Samstag, 20. September 2014

Depression

Depression in children and adolescents

Parachute

Depression in children and adolescents ..
Is there such a thing anyway?
And how does this manifest itself?
Until a few decades ago the diagnosis of depression in children was not yet "officially available", it was assumed that children can not be depressed ... But why? Because they do not have enough life experience? Because they still do not "get a head" thus allowing them like adults? Because they may feel about no long-lasting sadness? Because they can not "ruminate"? The all are questions that go to me as a psychotherapist for children and young people through your mind when I children (and young people) experience, showing a very blurry and not very tangible problem behavior ... and just have problems, their entire "bad mood" and everything related to it, to put into words.
And there lies the peculiarity: depression show up in children in a very different form than in adults or adolescents. It is not often make this typical brooding or self-To-Everything-thoughts, the typical sadness that we sometimes see in adults already on facial expression and body posture. Children show rather untypical behavior. For example you are irritable, have physical ailments, are aggressive, show mood swings or trouble concentrating or are suddenly very fearful separation and retire, have no desire in physical activities. Also, sleep and eating disorders to weight loss or gain occur.
Young people are more prone to negative future expectations and low self-confidence, feel everything is hopeless and meaningless, are often tired, maybe develop fears, power disturbances, suicidal thoughts or turn to alcohol and drugs. Young people can often develop aggressive behavior, restlessness and bad mood or even antisocial behavior in the context of depression ... because you do not think as parents or teachers first time: "The / The determined suffers from depression."
Therefore, it is in my opinion more important that you remain open to the thoughts and feelings that are hidden behind a childhood, "Bucky" facade or a juvenile "stubbornness" with a sudden problem behavior. But be open also means stubborn and still patiently stay tuned ... and insert rejection.
"Depression is not a sign of personal failure, deal with difficult life circumstances, but a disease. A depressed child is not lazy, aggressive or unbearable, because it will be so. A depressed child is sick and needs help. A depressed child is also no reason to doubt the parenting skills, but there is a reason to seek professional help. "
Last but not least, of course, the question remains: What the heck is normal at that age? What belongs particularly to puberty and passes over the months and years of self? Of / acts closed, irritable, brooding or bored Not every / r teenagers, is equal depressed. Here the boundaries between normal and depressive development, making an unambiguous timely diagnosis is often missed and is adequately addressed too late.
Incidentally, there are very different study results on the incidence of depression in childhood and adolescence. The probability of occurrence is in school children at 1-3% in adolescents at 3-5%, where (as in adults) girls / women are affected much more frequently. 5-10% of adults in Germany are affected by depression.
The article author sinking Koelle-Bork, is approved for children and adolescents psychotherapist.
Source: http://www.buendnis-depression.de/depression/kinder-and-jugendliche.php

Mittwoch, 16. Juli 2014

Multimodale Therapie von bei LRS

Verdacht auf LRS und/oder Dyskalkulie – und nun?

LRS ? Dyskalkulie?
Diese beiden Begriffe werfen in Eltern oft Fragen auf, ganz davon abgesehen, was diese bedeuten, erklären manche Lehrer, das eigene Kind könnte betroffen sein.
Und was nun?
LRS steht für Lese-Rechtschreib- Störung/Schwäche, früher hieß es Legasthenie. Dyskalkulie meint eine Störung des Rechnens.
Es gibt viele unterschiedliche Hinweise, die für eine LRS sprechen können, aber lange nicht müssen. Zum Beispiel sei typisch, dass die betroffenen Kinder oft in Spiegelschrift schreiben, ebenso dass es ihnen sehr schwer fiele Silben zu klatschen. Eine mir bekannte nun erwachsene Frau, die beides aus ihrer Schulzeit berichtet, hat heute einen Lehrstuhl der Germanistik inne.
Es gibt diagnostisch anerkannte Tests, die darauf spezialisiert sind, eine Störung oder Schwäche festzustellen.
Der bekannteste Test nennt sich HSP (Hamburger – Schreib – Probe) und wird häufig auch in Schulen, mit der ganzen Klasse, durchgeführt, was sinnvoll sein kann, denn natürlich ist es gut, wenn eine Schwäche des Kindes früh festgestellt wird, um diesem schnell Hilfe anzubieten. Die Frage ist nur, was kann auch zu früh sein? Lernen 1. und 2. Klässler nicht sehr unterschiedlich schnell? Und oft auf verschiedene Weise das Alphabet?
Falls sich Auffälligkeiten zeigen, muss das Kind der Schulpsychologin vorgestellt werden, die verweist entweder auf Sozialpsychiatrische Praxen, die die entsprechende Diagnostik anbieten oder macht sie selbst.
Beim Jugendamt kann ein Antrag auf Kostenübernahme der Lerntherapie gestellt werden, dafür muss der §35a SGB VIII erfüllt sein, was er in der Regel ist, wenn eine LRS diagnostiziert wurde.
Leider dauert das Prozedere oft sehr lange und wenn man die Bestätigung der Kostenübernahme bekommt, muss man noch einen Platz finden. Es ist sehr umständlich und den Kindern kann es in dieser Zeit schon schlecht ergehen.
Viele Kinder denken, sie seien schlicht zu „dumm“ (eine LRS oder/und Dyskalkulie kann nur diagnostiziert werden, wenn das Kind eine durchschnittliche Intelligenz hat!)
schreiben oder rechnen zu lernen. Die Angst vor einem Diktat und/oder einem Rechentest ist sehr groß. Sie kann so groß werden, dass die Kinder mit Bauch- und Kopfschmerzen zuhause bleiben möchten.
Manche Kinder schreiben sehr undeutlich, so dass die Buchstaben kaum erkennbar sind, um die hohe Fehlerquote zu vermeiden.
Der Selbstwert des Kindes ist in Gefahr, manche finden sich auf Sonderschulen wieder, da es noch sehr viele Laien auf diesem Gebiet gibt!
Die Autorin Daniela Penkwitz ist Erzieherin, Dipl. päd , Kinder- und Jugendlichentherapeutin i. A.

Samstag, 28. Juni 2014

Schema Therapy from private practice-herzberge.de Blog Part 1 and Part 2 together:


Schema Therapy - an inclusive approach leads therapy techniques along

ParachutePsychoanalysis and behavior therapy, the two major schools of therapy faced each other in the 80s and claimed alternately to be a better form of treatment. The psychotherapy researcher Klaus Grawe analyzed both therapy methods and demonstrated that both are effective in the treatment of mental illness. While the psychoanalytically oriented, psychodynamic process seem rather through a better understanding of the mental processes, so do the behavioral approaches by a specific change in behavior. Grawe suggested makes sense to combine both perspectives.
Parallel to Klaus Grawe developed Jeffrey Young in the U.S. end of the 80erJahre the approach of Schema Therapy. Schema Therapy is an integrative approach, proven therapy techniques from different psychotherapy approaches brings together and achieved good therapeutic effects. It combines concepts of depth psychology, behavioral therapy, and humanistic approaches, in particular the Gestalt therapy.

The relationship experiences in early childhood can change the whole life of that people shape (attachment research). The neurobiological research also provides evidence that human actions more by emotions (feelings) is controlled as of cognition (understanding). The American neuroscientist LeDoux was able to demonstrate that reflect these experiences and experiences directly in the structure of the brain or "branding".
For this reason, Jeffrey Young emphasizes that it is important in the context of schema therapy, verhalthenstherapeutische techniques to expand so that emotional experiences are strongly activated in order to change the brain "branded" content better.
The focus of the schema therapy is partly good and trusting therapeutic relationship between the patient and the therapist. In the therapeutic setting a similarly good relationship quality is to be prepared as between good parents and their child. It could be demonstrated neurobiological that in the context of this relationship design, the same neural structures can be re-enabled, which were created in early childhood.
The therapist strives thus positively influencing the activated structures and change it. J. Young speaks of "Nachbeelterung" or "limited parental care" (see E. Roediger, Getting out of life traps).

Montag, 2. Juni 2014

Unrecognized and taboo

Unrecognized and taboo

Source image http://www.google.de/imgres?imgurl=http% 3A% 2F% 2Fwww.ralf-tillenburg.de% 2FSudafrika_2009
Source image http://www.google.de/imgres?imgurl=http% 3A% 2F% 2Fwww.ralf-tillenburg.de% 2FSudafrika_2009
The nocturnal enuresis (nocturnal enuresis) and the daily bed-wetting (enuresis diurnal) is one of the most common childhood diseases. 10-20% of the 5-year and 3-5% of the 10-year-old children suffering from this pathology. (Heinemann and Hopf, 2012, p 245) is often shameful the topic and will be negotiated and tried to solve, because it is rarely noticed in the environment, especially if the bed-wetting at night only happens within the family.
School trips or overnight stays at friends become problems as the child and the parents are confused about how to deal with the bedwetting. Shame is often too large, that child may feel betrayed sometimes by the parents. In other cases, bedwetting is trivialized, perhaps because the parents einnässten as a child as well, the symptoms disappeared by itself or because the child is still small. Often then diapers are used.
The causes of enuresis can be very different. In addition to organic and genetic causes, is often clear that an emotional disorder (eg anxiety, depression), an extreme stress or a developmental disability is a priority. Therefore, a detailed diagnosis is essential.
The theories for the treatment of enuresis are of various kinds, many successes have been achieved by direct behavioral changes are sent with a reward system, a bell mat to the toilet, for example, keeping a diary. These are behavioral therapeutic approaches. Psychodynamic approaches attempt to gain from illness of enuresis to understand (eg go back to sleep in parent's bed) and to address these with the family and the child. In some cases, children do not dare to use the school toilet for fear of enclosed or to be annoyed. Other children are disgusted by the toilet or are too engrossed in the game and seem to forget that their bladder is full.
Even in this short blog will show how diverse is the theme and how different the schools deal with these. In the next blog will be about the treatment with sand play therapy in enuresis.
The author Daniela Penkwitz is educator, graduate päd, child and adolescent therapist iA you concerned for some time with "enuresis". In practice, she leads groups as well as individual modules on this topic.

Donnerstag, 22. Mai 2014

Scheme Therapy

Schematherapie – ein integrativer Ansatz führt Therapietechniken zusammen

Psychoanalyse und Verhaltenstherapie, die beiden großen Therapieschulen standen sich in den 80er- Jahren gegenüber und behaupteten wechselseitig, die bessere Therapieform zu sein. Der Psychotherapieforscher Klaus Grawe analysierte beide Therapieverfahren und konnte nachweisen, dass beide zur Behandlung psychischer Erkrankungen wirksam sind. Während die psychoanalytisch orientierten, psychodynamischen Verfahren eher durch ein besseres Verständnis der seelischen Prozesse wirken, tun dies die verhaltenstherapeutischen Ansätze durch eine konkrete Verhaltensveränderung. Grawe schlug vor, sinnvollerweise beide Perspektiven zu kombinieren.


Parallel zu Klaus Grawe entwickelte Jeffrey Young in den USA Ende der 80er­Jahre den Ansatz der Schematherapie. Schematherapie ist ein integrativer Ansatz, der bewährte Therapietechniken aus verschiedenen Psychotherapieansätzen zusammenführt und dadurch gute Therapieeffekte erzielt. Er kombiniert Konzepte der Tiefenpsychologie, der Verhaltenstherapie sowie humanistischer Ansätze, insbesondere der Gestalttherapie.
Die Autorin Judith Asfaha-Ebber wird in Zukunft weiter über die Entwicklung und das Modell der Schematherapie schreiben und dabei auch die wirksamen Techniken beschreiben. Elemente der Schematherapie fließen zunehmend in die therapeutische Arbeit unserer Praxis ein.