Forschung verbindet Disziplinen: Mediziner und Kinder- und Jugendpsychiater begegnen sich bei Kindern kranker Eltern

Abstract

Within the framework of the European Research project Children of somatically ill parents (COSIP), the child and adolescent psychiatry department of the University of Basel offered consulting services at various hospitals in and around Basel. The consultation was addressed to children with a severely ill parent. Studies within the last 15 years have shown that they are at risk of developing psychiatric disorders. The aims of the research project were: (1) to get further insights into the mental condition of children of somatically ill parents; (2) to identify the need for psychotherapeutic support for the respective families. The approach of the study was as follows: physicians were asked to identify among their patients those who are parents and to motivate them to participate with their children in the project.Therefore, a large number of different medical departments were asked for permission to present the project of consulting services to their medical staff. Illustrative folders and phone contacts with physicians and with patients were used as the means of recruiting patients and their families. Results were that 19 out of 28 contacted clinics supported the research project. In the end, 16 clinics referred patients and their families to the consulting services. Eighty-three parents with a total of 129 children received short-term counselling. All interviews were videotaped and the participant families filled out questionnaires. The number of participating patients differed a great deal among hospitals, care units and even from physician to physician within the same department. A closer look revealed that personal attitudes toward the unusual task and the workload of the doctors played a significant role. For the patients, in addition to their personal attitudes, there were disease-related factors that played an even more significant role, especially with regard to the type and phase of disease. Almost all of the children had a very positive attitude toward participation, because nearly 100% followed their parents' decision. The relatively high number of participants from clinics in the area of Basel showed that there is a need for such consulting services for parents and children during a severe or chronic disease. The precondition was interdisciplinary cooperation between physicians and the child and adolescent psychiatrists. The quality of this working together influenced the process and the results of the project highly. The team of child and adolescent psychiatrists had to overcome obstacles presented by interfaces between: (1) psychiatry and various medical disciplines, (2) experts for children and experts for adults. The difficulty for the research team was that the child and adolescent psychiatrists needed the active support of the physicians to meet with the children of somatically ill parents. In this process the child and adolescent psychiatrists learned important lessons about improving communication with the medical professionals as gatekeepers and also about redesigning the consulting services. Most striking was the result that positive feedback given by the patients to the physicians about the sessions influenced the latters' attitudes toward the project in an immediate and very positive way.