小兒科與精神科之病人有共通點,即病人不會自動協力治療並且不會提供各種有關病症消,事必家屬要參與治療。醫師需具備操縱病人及家屬之技術,理解其心理動因而表示容納態度以增進病人對醫師之疏通,而利用病人之感情移行(trans-ference)豫物病人心身恢復。於治療上偶然難免用強制手段,但不可處罰或欺騙病人。 本文係以兩個child hysteria為例檢討身體疾病合併心理疾患兒童之心理治療。綜合之;(l)小兒科及精神科協同診斷及治療之原則,(2)小兒科醫師宜受心理治療技術訓練,(3)遊戲治療方法及原則,(4)精神科諮詢之意義,及(5)將來之共同研究計劃等。探求兒童之精神身體發展過程,疾病全般之形成次序與其家庭社會環境之關係為社會醫學之出發點。
The importance of psychiatric knowledge and technique has been stressed in the handling of emotionally disturbed children who often appear in the pediatric ward. Behavioral disorders in childhood have close relationship with family, particularly with parents, so that the application of interview technique and understanding of psychodynamism should be broadened to the surroundings of the child especially to his mother. The pediatrician has an extremely important role in handling and preventing emotional problems and symptoms of the child, hence he should be equipped with advanced psychiatric technique. In this paper, the authors illustrated two cases of child hysteria and discussed the following problems; 1) the priciple and practice of co-therapy by the pediatrician and psychiatrist, 2) importance of psychiatric training for the pediatric residents, 3) the principle and method of play therapy in the pediatric ward, 4) the meaning of psychiatric consultation and 5) the collaborate research on child development in our culture.
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