[Assistance extended to patients with poor prognosis and their families--a lesson in role playing].
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The results of two psychological experiments (WURST 1976a,b) with a group of ASPERGER autists and KANNER autists and a parallel group considering age and intelligence show, that neither the belief, autism appears as a possible consequence of a psychoorganic syndrom nor the assumption that autistic behaviour is caused by a perception defect, can be proved with testpsychological methods. However, it seems, that KANNERS point of view, referring to autism as an inborn disturbance of the emotional contact influenced also by negative environment comes closest to the problem.
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The child life therapist utilizes play techniques with hospitalized children for preparation and integration before and after medical procedures and surgery. Unstructured and structured play sessions enable children to anticipate threatening events and mobilize their coping behaviors. Through manipulating appropriate play materials including miniature-size medical equipment, children communicate if facts of preparation have been understood, misinterpreted or denied. Concrete play experiences (e.g., doctor puppet play), enable children to understand hospital routines and sequences of events. Sensory experiences (e.g., needle play), help them dramatize situations and to adopt changes of role from passive to active ones. Opportunities for play after procedures (particularly intrusive ones) and surgery must be made available to clarify any misconceptions and to emphasize the nurturing and healing aspects of treatment. Psychological preparation for necessary procedures and surgery through play results in children enduring and cooperating more readily and have more trust in all medical personnel.
A new method of psychotherapy, imagotherapy, is offered. This method consists in restoring the capacity of many neurotic and psychotic patients to enter into an image adequate tao a given situation. Training of this capacity is of a substantial importance for rehabilitation treatment. The treatment forms are: story telling by the patient in a group, a fixed dialogue, an improvised dialogue, a combination of story telling with a dialogue, dramatization of a story. The conclusive stage of the imagotherapeutic process is conducted in a therapeutic theatrical studio. The therapeutic mechanism of the imagotherapy is based on activation of the second signal system, the regulating influence of which on the higher psychic activity is disclosed chiefly by Soviet neurologists and psychologists.
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