Das Traumanarrativ in der Kinderpsychotherapie

Abstract

The narratives of trauma in child psychotherapy The establishment of narratives is a major component of trauma-focussed cognitive-behavioural therapy for children and adolescents. According to comparative intervention studies with children and adolescents, fundamental aspects of effective treatment are the act of remembering the traumatic experience and its emotional and cognitive reprocessing. This paper defines the rationale of the therapeutic use of narratives in psychotherapy with children and adolescents, illustrated with case material. Furthermore, the authors demonstrate that this approach can also be applied in therapy with preschool children, if conducted in an age-appropriate way. Based on the principles of behavioural therapy and in keeping with other forms of treatment for anxiety disorders, the main goal of the treatment is that the patient becomes accustomed to the biographical memories that are specific to the trauma and the key stimuli associated with these. Negotiation of disorder-specific avoidance is achieved by graduated exposition and desensitization. Moreover, the trauma narrative helps the patient to reconsider and change cognitive distortions and dysfunctional beliefs and to establish an age-appropriate comprehension of the traumatic event and its impact on his or her future life. The contact with a dedicated, supportive, non-abusing and caring person improves the transfer of the therapeutic effects into daily routine and may also lead to sustained emotional and psychological relief for the caregiver - who is often equally traumatized. However, trauma-focussed therapy for children and adolescents has yet to be implemented on a larger scale: current medical practice still consists of unspecific, supportive and stabilizing interventions.