Patientenorientierte Medizin bei Flüchtlingskindern

Among refugees applying for asylum in Germany are increasingly more young children. That poses challenges in health care provision, especially concerning treatment of trauma-related disorders. In this article, we outline the diagnostic criteria for posttraumatic stress disorder (PTSD) and describe why especially young children are at high risk for long-term psychiatric disturbances after potentially traumatic experiences in the course of relocation. Considering that the primary developmental pathology of traumatized children is the dysregulation of emotional states when confronted by a stressor, the behavioral problems called »survival states« are understood both as a result of a child's dysregulation, as well as the inadequate capacity of their social environment to provide support. Therefore, we recommend a systemic treatment shifting the focus from the individual or families to a more public health approach by providing care and safety in childcare and early education environment soon after arrival in Germany. We report our experiences with low-threshold psycho-educative parents' college and cultureand traumasensitive childcare, which are prerequisites for further stressor-based psychotherapeutical treatments. The components of these approaches can be combined to offer individualized medical treatment for children with refugee background.