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Übersichtsarbeit

Psychotherapie von traumatisierten Kindern und Jugendlichen - kognitiv-verhaltenstherapeutische Behandlungsverfahren

Published Online:September 11, 2008https://doi.org/10.1024/1422-4917.36.5.345

Abstract

Zusammenfassung: Nach kognitiv-behavioralen Störungsmodellen tragen die Vermeidung traumaassoziierter Reize sowie negative «unrealistische» Interpretationen des Traumas und der anfänglichen Symptome zur Entstehung und Aufrechterhaltung von Traumafolgestörungen bei. Die traumafokussierte Kognitive Verhaltenstherapie beginnt oft mit einer Stabilisierungsphase, in der beispielsweise Entspannungsverfahren eingesetzt werden. Zentrale Bedeutung in der Behandlung hat die Expositionstherapie, bei der sich die Patienten mit vermiedenen externen Auslösereizen (Exposition in vivo) und mit den belastenden Erinnerungen an die traumatischen Ereignisse (Exposition in sensu) konfrontieren. Mit Hilfe kognitiver Interventionen werden zudem übertriebene Schuld- und Schamgefühle verändert. Verschiedene kognitiv-behaviorale Behandlungsprogramme liegen vor, von denen die traumafokussierte Kognitive Verhaltenstherapie insbesondere für Kinder und Jugendliche nach sexuellem Missbrauch die beste empirische Evidenz vorweist.


Psychotherapy for traumatized children and adolescents - cognitive-behavioral treatments

Summary: According to cognitive-behavioral models, both the avoidance of trauma-associated cues, as well as cognitive distortions of the trauma and the initial symptoms thereof lead to and subsequently maintain traumatic disorders. Trauma-focused cognitive behavioral therapy often starts with stabilizing interventions such as relaxation training. The main intervention consists of exposure to external trauma-associated cues (exposure in vivo) and to mental trauma reminders (exposure in sensu). Cognitive interventions aim to modify feelings of exaggerated guilt and shame. Of the different cognitive-behavioral programmes validated, trauma-focused cognitive-behavioral therapy yields the best evidence, particularly in the treatment of sexually abused children and adolescents.

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