1
|
Wichmann MLY, Pawils S, Richters J, Metzner F. School-Based Interventions for Child and Adolescent Victims of Interpersonal Violence. TRAUMA, VIOLENCE & ABUSE 2023; 24:1743-1762. [PMID: 35482522 PMCID: PMC10240654 DOI: 10.1177/15248380221078892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Interpersonal violence against children and adolescents can affect their mental health and functioning in the long term. To reduce mental health problems in children and adolescents, school-based mental health interventions have been shown to be beneficial. A review of school-based interventions designed to mitigate posttraumatic symptoms after interpersonal violence is lacking to date. METHODS We searched for original studies published in English or German until November 2019 in 6 electronic databases. Supplementary search strategies to reduce publication bias were implemented. Peer-reviewed original studies assessing school-based interventions for children and adolescents under the age of 21 after interpersonal violence were included. Relevant data was extracted, synthesised and assessed qualitatively. The methodological quality of included studies was assessed. RESULTS Of 5,021 unduplicated publications, 15 studies met eligibility criteria. The included studies were almost exclusively conducted in the USA; over half utilised a randomised-controlled design. Studies mainly focussed on Posttraumatic Stress Disorder (PTSD) or depression. In all studies, implemented interventions partially or fully mitigated posttraumatic symptoms. Nine school-based interventions, five of which were based on cognitive behavioural therapy (CBT), were identified. School staff were often involved in intervention implementation besides mental health professionals. CONCLUSIONS School-based interventions can be beneficial to reduce mental health problems in children and adolescents after interpersonal violence. Trained school staff aided by mental health professionals can implement trauma-informed practices at school. While school-based interventions may be a feasible way to provide children and adolescents with accessible mental health care, further research on school-based trauma interventions outside the USA is necessary.
Collapse
Affiliation(s)
- Michelle L-Y Wichmann
- Department of Educational Science, University of Siegen, Faculty II, (Chair for) Educational Science with Focus on Special Education, Siegen, Germany
| | - Silke Pawils
- Center for Psychosocial Medicine, Institute and Outpatients Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Richters
- Department of Educational Science, University of Siegen, Faculty II, (Chair for) Educational Science with Focus on Special Education, Siegen, Germany
| | - Franka Metzner
- Department of Educational Science, University of Siegen, Faculty II, (Chair for) Educational Science with Focus on Special Education, Siegen, Germany
- Center for Psychosocial Medicine, Institute and Outpatients Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
2
|
Ulrich HS, Kohler E, Spallek J, Richter M, Clauß D, Mlinarić M. Explaining psychosocial care among unaccompanied minor refugees: a realist review. Eur Child Adolesc Psychiatry 2022; 31:1857-1870. [PMID: 33779855 PMCID: PMC9663343 DOI: 10.1007/s00787-021-01762-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 03/18/2021] [Indexed: 01/26/2023]
Abstract
Research on the psychosocial care (PSC) of unaccompanied minor refugees (UMRs) has mainly taken a socioepidemiological approach and has focused on the perspectives of experts in the field. In contrast, the knowledge concerning the differing context factors and the underlying mechanisms of current PSC which could inform policy recommendations is scant. The study aims at unravelling the contexts, mechanisms and outcomes of PSC for UMRs. For a realist review (RR), scientific evidence and gray literature were synthesised consistent with the RAMESES publication standards for realist synthesis. Based on an iterative keyword search in electronic databases (e.g., PubMed) and screening, 34 works from 2005 to 2019 were included in a realist synthesis. Theory-informed context-mechanism-outcome configurations (CMOs) were extracted, to explain underlying processes and mechanisms. Characterised by their interrelatedness, the dominant CMOs included the UMRs' intersections of transitions (e.g., adolescence and migration), their needs for culture-, and gender-sensitive PSC, and the undersupply of PSC. These contexts and outcomes are mediated by pre-, peri- and post-migratory stressors as well as care structures and are moreover influenced by overarching discourses and concepts. They comprise adverse and beneficial mechanisms in the PSC of UMRs. The existing literature grasps the PSC of UMRs by different disciplines and approaches but does not offer a comprehensive overview on micro-macro intersections and included discourses. The inclusion of lay perspectives and an intersectional approach could inform health service research. The reflection of UMR-related categorical constructs of resilience and vulnerability, discourses of othering, as well as restrictive health policies may guide policy recommendations.
Collapse
Affiliation(s)
- Hanna-Sophie Ulrich
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle, Saale, Germany.
| | - Emma Kohler
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle, Saale, Germany
| | - Jacob Spallek
- Department of Public Health, Institute for Health, Brandenburg University for Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Matthias Richter
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle, Saale, Germany
| | - Daniel Clauß
- Department of Surgical and Conservative Pediatrics and Youth Medicine, University Hospital and Polyclinic for Pediatrics, University Hospital Halle, Saale, Germany
| | - Martin Mlinarić
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle, Saale, Germany
| |
Collapse
|
3
|
Hahnefeld A, Münch K, Aberl S, Henningsen P, Mall V. Versorgung traumatisierter Vorschulkinder. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01618-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
4
|
Gohlke BC, Bettendorf M, Binder G, Hauffa B, Reinehr T, Dörr HG, Wölfle J. [Effect of Psychosocial Factors on Growth]. KLINISCHE PADIATRIE 2021; 234:61-67. [PMID: 34902873 DOI: 10.1055/a-1672-4759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Genes, hormones and factors such as nutrition and psychosocial environment affect growth. OBJECTIVE What is the significance of various psychosocial factors on growth? METHODS Evaluation of results of a working meeting of paediatric endocrinologist with current literature research. RESULTS Psychosocial deprivation in children can be associated with growth hormone deficiency (GHD) and short stature. GHD can be reversed by a change of environment and psychosocial support. War and migration are often associated with underweight, growth disturbances and poor health care. These factors can improve after the end of conflicts, but children often remain too short. Consumption of alcohol or opiates during pregnancy are associated with lower birth weight and increased risk of early and small for gestational age (SGA) childbirth. Children with attention deficit hyperactivity disorder show a slight slowdown in growth after they started stimulant therapy. However, they reach normal adult height. CONCLUSIONS In children with idiopathic short stature, psychosocial causes should be taken into account in the differential diagnosis. Notably there is an increased risk of growth disturbances in children from conflict regions or after prenatal drug exposure.
Collapse
Affiliation(s)
- Bettina C Gohlke
- Pädiatrische Endokrinologie, Universitätskinderklinik, Endokrinologie Bonn, Germany, Bonn, Deutschland
| | - Markus Bettendorf
- Division of Paediatric Endocrinology and Diabetes, University Children's Hospital Heidelberg, University Hospital Heidelberg, Heidelberg, Deutschland
| | - Gerhard Binder
- Paediatric Endocrinology, University Hospital Tubingen Department of Pediatrics, Tubingen, Deutschland
| | - Berthold Hauffa
- Universitätsklinikum Essen, Klinik für Pädiatrische Hämatologie, Onkologie und Endokrinologie, Essen, Deutschland
| | - Thomas Reinehr
- Pädiatrische Ernährungsmedizin, Vestische Kinderklinik, Datteln, Deutschland
| | | | - Joachim Wölfle
- Department of Paediatrics, Erlangen University Hospital, Erlangen, Deutschland
| |
Collapse
|
5
|
Führer A, Niedermaier A, Kalfa V, Mikolajczyk R, Wienke A. Serious shortcomings in assessment and treatment of asylum seekers' mental health needs. PLoS One 2020; 15:e0239211. [PMID: 33027307 PMCID: PMC7540848 DOI: 10.1371/journal.pone.0239211] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 09/02/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The prevalence of psychological complaints is known to be very high in populations of asylum seekers. Despite this, data on the health care system's ability to adequately meet these high-risk populations' mental health needs are scarce. This article investigates how well the German outpatient health care system is able to detect and adequately treat them. METHODS To this end, we combined data from a cross-sectional survey with billing data from the local social welfare office from the year 2015. Using descriptive statistics, the data of the cross-sectional study are used to quantify the psychological health care needs of asylum seekers while the secondary data analysis indicates the actual access to and extent of psychological treatment. RESULTS In the cross-sectional study, 54% of patients were screened positive for symptoms of depression, 41% for symptoms of anxiety disorder and 18% for symptoms of Posttraumatic Stress Disorder. In total, 59% were screened positive for at least one of these three disorders. However, when contrasting these screening-based prevalences with the prevalences based on data from the health care system, a mismatch becomes apparent: According to the social welfare office's billing data, only 2.6% of asylum seekers received the diagnosis of depression, 1.4% were diagnosed with anxiety disorder and 2.9% with Posttraumatic Stress Disorder (PTSD). In combination, 4.9% were diagnosed with at least one of these three disorders. Overall, less than one tenth of asylum seekers with symptoms of depression, anxiety or PTSD received the corresponding diagnosis by the health care system. Among those who were diagnosed, about 45% received no treatment at all, while 38% were treated with drugs alone. Only 1% of all patients received psychotherapy. CONCLUSIONS Psychological complaints are very common among asylum seekers, yet only a small proportion of this population receives the corresponding diagnoses and treatment. While various factors can contribute to these shortcomings, there is an urgent need to systematically address this deficit and introduce measures to improve mental health care for this high-risk population.
Collapse
Affiliation(s)
- Amand Führer
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Andreas Niedermaier
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Vivian Kalfa
- Psychosocial Centre for Refugees and Victims of Torture (PSZ), Halle (Saale), Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| |
Collapse
|
6
|
Walg M, Angern JS, Michalak J, Hapfelmeier G. [Effectiveness of stabilization training for adolescent refugees with trauma-induced disorders: A randomized controlled trial]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2020; 48:369-379. [PMID: 32880227 DOI: 10.1024/1422-4917/a000749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Effectiveness of stabilization training for adolescent refugees with trauma-induced disorders: A randomized controlled trial Abstract. Unaccompanied minor refugees (UMR) are a group particularly vulnerable to mental illness. They pose a great challenge not only for child and youth psychiatric and psychotherapeutic care, but also for youth-welfare institutions. The study examines the effectiveness of Stabilization Training for Adolescent Refugees with Trauma Induced Disorders in inpatient youth-welfare facilities. Methods: We conducted a randomized controlled trial with pre-post design in a naturalistic setting, randomly assigning 9 housing groups for UMRs to the intervention or waiting control condition. The mental stress of 46 UMRs was assessed by both self-report and educational staff-report. Two educational staff members conducted the Stabilization Training for Adolescent Refugees with Trauma Induced Disorders as an intervention in each of the respective residential groups. Results: Participation in training led to a reduction in subjective general psychological stress. At the end of the training, psychological stress in self-judgment was significantly lower in the intervention group than in the waiting control condition. The effectiveness of the training is apparently not reflected by educational staff assessments. Conclusions: Stabilization training is a suitable instrument for the preclinical care of UMR and thus an essential basis for further psychotherapy.
Collapse
Affiliation(s)
- Marco Walg
- Zentrum für seelische Gesundheit des Kindes- und Jugendalters, Sana-Klinikum Remscheid
| | - Johanna Sophie Angern
- Zentrum für seelische Gesundheit des Kindes- und Jugendalters, Sana-Klinikum Remscheid
| | - Johannes Michalak
- Department für Psychologie und Psychotherapie, Universität Witten/Herdecke
| | - Gerhard Hapfelmeier
- Zentrum für seelische Gesundheit des Kindes- und Jugendalters, Sana-Klinikum Remscheid
| |
Collapse
|
7
|
Wilker S, Catani C, Wittmann J, Preusse M, Schmidt T, May T, Ertl V, Doering B, Rosner R, Zindler A, Neuner F. The efficacy of Narrative Exposure Therapy for Children (KIDNET) as a treatment for traumatized young refugees versus treatment as usual: study protocol for a multi-center randomized controlled trial (YOURTREAT). Trials 2020; 21:185. [PMID: 32059695 PMCID: PMC7023740 DOI: 10.1186/s13063-020-4127-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 01/31/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Germany hosts a large number of refugees from war-affected countries. The integration of refugees, in particular young refugees from the Middle East, is one of the major current social challenges in Germany. Mental disorders, first of all post-traumatic stress disorder (PTSD) that results from war experiences, are common among young refugees and interfere with quality of life as well as functional integration. Evidence regarding effective treatment options for this population is scarce. In this trial, we aim to evaluate the pragmatic, short-term psychotherapy Narrative Exposure Therapy for Children (KIDNET) for the treatment of young refugees in Germany. METHODS In a rater-blinded, multi-center, randomized-controlled trial, KIDNET is compared to treatment as usual (TAU) within the general health care system. A total number of 80 young refugees who fulfill the diagnostic criteria of PTSD will be randomized to either KIDNET or TAU. Diagnostic interviews will take place at baseline before treatment as well as 6 and 12 months thereafter. They will assess exposure to traumatic events, PTSD and comorbid symptoms, as well as parameters of integration. DISCUSSION The results of this study should provide evidence regarding effective treatment options for young refugees in Germany, a population that has been understudied and received only limited access to mental health care so far. Next to the effects of treatment on mental health outcomes, integration parameters will be investigated. Therefore, this study should provide broad insights into treatment options for young refugees and their potential implications on successful integration. TRIAL REGISTRATION German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS), ID: DRKS00017222. Registered on 15 May 2019.
Collapse
Affiliation(s)
- Sarah Wilker
- Clinical Psychology and Psychotherapy, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany.
| | - Claudia Catani
- Clinical Psychology and Psychotherapy, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany
| | - Jasmin Wittmann
- Clinical Psychology and Psychotherapy, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany
| | - Melissa Preusse
- Clinical Psychology and Psychotherapy, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany
| | - Telja Schmidt
- Clinical Psychology and Psychotherapy, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany
| | - Theodor May
- Independent Biostatistician, Johann-Strauß-Str. 11a, 33647, Bielefeld, Germany
| | - Verena Ertl
- Clinical Psychology and Biopsychology, Catholic University Eichstätt-Ingolstadt, 85071, Eichstätt, Germany
| | - Bettina Doering
- Clinical Psychology and Biopsychology, Catholic University Eichstätt-Ingolstadt, 85071, Eichstätt, Germany
| | - Rita Rosner
- Clinical Psychology and Biopsychology, Catholic University Eichstätt-Ingolstadt, 85071, Eichstätt, Germany
| | - Areej Zindler
- Medical Center Hamburg-Eppendorf, Outpatient Clinic for Refugee Children and Adolescents, Martinistraße 52, 20246, Hamburg, Germany
| | - Frank Neuner
- Clinical Psychology and Psychotherapy, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany
| |
Collapse
|
8
|
Lempertz D, Wichmann M, Enderle E, Stellermann-Strehlow K, Pawils S, Metzner F. Pre-Post Study to Assess EMDR-Based Group Therapy for Traumatized Refugee Preschoolers. JOURNAL OF EMDR PRACTICE AND RESEARCH 2020. [DOI: 10.1891/1933-3196.14.1.31] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cross-culturally effective, low-threshold therapies for refugees that can be carried out quickly are urgently required. Worldwide, therapies are lacking, particularly for preschool refugee children, which support coping and prevent chronification of posttraumatic stress. This pilot study examined eye movement desensitization and reprocessing (EMDR)-based group treatment for preschool refugee children in German daycare centers. Ten refugee preschool children aged 4–6 years (n = 5 female) with posttraumatic stress disorder (PTSD) symptoms took part in an EMDR-based group treatment (with 2–4 children per group). PTSD symptoms were rated by parents and preschool teachers using items from the Child Behavior Checklist (CBCL 1½–5), pre- and posttreatment, and at 3-month follow-up. After treatment children tended to display less fear of animals or situations than before treatment. According to preschool teachers' perspective, the total number of PTSD symptoms dropped significantly at posttreatment (d = .93) and at follow-up (d = .81). Before the intervention, preschool teachers rated the children as being more defiant than their parents did (p = .020). After the intervention, the PTSD symptoms of boys were significantly higher than those of girls (p = .036) according to preschool teachers. The results indicate that timely psychotherapeutic interventions can be conducted with refugee children displaying PTSD symptoms in daycare centers. The efficacy of this intervention needs to be studied in a larger sample under controlled randomized conditions.
Collapse
|
9
|
Sierau S, Nesterko Y, Glaesmer H. Herausforderungen im Fluchtprozess unbegleiteter Jugendlicher. KINDHEIT UND ENTWICKLUNG 2019. [DOI: 10.1026/0942-5403/a000284] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Spätestens seit 2015 ist ein Anstieg an Publikationen zu verzeichnen, die sich psychischen Belastungen von Geflüchteten widmen, wobei die Gruppe der unbegleiteten jungen Geflüchteten als besonders schutzbedürftig und vulnerabel für psychische Auffälligkeiten beschrieben wird. Fluchtphasenmodelle gehen von potentiell traumatisierenden Ereignissen im Herkunftsland, während der Flucht und im Aufnahmeland als mögliche Ursachen für psychische Belastungen aus, vernachlässigen jedoch im Fall von minderjährigen oder jungen volljährigen Geflüchteten die Besonderheiten der Adoleszenzphase, in der viele Jugendliche, unabhängig von ihrer Herkunft, mit einer Reihe von wichtigen Entwicklungsaufgaben konfrontiert sind. Die vorliegende Arbeit stellt eine theoretische Erweiterung von Fluchtphasenmodellen um adoleszenzspezifische Entwicklungsanforderungen aus einer kultursensiblen Perspektive dar und nimmt eine Spezifizierung dieser Modelle für junge unbegleitete Geflüchtete vor.
Collapse
Affiliation(s)
- Susan Sierau
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| | - Yuriy Nesterko
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| | - Heide Glaesmer
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| |
Collapse
|
10
|
Scheiber B, Greinz G, Hillebrand JB, Wilhelm FH, Blechert J. Resilienztraining für unbegleitete minderjährige Flüchtlinge. KINDHEIT UND ENTWICKLUNG 2019. [DOI: 10.1026/0942-5403/a000287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Die hohen Flüchtlingszahlen und die fortlaufende Ankunft schwer traumatisierter unbegleiteter minderjähriger Flüchtlinge (UMF) verschärfen die Suche nach wirksamen und niederschwelligen Präventions- und Interventionsprogrammen. Die vorliegende Pilotstudie evaluiert die Effektivität eines nicht-indizierten, sechs Sitzungen umfassenden Resilienztrainings für UMF. Teilnehmende (N = 55) wurden in einem randomisiert-kontrollierten Wartelistendesign vor (T1) und nach (T2) dem Gruppenprogramm untersucht. Abhängige Variablen waren das allgemeine Wohlbefinden sowie Symptome von Traumafolgestörungen. Weiter wurden aus mehreren Perspektiven (Teilnehmer, Dolmetscher, Gruppenleitende, Betreuende) qualitative Daten erfasst. Während Traumafolgestörungssymptome unverändert blieben, berichtete die Interventionsgruppe nach dem Programm einen Anstieg im Wohlbefinden, nicht jedoch die Kontrollgruppe. Die qualitativen Daten wiesen perspektivenübergreifend auf positive Veränderungen in mehreren Funktionsbereichen hin. Ein kurzes Resilienztraining hat somit das Potential Verbesserungen zu bewirken. Für eine Minderung von Traumafolgestörungssymptomen sind jedoch wohl längere bzw. traumaspezifischere Interventionen erforderlich.
Collapse
Affiliation(s)
| | | | | | | | - Jens Blechert
- Fachbereich Psychologie der Universität Salzburg, Österreich
- Centre for Cognitive Neuroscience der Universität Salzburg, Österreich
| |
Collapse
|
11
|
Barthel D, Ravens-Sieberer U, Schulte-Markwort M, Klasen F, Zindler A. Klinisch-psychologische Diagnostik in einer Flüchtlingsambulanz für Kinder und Jugendliche. KINDHEIT UND ENTWICKLUNG 2019. [DOI: 10.1026/0942-5403/a000286] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Für geflüchtete Kinder und Jugendliche wird in der Flüchtlingsambulanz des Universitätsklinikums Hamburg-Eppendorf ambulante psychiatrisch-psychotherapeutische und psychosoziale Versorgung angeboten. Seit Oktober 2016 durchlaufen die Patienten einen standardisierten klinisch-psychologischen Diagnostikprozess, welcher die Behandlungsplanung unterstützen soll. Von den N = 134 untersuchten Patienten im Alter von 8 bis 20 Jahren wurden n = 90 (69.8 %) mit einer gegenwärtig vorliegenden PTBS diagnostiziert. Weiterhin wiesen n = 67 (50.0 %) der Geflüchteten eine mittelgradige oder schwere depressive Episode auf. Nahezu alle Patienten gaben an, in ihrem Herkunftsland mehrfach interpersonelle Gewalt erlebt zu haben. Als Behandlungsziel wurde am häufigsten ein besserer Umgang mit negativen Gefühlen und Gedanken formuliert. Diese Ergebnisse demonstrieren, dass es sich bei den untersuchten geflüchteten Kindern und Jugendlichen, um eine äußerst stark belastete Gruppe mit hohem Behandlungsbedarf handelt.
Collapse
Affiliation(s)
- Dana Barthel
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - Ulrike Ravens-Sieberer
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - Michael Schulte-Markwort
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - Fionna Klasen
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | | |
Collapse
|
12
|
Bünnemann M, Schlarb AA. Entwicklung und Aufbau eines niedrigschwelligen psychologischen Versorgungsangebots für unbegleitete minderjährige Flüchtlinge. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2018. [DOI: 10.1026/1616-3443/a000493] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Mona Bünnemann
- Universität Bielefeld, Fakultät für Psychologie und Sportwissenschaft, Abteilung für Psychologie
| | - Angelika A. Schlarb
- Universität Bielefeld, Fakultät für Psychologie und Sportwissenschaft, Abteilung für Psychologie
| |
Collapse
|
13
|
Hanft-Robert S, Römer M, Morgenroth O, Redlich A, Metzner F. Handlungsempfehlungen für die dolmetschergestützte Psychotherapie mit Flüchtlingen und Asylbewerbern: Ergebnisse qualitativer Interviews mit Psychotherapeuten und Dolmetschern zu Chancen und Herausforderungen in der Triade. VERHALTENSTHERAPIE 2017. [DOI: 10.1159/000480667] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
14
|
[Decision Support for the Therapy Planning for Young Refugees and Asylum-Seekers with Posttraumatic Disorders]. Prax Kinderpsychol Kinderpsychiatr 2017; 65:707-728. [PMID: 27923340 DOI: 10.13109/prkk.2016.65.10.707] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Decision Support for the Therapy Planning for Young Refugees and Asylum-Seekers with Posttraumatic Disorders Due to the Convention on the Rights of the Child and § 6 of the Asylum Seekers' Benefit Act, there are legal and ethical obligations for the care of minor refugees suffering from trauma-related disorders. In Germany, psychotherapeutic care of adolescent refugees is provided by specialized treatment centers and Child and Adolescent psychiatries with specialized consultation-hours for refugees. Treatment of minor refugees is impeded by various legal and organizational barriers. Many therapists have reservations and uncertainties regarding an appropriate therapy for refugees due to a lack of experience. This means that only a fraction of the young refugees with trauma-related disorders find an ambulatory therapist. In a review of international literature, empirical findings on (interpreter-aided) diagnostics and therapy of young refugees were presented. Practical experiences on therapeutic work with traumatized young refugees were summarized in a decision tree for therapy planning in the ambulatory setting. The decision tree was developed to support therapists in private practices by structuring the therapy process.
Collapse
|
15
|
Heudorf U, Albert-Braun S, Hunfeld KP, Birne FU, Schulze J, Strobel K, Petscheleit K, Kempf VAJ, Brandt C. Multidrug-resistant organisms in refugees: prevalences and impact on infection control in hospitals. GMS HYGIENE AND INFECTION CONTROL 2016; 11:Doc16. [PMID: 27579250 PMCID: PMC4987489 DOI: 10.3205/dgkh000276] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Introduction: The refugee crisis is a great challenge to the social and healthcare system in European countries, especially in Germany. An abundance of data has been published on the refugees’ health problems (infections as well as physical diseases and psychiatric problems) and their prevention (i.e., sanitary and vaccination programs). However, data on prevalences of multidrug-resistant organisms (MDRO) in refugees are scarce, although it is known that most refugees are from or travelled through countries with high prevalences of MDRO. This paper presents current data on MDRO colonization of refugees admitted to hospitals, and the impact of screening upon admission and infection control in hospitals is discussed. Methods: Anonymous data obtained by screening upon hospital admission were reported by hospitals in the Rhine-Main region of Germany to the local public health department. Screening and microbiological analyses were performed from December 2015 to March 2016 according to standardized and validated methods. Results: 9.8% of the refugees screened (32/325) exhibited colonization with methicillin-resistant Staphylococcus aureus (MRSA), and 23.3% of the refugees (67/290) were colonized with Gram-negative bacteria with extended spectrum beta-lactamases, and/or enterobacteria with resistance against 3 or 4 groups of antibacterials, so-called 3MRGN (multidrug-resistant Gram-negative bacteria with resistance against penicillins, cephalosporins and quinolones) and 4MRGN (with additional resistance against carbapenems). Carbapenem-resistant Gram-negative bacteria (CRGN) were detected in 2.1% (6/290) of the refugees. Conclusion: The data confirms the studies published between 2014 and 2016, encompassing refugees tested in Germany, the Netherlands and Israel, with prevalences of MRSA and CRGN up to 13.5% and 5.6%. The MDRO prevalences are higher than those of “risk groups” for MRSA, such as hemodialysis patients and patients depending on outpatient home-nursing care or residing in nursing homes. Therefore, screening and special infection control in hospitals is strongly suggested when refugees are admitted to hospitals, in order to ensure best medical practice and safety for all hospital patients regardless of their country of origin.
Collapse
Affiliation(s)
- Ursel Heudorf
- Public Health Department, Division of Infectious Diseases and Hygiene, Frankfurt am Main, Germany
| | - Sabine Albert-Braun
- Institute for Laboratory Medicine, Klinikum Frankfurt Höchst, Frankfurt/Main, Germany
| | - Klaus-Peter Hunfeld
- Institute for Laboratory Medicine, Microbiology and Infection Control, Northwest Medical Centre, Frankfurt/Main, Germany
| | | | | | | | | | - Volkhard A J Kempf
- Institute for Medical Microbiology and Infection Control, University Hospital Frankfurt, Frankfurt/Main, Germany
| | - Christian Brandt
- Institute for Medical Microbiology and Infection Control, University Hospital Frankfurt, Frankfurt/Main, Germany
| |
Collapse
|