This article examines the role of school support assistance in Germany from both a pedagogical and a child and adolescent psychiatric and psychotherapeutic perspective. It analyzes its conditions, potentials, and limitations based on legal and structural-systemic considerations. The findings indicate that school support services too often serve as a central prerequisite for attendance in mainstream schools, as they are frequently deployed when schools are unable to provide the structural conditions for inclusive education. As a result, the responsibility for ensuring educational participation is shifted from the institutional level of the school system to individually approved services within the child and youth welfare system. Coordination and delineation problems emerge at the interface of these two systems. These problems are further intensified by heterogeneous qualification levels and role conflicts and increase the risk of unintended exclusionary effects. Particularly for students experiencing psychological distress, school support assistance often assumes tasks that would require a continuous and professionally grounded integration of child and adolescent psychiatric and psychotherapeutic expertise in school-based support processes. This situation points to the need for a quantitatively and qualitatively stronger presence of relevant professional expertise in everyday school practice as well as for systematically coordinated cooperation with the therapeutic systems involved in treatment. From the perspective of child and adolescent psychiatry and psychotherapy, binding cooperation structures between schools, child and youth welfare services, and child and adolescent psychiatry and psychotherapy as well as clearly defined qualification standards and an increased emphasis on structurally oriented support models must therefore be developed and consistently implemented to secure inclusive education in a sustainable and participation-oriented manner.
Neurodiversity refers to the natural diversity of human beings and thus emphasizes the natural range of differences between people. As simple, convincing, and popular as this assumption is, the interpretations, conclusions, and implications of this statement are just as varied. This article focuses on the scientific basis of the concept, on the one hand, and on autism and divergence, on the other. It outlines the implications regarding biological determinism, identity, and the effects on diagnosis and therapy, and examines and critically reflects on the demands arising from the concept. The author concludes that the claim of "neurological difference" posited in the context of neurodiversity - which asserts a fundamental, innate distinctiveness and, at the same time, a specific mode of functioning, as well as the determination of a persons identity by these factors - has not been sufficiently substantiated by empirical research. Clinical evidence regarding the etiology, heterogeneity, course, and changeability of the diagnoses encompassed by this concept is not compatible with the assumed determinism regarding a persons identity. Neurodiversity is an important approach to reducing stigmatization and promoting acceptance of difference, but diversity should not be limited by new stereotypes, and in-group-out-group processes are not helpful regarding acceptance, openness, and tolerance. Diagnoses instrumentalized in the sense of identity formation, stabilization, and justification for otherness do not imply an appreciative attitude toward those whose deficits, limited behavioral and developmental possibilities, suffering, and impairments are described by the diagnoses.
Objective: This study aimed to assess how relevant mental health professionals consider intercultural competence to be for their work, to evaluate the existing self-rated knowledge in this area, to conduct a needs analysis for additional training opportunities, and to identify influencing variables. Method: We sent a link to an online survey via the mailing list of the German Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy. We supplemented a standardized tool for assessing intercultural competence with aspects relevant to Child and Adolescent Psychiatry and Psychotherapy. Results: Of the N = 142 participants, over 95 % considered cultural aspects to be relevant in their work. Only 20 % had ever attended intercultural training, and over 90 % would like to receive further training. Variables such as age, sex, and experience abroad correlated with some of the item responses. Conclusions: The findings clearly show a need and desire for training in this field. We suggest including intercultural competence in curricula and training offers for all mental health professionals to improve the quality of mental healthcare in Child and Adolescent Psychiatry and Psychotherapy.
Objective: Depression is among the most common disorders in adolescence and is closely linked to sleep behavior and quality of life. Long-term studies examining the course of depressive symptoms after inpatient treatment are scarce. The present study investigated changes in depressive symptoms among adolescents following inpatient treatment, focusing on associations with sleep-wake rhythm and subjective quality of life. Method: The sample comprised n = 38 adolescents (Mage = 18.63, SDage = 1.71; 85.4 % female) who had previously been hospitalized for a depressive disorder. The follow-up study spanned 5 years, during which sociodemographic data as well as the values from the Beck Depression Inventory-II (BDI-II), the Morningness-Eveningness Questionnaire (MEQ), and the KIDSCREEN were collected annually online. Results: Significant reductions in depressive symptoms and increases in life satisfaction were observed between follow-up II and the catamnesis assessment. BDI-II and MEQ scores were significantly correlated, whereas changes in depressive symptoms were not associated with alterations in sleep behavior. The MEQ indicated a significant shift in chronotype from eveningness to morningness over time. Conclusion: Symptom improvement was evident at the catamnesis timepoint. Due to the small sample size, no generalizable conclusions can be drawn. Further follow-up studies are needed to examine symptom trajectories after inpatient treatment.
