Experience of Participation of Patients in the (Day) Inpatient Child and Adolscent Psychiatry The participation of patients in child and adolescent psychiatry is increasingly coming into focus, both due to child protection aspects and because of its effects on the success and quality of treatment. The study therefore investigated the experience of participation of patients in (day) inpatient child and adolescent psychiatry, its effect on treatment satisfaction and the connection with self-efficacy expectations. A quantitative questionnaire study was conducted using a cross-sectional design. The experience of participation and treatment satisfaction were measured using the instrument developed by Zerbe et al. (2021). To assess self-efficacy expectations, the General Self-Efficacy Expectation Scale developed by Jerusalem and Schwarzer (2003) was used. In total, data of 45 patients from the Child and Adolescent Psychiatry Department at the District Hospital Landshut were analyzed. The respondents were between 9 and 18 years old with an average age of 15.18 years. Regarding gender, 68.9 % of respondents stated "female", 24.4 % "male" and 6.7 % "diverse". Depending on the treatment setting and the admission modality (voluntary or emergency), children and adolescents experienced their participation differently. There was also a significant decrease in the experience of participation in the decision-making process. Patients felt well informed and perceived conversation about treatment options, but they felt significantly less involved in the decisionmaking itself. The experience of participation, especially in the decision-making process, had a significant influence on treatment satisfaction. Regarding the relationship between the three constructs of participation experience, self-efficacy expectation and treatment satisfaction, the study showed that, in addition to participation experience, self-efficacy expectation also had a significant influence on treatment satisfaction, although participation experience predicted treatment satisfaction significantly better.

Dimensions of the Therapeutic Relationship in Child and Adolescent Psychotherapy - Development and Validation of a Questionnaire Time-economic instruments with high conceptual breadth to assess the therapeutic alliance are missing in child and adolescent psychotherapy. To address this research gap, the newly developed Youth Alliance Scale (YAS) was validated in the current study. 168 patients and their therapists participated in the study and completed the YAS, consisting of 20 items and with a completion time of approximately 10-15 minutes. To the same measurement time point, an already existing therapeutic alliance questionnaire with a more limited conceptual scope was also completed. An external assessment of symptom severity was provided by the patients' parents. The YAS showed from patient and therapist perspective factor structures that mostly confirmed our hypotheses and showed significant associations to an established measure of therapeutic alliance. However, there were no significant associations to symptom severity. With some psychometric limitations, an economic measure with high conceptual breadth to assess therapeutic alliance in child and adolescent psychotherapy is now available. The instrument can be applied in research and routine care for the close-meshed monitoring of the most important components of the therapeutic alliance.

Attachment and Psychological Distress in Adolescents from Schools and Care Practices During and After the Covid-19 Pandemic The COVID-19 pandemic had a substantial impact on the mental health of children and adolescents. Internalizing symptoms such as anxiety and depression emerged early on, particularly among those with high pre-pandemic vulnerability. This study investigates the development of psychological difficulties (internalizing, externalizing, and social problems) among adolescents in rural areas after returning to in-person schooling, comparing a non-clinical school-based sample with a clinical sample from child and adolescent mental health services. The study examines whether symptoms persist over time, the role of attachment quality, and the potential buffering effect of early therapeutic intervention. At two time points, 46 adolescents (M_T1 = 14.65 years, SD = 1.08; M_T2 = 16.05 years, SD = 1.24) were assessed using the Adolescent Separation Anxiety Interview (ASAI) and the Youth Self Report (YSR/ 11-18). Findings indicate that participants were highly affected by pandemic-related measures such as lockdowns, homeschooling, and social isolation. Adolescents with insecure-preoccupied attachment reported the highest symptoms. Symptoms persisted beyond the end of public health restrictions. In contrast, connection to a care network emerged as a resilience factor. These results underscore the urgent need for expanded and more targeted support for youth in coping with crisis-related stress.

The Teacher-ProGRESS Instrument: Quantitative Measurement of Group-Analytic Pedagogical Dispositions and Strategies to Further Psychosocial Development in Schools The (individual and collective) professional competence of teachers is probably the most important quality feature of schools. The Teacher-ProGRESS instrument was developed to support teachers in successfully developing their psychosocial support skills. A total of 14 dispositions and strategies as well as five group dynamics and emotions were inferred from groupanalytic pedagogical theory and practical experience, and operationalized via student questionnaires. The instrument's internal structure has already been examined and further adjusted three times using exploratory factor analyses. The confirmatory factor analyses now conducted represent the next step in the development of the instrument. Results of the data collected in five schools in NRW suggest an overall good internal psychometric structure of the 19 scales. Further confirmation of the psychometric quality of the instrument requires additional longitudinal studies that can build on the present results in order to evaluate the predictive and divergent validity of the instrument. Teachers can already use the Teacher-ProGRESS instrument to obtain feedback from their students on their own psychosocial support skills.

MYNEEDZ - Satisfaction of Basic Psychological Needs in the Youth Life Areas of Family and School from the Perspective of Secondary School Students in a German-Italian Comparison The study analyses the basic psychological needs of adolescents in the youth life areas of family and school in Germany and Italy. The theoretical basis is the consistency theory according to Grawe (2004). Using the specially developed MYNEEDZ questionnaire, whose psychometric quality has been confirmed by confirmatory factor analyses and reliability parameters, N = 1.317 adolescents aged 13 to 18 (Germany: N = 789; Italy: N = 528) from various types of school were surveyed on their self-perceived satisfaction of their basic psychological needs. Non-parametric methods (Mann-Whitney-U, Kruskal-Wallis test) were used to test the hypotheses. The results show that adolescents in Italy report a significantly higher level of basic psychological needs satisfaction in the family and school areas than adolescents in Germany. Within the German sample, there were significant differences between the school types. Young people at special schools reported higher values than their peers at "Hauptschulen" and "Realschulen". In addition, there were gender-specific differences in favour of male adolescents living in Italy. The findings point to the influence of cultural relationship patterns, school structural conditions and gender-specific experiences of stress on the satisfaction of basic psychological needs. This has practical implications for culturally sensitive school development and for gender-sensitive educational approaches in school contexts.

Parental Reflective Functioning and Psychosocial Development in Preschool Children Parental reflective functioning (PRF) is considered an important predictor of children's emotion regulation and psychosocial development. In German-speaking countries, there is a lack of studies that focus on the preschool age, include both parents and consider children's emotion regulation as a mediator between PRF and psychosocial development. The aim of this cross-sectional study was to analyse the associations between PRF and child´s psychosocial development, taking emotion regulation as a mediator into account. Study 1 (78 mothers, 34 fathers; child´s age M=4.25 years) showed that higher PRF was associated with fewer psychological difficulties and greater prosocial behavior in preschool-aged children. Study 2 (109 mothers, 21 fathers; child's age M=2.92 years) confirmed these findings, and based on preliminary results, identified children's emotion regulation as a potential mediator. Overall, the results suggest that both PRF and emotion regulation represent key targets for early preventive interventions aimed at promoting psychosocial development.

Evaluation of a School-Based Prevention Project to Promote Mental Health Literacy Among Secondary School Students Given the growing mental health issues faced by children and young people, targeted prevention approaches are needed. Schools are increasingly being recognised as a suitable setting for such initiatives. Thus, the GetFit4MentalHealth preventative pilot project was initiated by the University Clinic for Child and Adolescent Psychiatry and the University of Innsbruck. In the first phase of the project, secondary school teachers completed a university training programme that prepared them to independently design and deliver teaching sessions to promote the mental health literacy of their students. This evaluation examined changes in the stigmatisation of mental disorders (r-AQ), mental health literacy (UMHL-A) and psychopathological symptom burden (YSR) among the participating students (n = 315, mean age = 12.33 years) through a pre-post questionnaire survey. The results of the study did not indicate any significant changes in stigmatisation (r-AQ) or psychopathological symptom burden (YSR). The results showed a significant improvement in knowledge of mental disorders, which is a key aspect of mental health literacy. This finding demonstrates the potential for teachers to positively influence an important aspect of mental health literacy through the implementation of a low-threshold preventative approach. The project demonstrated the principal feasibility of an innovative, school-based prevention approach by teachers. Further research is needed to establish the conditions for the effective and practical implementation of school-based interventions designed to promote mental health literacy through teachers.

Research on mHealth Solutions for Families with Psychosocial Burden: Lessons Learned from the I-PREGNO Project Psychosocial burdens in the postpartum period have a negative impact on parental well-being and the parent-child relationship. Preventive interventions often do not reach these families (prevention dilemma). Blended care approaches, digital interventions combined with support by professionals, offer a low-threshold way to support this hard-to-reach group. This article examines the research process, including the development, recruitment and implementation of the I-PREGNO project - a blended care intervention to promote mental health and weight management in psychosocially burdened postpartum families. The app was developed in collaboration with professionals and families and evaluated in a cluster-randomized controlled trial to identify strengths and challenges in recruitment and implementation. Despite initial strong interest from professionals, recruiting this hard-to-reach group proved challenging, highlighting the prevention dilemma. However, a low dropout rate was maintained among successfully recruited families throughout the study. The app's user-centered development led to high satisfaction but revealed the need for adherence strategies and multilingual materials. The involvement of healthcare professionals was crucial for accessing this vulnerable group but requires more generous resource planning for training and support. I-PREGNO provides important insights for future interventions to more effectively reach psychosocially burdened families and alleviate pressure on the healthcare system.

Mental Health Problems and Care Situation in Students with Problem Behaviour from the Autism Spectrum (ASD) at Special Schools for Emotional and Behavioral Disorder (EBD) Children Children and adolescents with ASD often require specific support both inside and outside of school. The majority of these children are educated at special schools for emotional and behavioral disorder (EBD). There is no data available on how often ASD problems occur at EBD special schools, what other emotional and behavioral problems are shown, and how the students are supported. In the study, teachers at EBD special schools were surveyed on their pupils' mental health problems, including ASD, and the use of care services (N = 551). 19.0 % were rated as having problems in the autism spectrum, 16.7 % as having slight problems, and 64.3 % as having no problems in the autism spectrum. Pupils with behavioral problems in the autism spectrum were considered to be more affected by symptoms of depression, anxiety, compulsions and tics, among others. The values for functional impairment and distress were also significantly higher. Furthermore, children with elevated scores in the ASD spectrum receive significantly less psychotherapy and significantly more school support and speech therapy. Pupils with ASD symptoms make slightly more use of support services than other children, despite much higher levels of strain. There seems to be a gap in care that is relevant for the adaptation of conditions in schools and medical- and therapeutic services.

Efficacy of Home-Visiting Programs in Early Childhood. Results from a Systematic Review of the International Research Literature Early childhood home-visiting programs are tried and tested for families in need of support. Little is known about its efficacy in Germany due to a lack of research activity. The aim of a systematic review was to compile the international research literature on the efficacy of homevisiting programs. From a pre-selection of 215 studies, 5 meta-analyses, 11 systematic reviews, 39 experimental studies, and 18 non-controlled longitudinal studies were evaluated and presented in detail. As a result, home-visiting program approaches were found to be robustly efficacious in preventing child abuse and neglect, intimate partner violence, and promoting age-appropriate child development, safe home environments, and appropriate parenting behaviors. The effects on behavioral problems in children, the promotion of parent-child interaction as well as social support in parents are promising, thus direct (proximal) factors of parenting behaviors. In contrast, the findings on health in children and mothers are uncertain and contradictory. The findings were differentiated according to outcome criteria, and programs, weighted according to evidence, and impact-promoting aspects. In early childhood, selective and targeted home-visiting programs appear to be more efficacious than universal approaches. The relevance and transferability of the results to home-visiting programs in Germany are discussed.

Recommendations for Teachers How to Support Young People Coping with Climate Change Climate change poses a major threat to current and future generations. Even the indirect experience via media can trigger stress in young people. The social environment can strengthen young people's resilience to cope with climate change and their climate emotions. In the context of a qualitative interview study, six adolescents were asked about their climate emotions and coping strategies as well as about the influence of their social environment. Hereupon, recommendations for teachers to support their students in building appropriate coping strategies were developed. This article examines them in more detail. To conclude, teachers can support their students in coping with climate change by acting as positive role models, educating about climate change, providing opportunities for action, as well as validating their student ´s climate emotions and creating spaces for conversations.

Because the effects of climate change become increasingly evident, climate change related negative emotions like anxiety become more prominent, particularly among younger populations. This study introduces psychometric properties and validity of the German Climate Anxiety Scale for Adolescents (GCAS-A), a tool specifically designed to assess climate anxiety in Germanspeaking adolescents. Results of a sample of 136 adolescents (Mage = 18.21 years, SD = 2.92, range: 14 to 24 years, 66 % female) are presented. Confirmatory factor analysis supported a fourfactor structure (factors affective, behavioral, physiological and impairment). Further analyses revealed significant associations between climate anxiety, gender, age, pro-environmental behavior, and awareness of climate change, thus aligning with previous research. The findings suggest that the GCAS-A is a valid and internally consistent tool for assessing climate anxiety in adolescents. This study highlights the importance of investigating climate anxiety in adolescents. Future research should focus on exploring the generalizability and validity of the scale across more diverse samples and on analyses of direction of effects in longitudinal studies.

Child and Adolescent Health in the Context of Planetary Health Due to various physiological, developmental, and behavioral factors, children and adolescents are particularly affected by the health effects of the planetary crises (climate change, pollution, and loss of biodiversity). In particular, climate change affects child health and development through direct (e. g., heat) and indirect effects (e. g., mental health). Against this background, the concept of planetary health is particularly important, since it builds on the concept of nine planetary boundaries that are considered a safe operating space for human existence. Planetary health describes the relationships between human health with the natural, political, economic, and social systems of the earth, which form the basis for human health. As a result, an intact natural environment is a basic requirement for a healthy life for the population of our planet. This review shows how this concept can help to further develop prevention, health promotion and health care in order to ensure adaptation to the changing conditions ("adaptation") and at the same time to weaken climate change ("mitigation"). Applications in the field of teaching, patient training and community health are presented. In the future, climatesensitive health counseling in particular can play a role in the future to support the individual health and that of the planet ("co-benefits").

Evaluation of the Effects of Systemic Further Training of an Interdisciplinary Team in an Open Adolescent Psychiatric Acute Ward Staff in inpatient adolescent acute psychiatry face major challenges including assaults, elopements and treatment drop-outs among the youths. In the care team, insufficiently reflected splitting processes, lack of learning culture, problem and deficit orientation as well as insufficient self-efficacy strategies lead to high turnover and low job satisfaction. Additionally, there is dissatisfaction among youth, parents and referrers. This study examined the work situation of employees in an open adolescent psychiatric acute ward and established new treatment routines, at the interface between organizational development and treatment quality. The aim of this study from an evaluation perspective was to test if interdisciplinary team training in systemic theories and techniques improves job satisfaction. This is a non-randomized intervention study with a pre-post design including a control group. Job satisfaction questionnaires were distributed before, 6 months and 5 years after the training. Semi-structured interviews supplemented information on what has proven useful in clinical practice. The training led to measurable team climate improvements and cooperation intensification. Information sharing and usefulness of team goals increased. Systemic handover discussions and adolescents' regular active case discussion participation led to greater transparency and an appreciative communication culture, benefitting both job satisfaction and treatment success.

Level of Personality Functioning in Adolescence: Psychological and Biological Aspects in the Context of Diagnosis and Therapy Adolescence is a crucial developmental phase in which identity, interpersonal relationships, and emotional regulation are further shaped and consolidated. These processes build upon early attachment experiences. At the same time, there is an increased vulnerability to personality disorders (PD), which are influenced by genetic and environmental factors such as abuse, neglect, and insecure attachment patterns. These factors can trigger neurobiological changes, including dysregulation of the stress and attachment system, contributing to the development of PD. This paper considers the level of personality functioning (LPF) as a central concept in the diagnosis and treatment of personality disorders. While traditional diagnostic systems (DSM-IV, ICD-10) have been criticized for their rigid categorization, recent approaches show a growing shift towards dimensional models. In DSM-5, categorical diagnosis for PD remains, complemented by the alternative dimensional model (AMPD) in the appendix. The ICD-11 has introduced a dimensional model for PD diagnosis for the first time. This allows for a more differentiated assessment of core psychological functions (identity, self-regulation, empathy, intimacy), leading to more precise diagnostics. A particular focus is placed on psychodynamic therapeutic approaches such as Transference-Focused Psychotherapy (TFP) and Mentalization-Based Therapy (MBT), which have proven to be particularly effective for young individuals with traumatic experiences. Studies indicate that these approaches positively influence psychological and neurobiological mechanisms. Future research on dimensional models, appropriate diagnostic tools, and therapeutic interventions is essential to identify impairments in LPF early, reduce stigma, and further develop personalized treatment strategies.

Attachment, Personality Disorders and Depression in Adolescence Depressive disorders are particularly common in child and adolescent psychiatric settings. There are high comorbidity rates, however, research on comorbid personality disorders in adolescent age groups remains limited. Attachment-related dynamics play a significant role in the development of both depression and personality disorders and they represent important indicators of therapeutic outcomes. The present study shows our latest findings on attachment patterns and personality pathology in an adolescent inpatient psychiatric sample with depression. More than half of the adolescents were classified with an unresolved attachment pattern, and one-third met the criteria for a personality disorder. Furthermore, young people with depression showed elevated levels of identity diffusion. Therapeutic approaches that address attachment- related aspects and personality pathology may offer an effective treatment option for adolescents with depression.

Attachment as Part of Personality Structure: A Comparison of Self- and Parent-Reports in Adolescents Summarywith Personality Disorder, Depression, and Anorexia Nervosa The present study examines attachment deficits as part of the personality structure in adolescents with personality disorders, depression, and anorexia nervosa using the OPD-CA2 Structure Questionnaire. The aim was to analyze systematic differences between the diagnostic groups and differences between self- and parent-reports and to identify potential discrepancies. The results show remarkable deficits in the dimension attachment of the OPDCA- 2 axis structure across all examined groups while adolescents with AN showed significantly lower impairment. Significant differences between self- and parent-perceptions were observed in depressed adolescents. The study emphasizes the relevance of assessing attachment related to personality structure for diagnostics and treatment planning in adolescent psychotherapy.