Systemic approach to сhild psychiatry: insights in etiopathogenesis and organization of assistance

Aim. Integration of information on systemic approach published in literature, and of the own practical experience in rendering psychotherapeutic assistance to children with different forms of phobic anxiety disorders (PAD) aimed at improvement of effectiveness of treatment, of social adaptation of patients with PAD, and at search for organization forms of medical assistance to the given category of children’s population.

Materials and Methods. Into the study 61 children of 8-17 years old were involved living at home and admitted to G.E. Sukharevskaya Research and Practical Center of Mental Well-Being of Children and Adolescents in 2018 for different mental disorders including PAD. In the study, analysis of medical histories and protocols of classes with a family psychologist were used.

Results. On the basis of the parameters of family functioning three groups of phobic anxiety syndromes were isolated: disorders of the structural aspect (limits, hierarchy, coalitions, triangles), disorders of communication sphere, or of family history. The working systemic hypotheses were illustrated with ten classic examples.

Conclusion. Systemic hypotheses of formation of PAD in children permit to construct treatment and rehabilitation strategies directed at improvement of patient’s state through creation of conditions for a prolonged stable remission in the family. Inclusion of classes with a family psychologist/psychotherapist into the plan of treatment and rehabilitation permits to shift the  accent of help to a child to the outpatient environment.