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症例를 通한 小兒精神科 治療의 一面 An introduction to the understandign of treatment in child psychiary

소아과 1971년 14권 4호 p.15 ~ 23
이규원,
소속 상세정보
이규원 (  ) 
가톨릭의과대학 정신과학교실

Abstract


In order to interocuce the concept of therapy, the author of this paper has attempted to review the child therapy in current practice and to demonstrate an aspect of it through a clinical case material.
In dealing with the children with psychiatric problems, remidies comparable to such specific and convenient chemicals as antibiotics and vaccines available to pediatric practice are not at our disposal.Based on the wide range of ideas on child therapy, there are multitude of techniques for treatment; namely, psychotherapy, play therapy, group therapy, chemical therapy. and behavior therapy etc. In the countries where there are adequate medical and social attention directed to the children with emotional problems, the types of facilities available for such therapeutic endeavor are no less in numbers than :those of therapy.
The question of where, when, and how to treat comes up with each individual patient and it should be dicided primarily on the basis of the understanding of the child in question and his interaction with his environment. Baring the historical background of child psychiatry in mind, the author introuduced the concept of psychotherapy, esp. play therapy and also of adjunct therapy with the parent as a decisive factor in child therapy.
The auther then briefly touched upon the issue of child therapy in Korea, a subject that deserves a writing of separate paper. Not having at our disposal as yet either a specialized clinical team or a facility specific for the practice of child psychiatry, the author´s comment on the subject started out with as basic a question as whether or not the principle. of psychonalytically oriented therapy is applicable to the children in this country. This queation was answered by her belief which stemmed out of her clinical expreience of the past two years that they are applicable withought much modification so long as the therapy is limitted to the children. However, when it comes to dealing with the parents one could not but face the enfluence of cultural difference and consequently with the necessity for modification. It is hoped that in the near nature, we will be able to have at least a clinical team consisting of trained social worker and a psychologist as well as a child psychiatrist to investigate this problem through thier collaborative effort.
The rest of the paper deals with the clinical course of a short term therapy with a psychotic orphan girl of eleven. Her tretment comprised chemotherapy, milieu therapy, and psychotherapy. Chemotherapy was utilized during the acute psychotic periods and psychotherapy limitted to integrating recent traumatic experiences prior to paychosis. In this case, milieu therapy was conducted by a catholic nun working at the orphanage, whose intuition and degree of understanding were almost competable to those of a psychiatric social worker. For its brevity and simplicity, this case was selected for presentation with a modest hope of interposing a glimpse of what the treament in child psychiatry is like.

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