Oswald Sylvia H, Fegert Jörg M, Goldbeck Lutz
Klinik für Kinder- und Jugendpsychiatrie/-psychotherapie, Universitätsklinikum Ulm.
Prax Kinderpsychol Kinderpsychiatr. 2013;62(2):128-41. doi: 10.13109/prkk.2013.62.2.128.
Foster children are exposed to multiple psychosocial and biological risk factors and have an elevated risk for developmental delays and the development of mental disorders. Many children experienced compromising situations such as neglect, physical abuse, or sexual abuse before out-of-home placement. Consequently, they show a higher need for mental health services than other children. However, out-of-home placement is often considered as the sufficient measure to help these children. Hence this project had the aim to sensitize child welfare agencies and foster parent organisations for the special needs and history of foster children, to provide them with instruments for the assessment of emotional and behaviour problems and to promote the cooperation at the interface between child welfare system and mental health system. Twenty-four child welfare agencies and four foster parent organisations participated. The control group consisted of 16 non-participating child welfare agencies. After one year, participants recorded more often children's social history (p = .023), conducted more often standardized psychosocial assessments (p = .001), assessed more often the medical needs of foster children (p = .029), and informed foster parents more often about behaviour problems of their foster child (p = .034). In summary, child welfare agencies were very interested, could be sensitized for mental disorders following traumata and implemented the offered instruments in their work. Limits of resources could be observed due to the case workers' high case load.
寄养儿童面临多种心理社会和生物学风险因素,发育迟缓及患精神障碍的风险较高。许多儿童在被安置到家庭外之前经历过诸如忽视、身体虐待或性虐待等不良情况。因此,他们对心理健康服务的需求比其他儿童更高。然而,家庭外安置往往被视为帮助这些儿童的充分措施。因此,本项目旨在提高儿童福利机构和寄养父母组织对寄养儿童特殊需求和经历的认识,为他们提供评估情绪和行为问题的工具,并促进儿童福利系统与心理健康系统之间的合作。24个儿童福利机构和4个寄养父母组织参与了项目。对照组由16个未参与的儿童福利机构组成。一年后,参与者更频繁地记录儿童的社会历史(p = .023),更频繁地进行标准化心理社会评估(p = .001),更频繁地评估寄养儿童的医疗需求(p = .029),并更频繁地向寄养父母通报其寄养儿童的行为问题(p = .034)。总之,儿童福利机构非常感兴趣,能够对创伤后精神障碍有所认识,并在工作中采用了提供的工具。由于个案工作者的高工作量,可以观察到资源限制。