[Psychotherapy with physically challenged children and young people: implications of a change of paradigm]

In the light of newer scientific developments the biopsychosocial approach in psychotherapy appears to be in need of a revision. In neurosciences a paradigm change from a linear to a dynamic outlook on development as a self-organizing process guided by interactions with the environment took place under the heading of Neural Plasticity during the last ten years. This implies that the conditions of development for challenged children are not comparable with those of healthy children as the case-examples of children with Spina Bifida indicate. On this background, a pilot project was launched with the goal of determining which forms of psychotherapy are helpful for challenged children. A practically oriented, eclectic approach was developed applying empiric-regulative cycles which promotes the dynamics of self-organizing psychic and physical processes as shown in a presented example of a child experiencing post-lesional plasticity. Thus, psychotherapy is understood as a co-constructive process of reciprocal shaping of relationship; it fosters beneficial organization processes of psychic and physical impact.