A survey by the German Association of Psychotherapists found that consultations with psychotherapists increased by 60% during the pandemic. The pandemic was followed by other crises, such as the war in Ukraine, the conflict in the Middle East and climate disasters – which also put pressure on children’s souls. Julia Asbrand says in the interviewProfessor of Clinical Child and Adolescent Psychology at the Friedrich Schiller University Jena: “It is not true that without these crises children would no longer become mentally ill, but they are another aspect that worries young people a lot and can make life more difficult, for example because they steal future perspectives.”
Regardless, children and young people are generally a psychologically vulnerable group: around three-quarters of all mental illnesses begin before the age of 25, the majority before the age of 14. depressionsanxiety disorders, eating disorder or vices.
Our advice
seek conversation. If you suspect that your child has psychological problems, talk to him or her about what you have observed. The first professional contacts are pediatricians, general practitioners and Child and adolescent psychotherapists. Don’t hesitate too much.
Schedule an appointment. Consultation hours at a psychotherapy office are free for children and young people with mandatory health insurance. You can find specialized psychotherapists through the Federal Chamber of Psychotherapists bptk.de. O Service points with appointment The Association of Statutory Health Insurance Doctors organizes free consultations by calling 116 117 – within four to five weeks.
The challenges for young people are high
“Young people have to face a particularly large number of developmental tasks,” says Julia Asbrand. “We are dealing with big issues at the moment: children and young people have to develop their own identity, become independent from their family and adapt to the constant changes in their lives. At the same time, a lot is happening to them physically. They are still developing, not yet established. External crises therefore have a particularly big effect on them.”
External crises can be major global problems, but also very personal ones: parental separation, huge problems at school, bullying, moving to another city, the death of a close family member, violence. All of these are much harder for young souls than for adults.
perceive changes
Parents in particular are important interlocutors for them. They are also the ones who can tell whether the child is feeling so unwell that he or she needs professional help. “Parents don’t have to be able to diagnose an illness. But they are more likely to recognize it if their child has changed relatively suddenly, for example,” explains the Jena psychology professor. Completely different moods, declining school performance, withdrawal from peers: these are all possible signs. “But during puberty, these behaviors can sometimes also be completely normal,” warns Asbrand.
Pay attention when self-isolating
However, if the child avoids friends, there may be more to it than that. “So it’s not important to make an appointment with the therapist right away, but to talk to the child first. For example, that you noticed something, if he or she is not feeling well and if you can help.”
Heiko Borchers is active in the expert group for child and adolescent psychotherapy of the German Association of Psychotherapists. “If you have a bad feeling and perhaps the mother and father have independently noticed a change in the child, it is better to have this clarified professionally too early than too late,” says the psychotherapist, who has a psychotherapy practice in Schleswig-Holstein.
Don’t waste time, ask for advice
Pediatricians and family doctors can be the first point of contact. Therapist Borchers recommends psychotherapy consultations in a suitable practice. For children and young people, this can include up to ten consultations and last up to 250 minutes in total. It examines what symptoms the child is presenting, whether he or she needs psychotherapy, perhaps even acutely, or what other help might be useful. For example, if the psychological problem is due to marital conflicts between the parents, it may be advisable to visit a family counseling center. If medication makes sense, a psychiatrist should be consulted.
But: The first step is important. “You shouldn’t waste time, especially with children, because their clock ticks faster”, emphasizes Borchers. “Six months means something completely different for a child than it does for an adult. He developed a lot during that period.”
Health insurers pay for psychotherapy for children
Psychotherapy is considered effective and safe for children and adolescents. It can help alleviate mental suffering even at a young age. Legal health insurance companies pay for psychotherapy for children and young people if there is a diagnosis and the psychotherapist is licensed to bill legal health insurers.
Long waiting times for a therapy spot
Therapists studied psychology, pedagogy or social pedagogy and then completed several years of training to become child and adolescent psychotherapists. Currently, about 20% of psychotherapists with a health insurance license specialize in children and adolescents. “Waiting times for a therapy location are sometimes even worse than for adults. There is an extreme shortage of supply, especially in rural areas”, highlights expert Julia Asbrand from Jena.
Tip: You can find out what options you can use to find a psychotherapy location for your youngest child or teenager in our Special for finding a psychotherapy place.
Playful treatment
Psychotherapist Heiko Borchers works with adults, children and young people. Half of your treatment room is therefore much more colorful. Instead of 50-minute conversations, much of the treatment given to children is playful. Hand puppets can be used to represent a conflict in the family or plastic animal figures can be used to talk about fear. Children use pens to draw a school problem. “In some practices it is possible to find plastic swords or punching bags that children and young people can use to escape aggression,” says Borchers. There are also many board games with which you can, on the one hand, assess cognitive performance and, on the other, talk to children.
Not being condescending is important
“When two school-age children meet, they don’t meet to drink coffee and talk, but to play,” says Professor Asbrand. “Playing is their form of communication and psychotherapists interact with them on this level.” Therapist Borchers knows that games are less effective with young people. “But as a therapist, you also need to meet them where they are. You have to engage with them and not patronize them,” he says.
Conversations with relatives
In therapy for children and adolescents, the personal environment plays a very important role, unlike adults. Psychotherapists regularly bring in parents or significant others, such as siblings, teachers or grandparents, or arrange one-on-one discussions with them. You have at least 100 minutes for such discussions without the children or young people and can bring the social environment into all phases of therapy.
Training aimed at parents
Discussions with family members include, among other things, the child’s living situation and how adults can help them. Some practices offer targeted training to parents. “If psychological problems arise from parental conflict or bullying at school, it doesn’t help if I simply talk to the child about it. “Something has to change the situation,” says Asbrand.
Confidentiality also applies to parents
“Parents also have the right to know what happens during treatment,” adds Borchers. At the same time, psychotherapists are subject to confidentiality. Therefore, they discuss the content of family discussions with young patients in advance. Generally, general things are discussed rather than details. “For example, you might tell parents that their children are reporting problems at school, but not describe the specific incident they talked about,” says psychotherapist Borchers. He and his colleagues have to create a balance between transparency and trust – so that psychotherapy with young children can be successful.