrauens in der Mentalisierungsbasierten Therapie mit Kindern

Zur Diskussion / Up for Discussion. Entgegnung zum Beitrag von Nadja Gaßmann

Originalarbeiten / Original Articles. Sexuelle Risiken bei jungen Patient:innen in der stationären kinder- und jugendpsychiatrischen und -psychotherapeutischen Suchtbehandlung / Sexual Risks in Young Patients in Inpatient Child and Adolescent Psychiatric and Psychotherapeutic Addiction Treatment

Originalarbeiten / Original Articles. Schulabsentismus als Funktionsbeeinträchtigung von Jugendlichen mit Persönlichkeitsstörungen gemäß ICD-11 / School Absence as Functional Impairment of Juveniles with Personality Disorders Based on ICD-11

Originalarbeiten / Original Articles. Diagnostik und Behandlung bindungsbezogener Aspekte bei Jugendlichen mit Persönlichkeitsstörungen / Assessment and Treatment of Attachment-Related Aspects in Adolescents with Personality Disorders

Zur Diskussion / Up for Discussion. Entgegnung zum Beitrag von Nadja Gaßmann

Originalarbeiten / Original Articles. Sexuelle Risiken bei jungen Patient:innen in der stationären kinder- und jugendpsychiatrischen und -psychotherapeutischen Suchtbehandlung / Sexual Risks in Young Patients in Inpatient Child and Adolescent Psychiatric and Psychotherapeutic Addiction Treatment

Originalarbeiten / Original Articles. Schulabsentismus als Funktionsbeeinträchtigung von Jugendlichen mit Persönlichkeitsstörungen gemäß ICD-11 / School Absence as Functional Impairment of Juveniles with Personality Disorders Based on ICD-11

Originalarbeiten / Original Articles. Diagnostik und Behandlung bindungsbezogener Aspekte bei Jugendlichen mit Persönlichkeitsstörungen / Assessment and Treatment of Attachment-Related Aspects in Adolescents with Personality Disorders

Zur Diskussion / Up for Discussion. Gefährdet die Cannabislegalisierung Kinder und Jugendliche? / Does Cannabis Legalization Endanger Children and Adolescents?