Die Beurteilung von Resilienzfaktoren im diagnostisch-therapeutischen Gespräch mit Kindern

Abstract

In a previous article, theory, research and clinical applications of resilience were explored. Resilience is for the authors an interactive concept. It refers to a relative resistance to environmental risk experiences or the overcoming of stress or adversity. Underlying psychosocial and biological processes, risk, vulnerability and the importance of gene-environment interactions as well as protective mechanisms against psychosocial risks were discussed in view of their contribution to resilience. This article explores as a main focus the importance of the quality of interpersonal relationships in preventive and therapeutic interventions on an individual and family level, as well as the role of intrapsychic processes facilitating the development of resilience. The authors present a case study of a girl, first seen at the age of two and a half year in a child psychiatric hospital presenting a severe psychopathology. She was then followed continuously - pedagogically and therapeutically - from the age of five and a half until eleven year old. The authors examine aspects of the family and the personal history of the patient, showing the inherent risk factors such as parental psychopathology and early developmental disturbances of the patient. Then two videotaped diagnostic-therapeutic interviews with the patient are presented in detail. They reveal the intrapsychic and interactional processes and demonstrate the capacity of the patient to use significant relationships for her own psychosocial development. Protective processes during the hospitalisation of the patient in a child psychiatric hospital as well as during the psychoanalytically oriented psychotherapy are explored with respect to the development of resilience. The authors confirm an important result of the resilience research, namely that vulnerability of children and adolescents, exposed to adverse critical life situations, does - thanks to long term preventive and therapeutic interventions - not lead inevitably to a psychopathological evolution. Understanding the process of resilience may thus guide environmental interventions in order to prevent tragic outcomes for children growing up in high risk environments.