Matejka Pintar Babič
Enota za intenzivno otroško in adolescentno psihiatrijo, Center za mentalno zdravje, Univerzitetna psihiatrična klinika Ljubljana, Ljubljana, Slovenija

Žiga Rosenstein
Enota za intenzivno otroško in adolescentno psihiatrijo, Center za mentalno zdravje, Univerzitetna psihiatrična klinika Ljubljana, Ljubljana, Slovenija

Maja Drobnič Radobuljac
Katedra za psihiatrijo, Medicinska fakulteta, Univerza v Ljubljani in Enota za intenzivno otroško in adolescentno psihiatrijo, Center za mentalno zdravje, Univerzitetna psihiatrična klinika Ljubljana, Ljubljana, Slovenija

Abstract

Children and adolescents often reject healthcare interven-tions due to various experiences, expectations, cognitive abilities and understanding of medical treatment. They may respond aggressively to different approaches from healthcare staff. The likelihood of an aggressive response is particularly high when a child or adolescent is in poor physical condition, frightened, under the influence of psychopathological experiences or psychoactive substances. Managing such situations poses a complex challenge for healthcare professionals, requiring an individualized and holistic approach. The goal of healthcare is to establish a safe environment. This ensures that the child or adolescent remains uninjured and it prevents worsening of the current mental state for which they were admitted. Safety is ensured through a series of concurrent nursing interventions. The facilities at the Unit for Intensive Child and Adolescent Psychiatry are therefore technically adapted. During treatment, staff employ de-escalation techniques to create a therapeutic environment, allowing children and adolescents to express distress in a safe manner. Predictive factor scales for the occurrence of auto or heteroaggressive behavior are also used. Following the doctor's instructions, medications are administered in cases of escalating aggressive behavior, and/or in extreme cases, a specific protective measure is implemented in accordance with legal standards and nursing protocols.

Key words: child and adolescent, psychiatric health care, aggression, de-escalation techniques, physical disability.