Psychiatric-psychotherapeutic crisis intervention for inpatient adolescents

We assessed retrospectively in two periods of evaluation all inpatient crisis interventions (n1 = 75, n2 = 65) conducted in a psychiatric hospital for children and adolescents aged 13 to 19 years. In a first preliminary study we described patterns of family dynamics and developed an evaluation plan, which was used in the second study reported here. Familial conflict situations proved to be the essential factors. The adolescents' psychiatric diagnoses differed considerably from those of adult patients. Therapeutic management using a psychoanalytically oriented focal therapy and a more social-psychiatrically oriented crisis management is discussed. Data on adolescents' and families' collaboration as well as on the success of therapy are reported. It was possible to offer developmental prospects if the adolescents were able to consider their inner conflicts and if concurrently an agreement could be reached with the family. Collaboration with community health-care professionals, in particular with the appropriate social workers, was an important step in the majority of cases. Usually discharge to the home followed within a few days, in some cases to a supervised residence group. Twenty-three percent of patients required longer inpatient therapy.