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Übersicht

Gruppentherapie bei Kindern und Jugendlichen mit aggressivem Verhalten

Published Online:August 24, 2018https://doi.org/10.1026/0942-5403/a000260

Abstract

Zusammenfassung. Gruppentherapeutische Maßnahmen stellen einen wesentlichen Bestandteil der kognitiven Verhaltenstherapie von Kindern und Jugendlichen dar. Der Vorteil einer Gruppentherapie besteht darin, dass sie Probleme dort behandelt, wo sie entstehen – in den sozialen Beziehungen der Patienten. Kinder und Jugendliche mit aggressivem Verhalten weisen Defizite in ihren sozialen Kompetenzen auf, sodass zur Behandlung ein gruppentherapeutisches Vorgehen indiziert ist. In der vorliegenden Übersichtsarbeit werden unterschiedliche nationale und internationale Programme zur Behandlung von Kindern und Jugendlichen mit aggressivem Verhalten vorgestellt. Es wird der Frage nachgegangen, inwieweit es diesen Programmen gelingt, die wesentlichen Therapieziele bei aggressivem Verhalten umzusetzen. Dabei werden Erkenntnisse über die Wirksamkeit der einzelnen Programme diskutiert. Schließlich werden Gelingensbedingungen aufgezeigt, die die Wirksamkeit einer Gruppentherapie zur Behandlung aggressiven Verhaltens noch einmal steigern können.


Group Therapy in Children and Adolescents With Aggressive Behavior

Abstract. Group treatment methods are an essential part of cognitive behavioral therapy for children and adolescents and are often part of multimodal approaches to therapy. They are equally used in inpatient, day-patient, and outpatient settings. Group treatment methods treat problems where they arise – in the social relationships of the patients. Group treatment methods harness group characteristics, such as interrelated roles and shared norms and values for therapeutic use. In doing so, group treatment methods help children and adolescents learn interpersonal and problem-solving skills. Aggressive behavior as it occurs in conduct disorders is widespread among children, with a prevalence up to 2.0 % for girls and up to 6.0 % for boys. Children and adolescents with aggressive behavior have shortcomings in their social skills, especially in their ability to control their anger. Their impulsively aggressive behavior causes them to be frequently rejected by their peers. Thus, they do not manage to build lasting, sustainable relationships and make new friends. The treatment of aggressive behavior should therefore always include group treatment methods that enable children and adolescents to practice new skills in a confidential setting. The present review presents different national and international group treatment methods for children and adolescents with aggressive behavior. Eight different treatment methods were identified that address aggressive behavior in settings of varying intensity, with a range of seven to 34 sessions. This review investigates the extent to which these programs manage to achieve key therapeutic goals for children and adolescents with aggressive behavior (differentiated perception of situations, perspective taking and empathy, appropriate treatment of frustration and anger control, problem solving and conflict ability, self and impulse control, prosocial behavior). Therefore, new insights into the effectiveness of the individual programs in relation to the overall therapeutic goals are discussed. It has been found that group treatment methods can reduce aggressive behavior in the long term. Whether additional positive effects on, for instance, anger control or empathic abilities of children and adolescents can be supported by evidence is rarely investigated. For therapy effects to be detectable, a sufficient time interval should be chosen between the end of treatment and the follow-up time of measurement. Finally, conditions are discussed that may improve the effectiveness of group treatment methods for aggressive behavior. Particularly important here is the development of cohesion, the creation of sufficient practice opportunities, the development of motivation to implement the new skills, the assignment of homework to increase the transfer of everyday life, the respectful and appreciative interaction with each other, and the patient’s treatment satisfaction. All this should be taken into account when planning and implementing group treatment methods.

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