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Open AccessBehandlung

Kompetenzerleben von Psychotherapeut_innen im Umgang mit Kindern und Jugendlichen mit Gewalterfahrungen und Traumafolgestörungen

Published Online:August 26, 2021https://doi.org/10.1026/0942-5403/a000347

Abstract

Zusammenfassung.Theoretischer Hintergrund: Die psychotherapeutische Versorgung von Kindern und Jugendlichen mit psychischen Störungen nach Gewalterfahrungen ist ungenügend. Zu ihrer Verbesserung wird eine routinemäßige Exploration von Gewalterfahrungen und Traumafolgestörungen und eine evidenzbasierte Behandlung empfohlen. Behandelnde berichten jedoch Unsicherheiten und Befürchtungen dahingehend. Fragestellung: Beeinflusst das therapeutische Kompetenzerleben das konfrontative Vorgehen, den Einbezug von Bezugspersonen, die berufliche Belastung und das Interesse an Weiterbildungen? Methode: 323 Psychotherapeut_innen nahmen an der Online-Umfrage teil. Zur Beantwortung der Fragestellung wurde ein Strukturgleichungsmodell spezifiziert und geprüft. Ergebnisse: Ein höheres Kompetenzerleben ist mit einem konfrontativeren Vorgehen, einem häufigeren Einbezug von Bezugspersonen und einer geringeren beruflichen Belastung assoziiert, nicht jedoch mit einem geringeren Weiterbildungsinteresse. Organisatorische Aspekte werden als häufigste Gründe gegen Weiterbildungen genannt. Diskussion und Schlussfolgerung: Es ergeben sich praktische Implikationen für die inhaltliche und organisatorische Gestaltung von Weiterbildungen und Supervisionen.


The Perceived Competence of Psychotherapists in Dealing with Children and Adolescents with Experiences of Violence and Related Mental Disorders

Abstract.Theoretical background: The mental healthcare of children and adolescents with mental disorders following experiences of violence is deficient in Germany. For psychotherapists, it demands, on the one hand, early identification of the traumatic events and resulting mental disorders utilizing a routine exploration of violent experiences and, on the other hand, evidence-based, trauma-specific interventions including trauma confrontation and caregiver involvement. However, regular training programs for psychotherapists do not seem to sufficiently convey relevant content. German psychotherapists report insecurities in dealing with children with experiences of violence and related mental disorders. Additionally, high occupational stress is reported because of the secondary exposure to traumatic events in the context of trauma treatment. Objective: The present study examines whether psychotherapists’ perceived competence in dealing with children with experiences of violence and related disorders is associated with the routine exploration of experiences of violence and subsequent mental disorders, the use of trauma-confrontational methods, the involvement of caregivers in treatments, occupational stress following secondary exposure to traumatic events, and their interest in further training. Method: A sample of 323 German psychotherapists was recruited online to participate in the survey. A structural equation model was specified and tested. Results: The professional experience of psychotherapists has an impact on their perceived competence in dealing with children with experiences of violence and related mental disorders. Their perceived competence in turn affects the routine exploration of and confrontational approach taken to deal with experiences of violence and related mental disorders, the involvement of caregivers in the treatment as well as the professionals’ own occupational stress. Specific fears regarding the exploration of violence against children and subsequent mental disorders well known from previous studies are also reported in the present sample of German psychotherapists, in particular regarding being suggestive, dealing with caregivers, and destabilizing children. The perceived competence of therapists in dealing with children with experiences of violence and related disorders seems to be a protective factor for the development of secondary traumatic stress. Concerning their interest in further training concerning violence against children and related mental disorders, a higher perceived competence does not explain the lower interest that accompanies increasing professional experience. We also assessed other obstacles to continuing training, which indicate that organizational aspects of training programs play a major role. Discussion and conclusion: Practical implications for future investigations as well as for the training and supervision of psychotherapists are discussed. These efforts could in turn have a positive effect on the German mental healthcare of children and adolescents with mental disorders following experiences of violence.

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