[Psychosocial management in pediatrics. Do we really mean the patient?].

Due to technological perfection of medical treatment there is an increasing concern about the patient (as a person). As the treatment-demands grow, treatment becomes dependent on the patient's tolerance to adapt to these demands. Instead of this dependence, general discussion focuses on the patient's "failure" or "non-compliance". Without a critical reflection on this context psychological care for the "failing" patient is in danger to exclude the patient's individuality instead of integrating it into the whole treatment plan. It is not the patient who fails, but it is a treatment plan which reduces the patient's individuality to the question whether he complies, or not. It is especially true for the care of the chronically ill that the treatment plan has to be openly negotiated with the patient's individual experiences and purposes.