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["若非被迫,我绝不会这么做……”——一家家庭精神病学和心理治疗日间诊所中的强迫与强制经历]

["I Would Never have done it Without Coercion …" - Experiences with Coercion and Compulsion in a Family Psychiatric and Psychotherapeutic Day Clinic].

作者信息

Oelkers-Ax Rieke

机构信息

Familientherapeutisches Zentrum (FaTZ) Familienpsychiatrische Akuttagesklinik Hermann-Walker-Str. 16 69151 Neckargemünd Deutschland.

出版信息

Prax Kinderpsychol Kinderpsychiatr. 2019 May;68(4):253-270. doi: 10.13109/prkk.2019.68.4.253.

Abstract

Coercion and compulsion have negative connotations, especially in psychiatric therapy. But in families, children are always also affected if parents do not want or are not able to make use of therapy. The avoidance of therapy can be a symptom of illness, e. g. separation anxiety. Perceived or real external coercion, e. g. from the youth welfare office or school, can be used to initially open up access to therapy and to allow parents to become capable of acting again. Coercion can initially reduce the ambivalence of the parents. The Family Therapeutic Centre (FaTZ) is a psychiatric and psychotherapeutic day clinic for parents and children. Family constellations are described in which initial coercion was a door-opener to therapy. During courses of treatment therapeutic alliances could be established, hope for positive change emerged, and the outcome was favourable. School avoidance of the child (e. g. due to separation anxiety) in combination with mentally ill parents is an exemplary constellation in which initial coercion can pave the way to therapy for families that otherwise wouldn't get access. Afterwards, voluntary cooperation should be intended, as the overriding objective is to reduce coercive measures to a minimum.

摘要

强制和强迫带有负面含义,尤其是在精神治疗中。但在家庭中,如果父母不想或无法接受治疗,孩子也总会受到影响。逃避治疗可能是疾病的一种症状,例如分离焦虑。感知到的或实际存在的外部强制,例如来自青年福利办公室或学校的强制,可以用来初步打开治疗渠道,让父母重新具备行动能力。强制最初可以减少父母的矛盾心理。家庭治疗中心(FaTZ)是一家为父母和孩子提供精神科和心理治疗的日间诊所。文中描述了一些家庭情况,其中最初的强制是开启治疗之门的契机。在治疗过程中,可以建立治疗联盟,出现积极改变的希望,且结果良好。孩子逃避上学(例如由于分离焦虑)且父母患有精神疾病,这是一个典型情况,在这种情况下,最初的强制可以为那些原本无法获得治疗的家庭铺就治疗之路。之后,应致力于实现自愿合作,因为首要目标是将强制手段减少到最低限度。

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