Hildegard Horn

Die therapeutische Beziehung in der Kinder- und Jugendlichen-Psychotherapie:

Zusammenfassung. Theoretischer Hintergrund: Die therapeutische Beziehung stellt innerhalb der Psychotherapieforschung bei Kindern und Jugendlichen ein weitgehend unerforschtes Gebiet dar. Eine Ursache dieses Forschungsdefizits liegt im Mangel an psychometrisch evaluierten Messinstrumenten. Fragestellung und Methode: In der vorliegenden Untersuchung wurde die ins Deutsche ubersetzte Version der Therapeutic Alliance Scales for Children (Shirk & Saiz, 1992) an einer Stichprobe von N = 80 ambulant pychotherapeutisch behandelten Kindern und Jugendlichen und ihrer Therapeuten evaluiert. Ergebnisse: Die Drei-Faktoren-Losung der amerikanischen Originalversion der Fragebogen konnte repliziert werden. Fur die Skalen Arbeitsbeziehung und positive und negative Aspekte der emotionalen Beziehung ergaben sich gute Reliabilitatskennwerte. Der Zusammenhang zwischen Therapeuten- und Patienteneinschatzungen lag vergleichbar dem bei Erwachsenen im mittleren Bereich. Schlussfolgerungen: Der Fragebogen zur Therapeutischen Bezi...

Attachment Styles and Outcome of Psychoanalytic Psychotherapy for Children and Adolescents

Background: Until now few studies have proven that an attachment style can be changed in the course of psychotherapy and that the attachment style has an impact on the therapy outcome. In particular, there is a lack of studies about these relationships in long-term psychoanalytic psychotherapy with children and adolescents. Sampling and Methods: Seventy-one children with mental disorders receiving long-term outpatient psychodynamic psychotherapy were assessed 4 times using the Heidelberg Attachment Style Rating for Children and Adolescents. The measurements were conducted at the beginning of treatment, at the 25th treatment session, at the end of treatment and 1 year after the completion of treatment. Results: The results showed a significant change in attachment style during treatment. The proportion of children and adolescents with a secure attachment style increased from 23% to 63%. There was no significant difference in the attachment style between patients with good and poor treatment outcome, but a significant relationship between secure attachment and the number of treatment sessions could be demonstrated. Conclusions: A reorientation towards a secure main attachment style over the course of psychotherapy is possible. However, attachment style seems to be not a moderator but a mediator for the outcome of psychoanalytic psychotherapy in children and adolescents.

Bindungsstil und Therapieerfolg in der psychodynamischen Kurzzeittherapie bei Kindern und Jugendlichen

In several studies, the association between attachment style and psychotherapy outcome has been shown for adults. The aim of the present study was to examine the association between attachment style and outcome of short-term psychodynamic psychotherapy for children and adolescents. 71 children and adolescents with a mental disorder receiving out-patient short-term psychodynamic psychotherapy were studied. Attachment style was assessed with the Heidelberg Attachment Style Rating for Children and Adolescents (HASR-CA). Therapy outcome was measured using the Severity of Impairment Score for Children and Adolescents (SIS-CA). It could be shown that good outcome in therapy is significantly more frequently associated with a secure attachment style than with an insecure attachment style. No significant changes in attachment security were observed during treatment. Thus, attachment style is a good predictor of a successful short-term psychodynamic psychotherapy for children and adolescents and therefore is an important criterion for the differential indication for psychodynamic therapies.