The Treatment of Children and Adolescents with Substance-Related Disorders in the German Health Care System - a Quantitative Study This study evaluates the minimum characteristics of OPS code 9-694 for specific treatment in special settings for substance-related disorders in children and adolescents. The research questions to be answered are the extent to which given minimum characteristics and potentials are assessed as practical, up-to-date, needs-oriented and necessary. The survey was conducted using a nationwide online survey in special wards of child and adolescent psychiatric clinics. Given minimum characteristics reflect everyday clinical practice and are assessed as practical, up-to-date and relevant. Nevertheless, setting- and method-specific potential for further development was identified, most of which has already been implemented in the clinics but has not yet been incorporated into the minimum characteristics. The topic has received little research attention to date. The findings of the original study can provide a basis for the optimization and adaptation of minimum characteristics and treatment offers for children and adolescents with substance-related disorders and lead to the further development of the OPS code. A theory-practice transfer tailored to the target group requires the networking of individual players in the help system as well as the health policy discussion and gradual adaptation of the content of given minimum characteristics and potential for change.

Employees in child and adolescent psychiatry navigate a complex field of ethical requirements. At the Clinic for Children and Adolescents of the University Psychiatric Clinics Basel (UPKKJ), these areas of tension were examined in a project that spanned across numerous departments and professional groups. Based on a survey study and a narrative literature review, ethical guidelines were developed: the UPKKJ Ethics Compass. The Ethics Compass highlights various areas such as participation, child welfare, justice and developmental health, which are relevant to the relationships between children, adolescents, parents, and the treatment team. To implement these principles in everyday clinical practice, the Ethics Compass is now regularly used in case work and as a communication aid with external partners. Furthermore, a procedural action plan was developed for collaboration with the Department of Clinical Ethics at the University Hospitals in Basel.

Prevention of Child Sexual Abuse: Prevention Programs and Safeguarding Concepts in the Context of Sports, Musical Education, and Religious Organizations Prevalence rates of child sexual abuse by caregivers in private and non-public institutions underscore the need for implementing safeguarding concepts. However, factors driving the implementation of prevention and safeguarding in the field are not well understood. What supportive and inhibiting factors can be identified in the implementation of safeguarding concepts and prevention programs? Content analysis of semi-structured interviews with professional and volunteer staff in clubs and institutions (n = 10, 69 % female) as well as with individuals who experienced child sexual abuse during their childhood (n = 3, 66 % female). Safeguarding concepts in clubs or religious institutions were primarily initiated by umbrella organizations. Current incidents of child maltreatment, public pressure, and media attention substantially increased the need for preventive actions. The provision of training, resources, and networking structures by umbrella organizations further facilitated their implementation. Main implementation challenges included limited personnel and time resources, lack of expertise, insufficient training opportunities, and absence of guidelines and support from umbrella organizations. Due to club leaders' limited knowledge and resources an independent implementation of safeguarding concepts is largely lacking without concrete guidelines and support from umbrella organizations. To upscale safeguarding, public policies or incentive systems such as state-funded child protection certifications are thus paramount.

Implicit and explicit bias and distortions of perception are partly responsible for the unequal and significantly deficient psychotherapeutic and psychiatric care situation for children and adolescents with intellectual disabilities and additional behavioral problems. The extent to which these biases influence misdiagnoses and treatment errors, refusals and exclusions from professional care, and grossly hostile rejections of people with disabilities requires empirical evidence (Bartig et al., 2021). The fact that all forms occur - probably to a considerable extent - contradicts the ethical principles of the medical and psychotherapeutic profession. In order to avoid misdiagnosis and treatment as a result of bias, this must be openly addressed. Selfawareness, supervision and second views, the concept of working diagnosis and, above all, the full application of child and adolescent psychiatric standards help to reduce bias.

What Would we Like to (Diagnose) and what do we have to Diagnose. A Systemic Overview and Perspective Behavioral problems in children and young people are currently quickly suspected of being a sign of a psychological problem or a psychiatric disorder. In many cases, the caregivers agree on this, but in others there are clearly different perspectives from obvious to possible diagnoses. Whether a diagnosis makes sense and whether appropriate diagnostics are effective depends on various factors. From a systemic perspective, the common process, the symptomatic patients and their environment benefit from a solution- and resource-oriented view, which should have a greater impact on the future design of classifications of health and illness.

Current Approaches and Methods of Systemic Therapy and Counselling: KIKOSR Combines Techniques and Systems Therapy with children and teens could often be more effective and sustainable if the therapeutic process included not only the family environment, but also the more distant environment, such as teachers and pedagogues from school and leisure activities. It is important to take a look at the principles of hypnotherapeutic and systemic therapy approaches and perhaps even beyond. Whenever working according to guidelines or manuals no longer shows success, it can be extremely helpful to interrupt those patterns by making use of a combination of different therapeutic techniques, such as PEP®, impact and embodiment techniques, as well as resource and solution-oriented approaches. KIKOS® is an approach that promotes tolerance of ambiguity in all systems, regardless of the basic therapeutic orientation, by combining techniques and systems while taking into account the individuality of client and practitioner.

Opportunities and Risks of Gender-Stereotypical Approach to Men in the Context of Education and Counselling Work Using the Example of Birth Preparation for Expectant Fathers At first glance, it seems absurd that families or mothers and fathers become addressees of social work when they decide to have a child. But the legislator has also formulated it: "Mothers and fathers as well as pregnant women and expectant fathers should be offered advice and help in questions of partnership and the development of parental parenting and relationship skills" (§16 paragraph 3 SGB VIII). One can argue that this makes sense, especially in complex and challenging times. Fathers in particular are confronted with an increasing ambivalence between caring father and providing breadwinner. Against the background of crisis-ridden conditions, this ambivalence can be perceived as strenuous living conditions, so that the addressing of social work is justified. Gender-homogeneous psychosocial services for fathersto- be make counselling and educational processes in the sense of helping them to help themselves be used by the addressees. In this article, the gender-stereotypical addressing of men in the context of education and counselling services is presented and discussed using the example of gender-homogeneous birth preparation courses for expectant fathers, on the basis of empirical findings.

Autism in Systemic Group Psychotherapy: "Strong Together" a Care Model for Children and Adolescents from Practice Awareness of people with autism in our society is constantly increasing. Nevertheless, ambiguities and caution in dealing with autistic clients are still tangible. Due to the growing demand, there is a shortage of care for clients on the autism spectrum. This applies in particular to group therapy services in German-speaking countries. However, the international AWMF guidelines state that group therapy is the therapy method of choice for children and adolescents with autistic perception. In order to counteract this gap in care, this article presents a systemic group therapy for autistic people. It explains the extent to which the systemic approach in combination with a multimodal approach is a beneficial approach. It also highlights the importance of expanding the range of care services, interdisciplinary cooperation, and exchange. The compatibility of practice and research in systemic psychotherapy will be explained, teamwork in private practice will be emphasized, therapeutic experiences will be shared and an outlook on ongoing evaluation research will be presented.

Do Adolescents with Substance Use Disorders Recognize and Adopt Self-Regulation from Peers? - A Qualitative Interview Study Self-regulation often plays a central role for adolescents who develop a substance use disorder, as deficits may trigger the onset of the disease. Likewise, the improvement of self-regulation strategies is an important element of many therapy programs. Additionally, peers are important in the development of substance use disorders.The aim of this paper is to investigate the role of self-regulation by other peers in adolescents with substance use disorders through a qualitative interview study. For this purpose, a total of N = 13 (54 % female) adolescents were interviewed using semi-structured interviews, which were then evaluated using a qualitative content analysis according to Mayring.The results showed that the adolescents were familiar with the concept of self-regulation but did not name the interplay between cognitions, emotions, motivation, and behavior within self-regulation. Furthermore, the adolescents reported having observed and adopted both adaptive and maladaptive self-regulation strategies in others, placing the maladaptive strategies retrospectively before the start of therapy, while the adaptive strategies were rather placed during the therapy phase. This might partly explain the effect that peers pose a risk factor for the development of substance use disorders. However, peers might also be considered as a resource in therapeutic settings.

The Protective Role of Self-Regulation for HRQOL of Adolescents with a Chronic Physical Health Condition A physical chronic condition comes with many challenges and negatively impacts the healthrelated quality of life (HRQOL) of those affected. Self-regulation plays an important role in successfully coping with the demands of a chronic condition. In line with a resource-oriented approach, this study aimed to investigate themoderating effect of self-regulation on the relationship between disease severity andHRQOL. For this, 498 adolescents with cystic fibrosis, juvenile idiopathic arthritis, or type-1 diabetes aged of 12-21 years (M= 15.43, SD= 2.07) were recruited through three patient registers. Subjective disease severity, self-regulation (Brief Self-Control- Scale), andHRQOL (DISABKIDSChronicGenericMeasure)were examined at two time points (T₁ and T₂, one year apart). Cross-sectional analysis showed significant effects of subjective disease severity and self-regulation on HRQOL. Prospective analysis, in which HRQOL at T₁ was controlled for, revealed that disease severity only predicted emotion-related HRQOL at T₂; selfregulation emerged as a predictor for HRQOL subscales independence, emotion, inclusion, exclusion, and treatment. A significantmoderation effect of self-regulation was found on the relationship between disease severity and HRQOL emotion. Our results highlight the positive impact of self-regulation on quality of life, specifically in the context of chronic conditions and represent a starting point for prevention and intervention approaches.

The Development of Epistemic Vigilance and Epistemic Trust Across the Lifespan: Perspectives from Empirical Research on Self-Regulatory Social Learning This article examines what we know about the development of epistemic vigilance and epistemic trust between early infancy and adolescence.With this brief review, we intend to help put into perspective the hypotheses advanced by Fonagy and his colleagues within the socio-epistemic theory of psychopathology, according to which psychopathology reflects a closure to interpersonal communication resulting from unfavorable learning experiences in early development. Here, we will discuss how children become sensitive to overt interpersonal communication, and what cognitive skills underpin such sensitivity. Next, we shall discuss the empirical evidence that children in the second year of life already possess a rudimentary capacity for epistemic vigilance: they seem to evaluate the competence of different adult informants and appear to seek information and learn from adults based on such evaluations. Third, we will outline studies showing that in the third year of life children appear to increasingly trust ostensive communication, up to the point of becoming (at least apparently) less sensitive to the possibility of being misinformed or deceived. Finally, we will discuss how, between late childhood and adolescence, children first learn to distinguish lies, then irony, and increasingly engage in complex communication ecologies. Our review simultaneously supports the basic principles of the socio-epistemic theory of psychopathology and suggests that the theory needs further refinement of its ontogenetic predictions.

Pediatric Skills Lab: Strengthening Communication Skills for the Conversations with Psychologically burdened Families To identify psychosocially burdened families early and motivate them to seek further assistance is a central aspect of pediatric preventivemedicine.The aim of the feasibility study was to develop the Pediatric Skills Lab to promote methods for identifying and addressing psychosocially burdened families, and to evaluate it. Thirteen primary care pediatricians participated in two trials of the Pediatric Skills Lab, an interdisciplinary developed two-part digital training.They answered questions regarding their work with psychosocially burdened families and their satisfaction with the Pediatric Skills Lab. Overall, there was a high level of satisfaction reported with the Pediatric Skills Lab. Specifically, the presentation of results on the effects of psychosocial stressors, the practical exercises, and the exchange with colleagues during the interactive webinar were highly praised. Criticisms included, for example, the short duration of practical exercises and the lack of sufficient examples and live demonstrations. The Pediatric Skills Lab is a training concept tailored to meet the existing needs. With widespread implementation, it could enhance psychosocial care provision. Consideration should be given to extending the duration of the training to allow formore practical exercises. Future studies building upon this feasibility study should examine the effects of the training. Additionally, ways to integrate the Pediatric Skills Lab into existing curricula formedical education should be explored.

The Importance of Self-Regulation in the Development of Internalizing Symptoms During Middle Childhood Current research discusses low self-regulation abilities during childhood as risk factors for the development of internalizing symptoms. However, longitudinal studies investigatingmultiple self-regulation facets simultaneously are scarce. We examined whether impairments in various self-regulation facets (emotional reactivity, inhibition, inhibitory control, planning behavior) in middle childhood predict internalizing symptoms two years later and whether they make an incremental contribution when established risk factors (gender, family adversity) are considered. Furthermore, we investigated whether self-regulation facets predict later internalizing symptoms under consideration of internalizing symptoms at baseline.The sample consisted of 1,617 children (t1:Mage = 9.1, t2:Mage = 11.1 years), assessed at two measurement points. Internalizing symptoms were rated by parents on the Emotional Problems Scale of the Strengths and Difficulties Questionnaire. Self-regulation facets were measured at the first measurement point using various methods and informants. A stepwise regression analysis revealed that increased emotional reactivity, reduced inhibitory control, and reduced planning behavior significantly predicted later internalizing symptoms, explaining 14.8 % of the variance. Adding risk factors increased the explained variance by 2.5 %. Under consideration of baseline internalizing symptoms, reduced inhibition and inhibitory control significantly predicted later internalizing symptoms, while other self-regulation facets and risk factors did not. Results of this study may inform prevention and intervention measures.

Child-to-Parent Violence -The Blind Spot in Research on Family Violence? A Systematic Review Child-to-parent violence (CPV) is a phenomenon that has received little attention in the German scientific community. With this paper, the authors present the international state of research in the context of a systematic review. By means of a search a dataset of 317 scientific publications for the period 2012-2022 was identified at August 2022. After applying the inclusion and exclusion criteria, 14 studies were finally defined and analyzed in detail. Based on the analysis, the following variables are highlighted as outcomes: Forms of CPV, prevalence, age and gender of individuals performing CPV, risk and protective factors, the direction of CPV within family constellations as well as external conditioning factors of CPV.The results show that there are some concrete findings in research regarding these variables, particularly in the area of risk and protective factors. An initial systematization of violent behaviour in the context of CPV can also be derived fromthe current state of research. At the same time, however, there are still clear gaps in research, e. g. in terms of prevalence, which is mainly due to very different definitions of "violence". This applies both with regard to the international state of research, but especially with regard to the situation in German-speaking countries.

Children Create Narratives - First Experience with the Revised Sceno-2 Test The Sceno Test, created by Gerthild von Staabs, has been in use and has been useful in its original version for more than 80 years. It has now undergone a major revision.The test will retain its relevance as a projective diagnostic procedure offering children and juveniles opportunities to design scenes and to voice narratives coming along with them. It can serve as an instrument encompassing all therapeutic approaches to explore infantile wishes, perceptions, and interpretations and can provide, as intended by Gerthild von Staabs, indications of family dynamics.The revision of the test will be discussed at great length.

How Does the Kaufman Assessment Battery for Children-II Stand the Test of Clinical Practice? Findings in 7- To 12-Year-Old Children Reliability and validity of the KABC-II were investigated in 646 children aged 7 to 12 years who had been assessed in four social pediatric centers and one pediatric clinic in Germany due to developmental, behavioral, or emotional disorders.The reliability of the global scales Fluid-Crystallized-Index (FCI) and Mental Processing Index (MPI) proved to be very high in all age groups, with values ≥ .96. Reliability values for the scales were above .85 for Sequential/ Gsm and Delayed Recall, and above .90 for the other scales. Relatively higher test scores were found for Learning/Glr in children with intellectual disability than in other scales. Findings for discriminative validity for clinical diagnostic groups and educational backgrounds were as expected, with the lowest intelligence scores for children with intellectual disabilities.The correlation between FCI and the full scale IQ of the SON-R 2.-7 was .73 in a longitudinal subsample. Divergent validity for behavioral variables was confirmed in a subsample by low and nonsignificant correlations with the CBCL/6-18R. With some limitations, psychometric data indicate the suitability of the KABC-II for individual clinical assessment.

The Current Status of the Intercultural Opening of the Psychiatric-Psychotherapeutic Care for Children and Adolescents from the Perspective of Professionals Children and adolescents with a migration background have a high demand for psychiatricpsychotherapeutic care in Germany. Nevertheless, they often do not receive the care needed, despite the Intercultural Opening, which aims at adjusting the services to their needs.The aim of the study is to get insights in the current status of the Intercultural Opening of the psychiatric- psychotherapeutic care system by examining the perspectives and needs of the staff working with this vulnerable population. A sample of N = 232 pedagogical and health care professionals completed the online survey. Intercultural competencies, further training needs and challenges in their work were assessed by open and closed questions. Overall, our results demonstrate high intercultural competencies. Pedagogical and health care professionals reported several challenges in their work (e. g. with the language barrier). There was a great demand for specific transcultural trainings. Despite high intercultural competencies of the professionals, there is a clear need for action to improve the Intercultural Opening of the psychiatric-psychotherapeutic care systems. Further transcultural trainings and several structural improvements (e. g. changes in the training curriculum of the professionals, provision of more trained translators) would help to open the care system.

The Importance of Leisure Activities for Suicidality in Adolescents and Young Adults Leisure time is important for the development of adolescents. It influences adolescents' psychological well-being and psychosocial development. It may also have a protective effect on suicidality. This study investigates how adolescents' leisure time is related to suicidality, distinguishing between general aspects and various specific leisure time activities. Data from adolescents in counseling (n = 25) and the general population (n = 57) were analyzed. Adolescents who spend most of their leisure time alone are more suicidal than adolescents who spend their leisure time with others. General aspects of leisure activities were related to suicidality; among specific activities, only sports activities were found to be significant.The strongest association with suicidality was shared activities with others. Based on these results, it can be shown that leisure time activities could be effective as a preventive measure. In particular, social activities in leisure time should be encouraged.

Expanding the Psychotherapeutic PerspectiveThrough Bifocal Young Child Observation. Methodological and Case-Related Considerations on the Design of the Vienna Parent-Toddler Group Study The parent-toddler group concept was developed at the Anna Freud Centre in London. Since 2021 it has also been used at the Child Guidance Clinic in Vienna.The Vienna Parent-Toddler Group (PTG) study investigates the significance of participation in such a therapeutic group for changes in children's relational experiences and developmental problems in their families. Among other research tools, the bifocal use of Young Child Observation according to the Tavistock concept is used:The children are observed as continuously as possible in their interactions and relations both in the group and at home.The article first describes the background and the design of the research project. Subsequently, with reference to accounts from the observation of a child with eating problems, it is shown in which respect this observation design provides a deeper understanding of the eating problem. Finally, the arguments for and against an early exchange of considerations between the observers and the psychotherapists are discussed.

Development and Evaluation of an Information Brochure on Anxiety and Anxiety Disorders for Adolescents Low mental health literacy and fear of being stigmatized are two main barriers that detain adolescents fromseeking professional help. An information brochure about anxiety disorders for adolescents was developed. To make a first statement about the quality of the brochure, 19 experts, consisting of (child and adolescents) psychotherapists, psychiatrists, and psychologists, rated a first version of the brochure regarding content validity and age-appropriatness. To evaluate the efficacy in knowledge and the acceptance of the brochure, a revised version was evaluated by N = 174 adolscents (106 female-, 66 male- and two non-binary) between 14 and 17 years of age (M = 16.56 years.; SD = 0.57).The experts' approval of all content items totals a mean average of 95.2 % (range: 84.2-100 %). In the adolescent sample, the intervention increased knowledge about anxiety disorders (d = 1.04) and improved attitudes about coping strategies (d = 0.99). Results of the experts' rating showed that content validity of the brochure can be assumed.The revised brochure seems to be a useful and effective tool to inform adolescents about anxiety disorders.