Child and adolescent Liaison-Consultation Psychiatry and Psychosomatic Medicine in a Clinical-Teaching Hospital. / Psiquiatría de Enlace y Medicina Psicosomática Infanto Juvenil en un Hospital Clínico-Docente.

Psychosomatic medicine explores the psychological, behavioral, and social elements that influence people's health and quality of life. This discipline develops skills and knowledge used in the evalua tion and management of psychosocial elements interfering in the process of illness and healing. The Child and Adolescent Consultation-Liaison Psychiatry (CACLP) is a discipline that has been empi rically installed in order to favor adherence to treatments and recovery of children and teenagers du ring the process of illness. There is a need for developing this discipline in Chile, but so far there are limited national and international records and literature dedicated to it. The objective of this article is to update the concepts of structure and describe how a CACLP unit in a high complexity teaching hospital works in general, discussing the clinical challenges involved in these issues.

[Structural quality in inpatient and daycare child and adolescent psychiatry- indicators for planning future staff ratios for the era following the Psychiatry Personnel Act]. / Strukturqualität in der stationären und teilstationären Kinder- und Jugendpsychiatrie.

The German Psychiatry Personnel Act, which went into effect in 1990, has led to a decrease in the number of child and adolescent psychiatry inpatient beds, to a decrease in the length of stay, and to an increase in inpatient psychotherapy. Today, this act is outdated~ for a number of reasons, such as changes in the morbidity of the population, the rising number of emergencies, and new professional standards such as documentation. In addition, new legal provisions and conventions (like the UN Convention on the Rights of the Child) necessitate a complete reevaluation. Child and adolescent psychiatry needs a normative act to enable the necessary implementation. Many different rationales are available to support the debate.

Play therapy as a mental health intervention for children and adolescents.

Play therapy is a child-centred therapy for children between the ages of 3 and 16 years who have mental health and/or other difficulties. The play therapist works one to one with the child, allowing children to explore their inner emotional world in almost any way they choose in the play room. The therapist sets a few necessary behavioural limits in order to safeguard physical and emotional safety during the weekly sessions. Children from all kinds of families come for play therapy. Some have witnessed domestic violence, or experienced abuse or other trauma. Some have conflicted relationships with the parents or carers arising out of insecure attachment and/or other issues. Provided that the child has some level of symbolic play, play therapy has the potential to help. The other provisos are that the home environment is sufficiently supportive at a basic level, and that the parent or carer is willing to support therapy. Children typically have play therapy for between two and 12 months, depending on the complexity of their difficulties. Play therapists analyse sessions and track changes to determine when to plan the ending with the child. Play therapists come from a range of professions and undertake full-time or part-time training in play therapy leading to a post-qualifying diploma or Master's degree. Qualified play therapists work in, or undertake work for, Child and Adolescent Mental Health (CAMH) services, Children's Services (Social Care), schools, and voluntary sector agencies.

Development of a music group psychotherapy intervention for the primary prevention of adjustment difficulties in Korean adolescent girls.

PROBLEM: Traditionally, adolescent mental health in Korea has not been a prime focus for educators, health workers, and politicians, yet a majority of sampled adolescents report interpersonal sensitivity (Kim, 2003). METHOD: Thirty-five adolescent girls took part in a six-session school-based music group psychotherapy pilot intervention designed to promote relationships and improve self-control skills. FINDING: Participants identified several outcome benefits that may serve as protective factors in their continued social and emotional development. CONCLUSIONS: Music is a medium that promotes interpersonal relatedness among Korean adolescent girls. More research is necessary to identify long-term benefits of preventive music group psychotherapy interventions among the adolescent population.

Redevelopment of a consultation-liaison service at a tertiary paediatric hospital.

OBJECTIVE: This paper aims to describe the way a multidisciplinary team set out to redevelop a consultation-liaison (C-L) service at a tertiary paediatric hospital. METHOD: The activities and processes in which the team members engaged were documented within a continuous quality improvement cycle. These activities included literature review, analysis of referral patterns, consultation with extant services, survey of referral sources and consultation with other tertiary paediatric services. RESULTS: The outcomes of these initiatives were integrated into a re-formulated multidisciplinary team model dedicated to providing C-L services to the paediatric hospital. Significant challenges identified in the initial process were ongoing issues with caseload management and clarification of boundary demarcations. CONCLUSION: There has been a gradual acceptance of the new C-L service by medical staff. The structure has resulted in a focused and coordinated C-L team that has contributed to innovations in the C-L process within the hospital.