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The Child Oriented FamilyTherapy (COF) is a new therapeutic method aiming towards infants in the playing age group and their families. COF is - originally invented in Scandinavia - spreading over Germany since the beginning of the 21st century. The prevalence for psychiatric disorders in toddlers, preschoolers and young infants in Germany lies between 14 and 22 %. Treatment in an outpatients' clinic with partial hospitalization is indicated whenever the psychosocial resources are too low or the symptoms are too severe to be treated in an ambulant environment. The outpatients' department for pediatric psychiatry in Gelsenkirchen is the first institution in its field to use COF as one module to treat their young patients and their families. Due to the setting adjustments of the original method are necessary, for example a conceptualization of disease, the use of COF as a diagnostic method and the embedding of COF in an underlying treatment plan.

Hans Heinze and the Research Programme of the German Association of Child Psychiatry and Therapeutic Education 1942-1945 Upon its foundation in 1940, Paul Schröder, full professor for psychiatry in Leipzig, was the first president of the German Society for Child Psychiatry and Therapeutic Education (DGKH). Following his death in 1941, his student Hans Heinze (Brandenburg/H.) succeeded him, prevailing over Werner Villinger (Breslau). The principal task of the DGKH was considered to be the exploration of the genetic origins of intellectual disabilities and behavioural disorders among children and adolescents. Based on their research since the 1920s, Schröder and Heinze believed that genetically predisposed, i. e. hereditary, character structures were aetiological for behavioural deviations among minors. It was their opinion that, based on the characterology they had established, development capabilities of children, as well as their "value" for the community, could be reliably predicted. In order to spare the community fruitless expenditures, they suggested that pedagogical stimulation was to be diminished in cases that reached the "hereditary boundaries of education". This assessment of a hereditary and hence unswayable inferiority was contested by the "Berlin School", represented by psychiatrist Franz Kramer and social pedagogue Ruth von der Leyen. They argued that while the possibility of "brutal-egoistical behaviour" existed, given the hereditary predisposition, it could however be successfully counteracted by pedagogic-therapeutic measures. After 1933, this faction controversy within the institutionally emerging child and adolescent psychiatry was decided in favour of the "Leipzig School", which was conform to the system and ideology of the time.

Coercive Measures in Child and Adolescent Psychiatry in Post-war Germany, Using the Example of the "Pflege- und Beobachtungsstation" in the State Psychiatric Hospital Weissenau (1951-1966) The patient admissions at the children's ward of the State Psychiatric Hospital Weissenau in the years 1951, 1956, 1961 and 1966 were analyzed regarding documented coercive measures. Shortage of staff, mainly inadequately skilled personnel, a mixing of age groups in the patient cohort, neurological and psychiatric disorders and of patients who were in need of nursing and of those who needed treatment constituted the general work environment. Coercive measures against patients, mostly disproportionate isolations, were a constant part of daily life on the ward. This affected in particular patients who had to stay longer at the hospital and whose stay was financed by public authority. The uselessness of such measures was known, which can be seen e. g. in the Caretaker's Handbook of that time and the comments in the patient files. The situation still escalated in some cases (for example by transfer to an adult ward). For a long time, coercive measures against patients were part of everyday life at the children's ward of the Weissenau; the actual figures are suspected to be much higher.

Gene-environment-interaction of ODD and Conduct Disorder Versus »Anethic Psychopathy«. In 1934, Kramer and von der Leyen demonstrated in a sophisticated longitudinal study with eleven conduct disordered and neglected children labelled as »anethic psychopaths« that »anethic traits« subsided in a favourable educational setting. Sound prognoses, due to the diversity of environmental factors, were found to be impossible. On the contrary they stated that negative labelling led to an affirmation of a negative prognosis. In theory, they supposed a genetic predisposition resulting in a heightened sensitivity to the environment. This early theory of epigenetics radically contradicted the Nazi dogma of hereditability and ostracism and the selection procedures in mainstream psychiatry at that time. The debate ended with von der Leyen's suicide and the prohibition of medical work and publication towards Kramer. Even after the end of the Nazi policy of »eradication of the socially debased«, this early theory was not taken on again, nor dignified.

The evolution of professional child psychiatry partly took place against a historically difficult background: the National Socialism. Physicians who shaped the profession scientifically were at the same time offenders in forced sterilisation and euthanasia. Substanciated understanding of the professional history implies a differenciated examination of relevant biographies. The careers of Werner Villinger and Hans Heinze are being outlined and related to the historical context. A distinct and satisfactory understanding has not taken place during postwar period in Germany. However, in the meantime there has grown an awareness and also a consternation about the incidents due to research and publications.

The article shows, through a study of the Berlin-Brandenburg region, that children and juveniles who were subjected to the killings of diseased and disabled, or mentally retarded persons during the Third Reich did not only fall victim to the operations of the "Reichsausschuss" ("Reich Commission for Registration of Severe Disorders in Childhood"). Many were also included in the gas chamber killings of the "T4"-action and in various decentralized killing actions. To gain scientific knowledge, the brains of many of these patients were examined by German neuropathologists. It will be shown that the purpose of the killings was not the painless ending of individual suffering, but that they constituted a means of freeing the public from so-called "ballast existences", whose lives were only prolonged if they could be of scientific use.

During the period of national socialism in Loben/Lublinitz (Silesia) existed a children's special department, where many disabled and mentally retarded children were killed. This was happened under participation of the physician Elisabeth Hecker, who was one of the pioneer's of child and adolescent psychiatry in Germany. During the Second World War she was director of the Loben's clinic for adolescent psychiatry--one of the first of its sort and situated directly in the neighbourhood of the children's special department. Hecker announced children with negative ratings to the "Reich Committee for the Scientific Registration of Severe Genetically and Constitutionally Determined Diseases" in Berlin and transferred them to the children's special department in Loben. In 1979 the German Association of Child and Adolescent Psychiatry appointed Hecker as a honorary member for her commitment after the war. This honorary membership has been discussed critically because of her activities during the period of national socialism. The following paper analyses Hecker's involvement to the child "euthanasia" program based on unnoticed archival sources.

Starting from race hygienic and eugenic ideas at the end of 19th and at the beginning of the 20th century the development and the execution of the "euthanasia of children" by the Nazis is described. Particularly the carrying out of the killing action is so-called "special children's departments" is dealt with in detail by the use of available investigations. Finally questions about the perpetrator profile and regarding the significance of ethical principles in child and adolescent psychiatry are raised.

Hans Heinze was one of the three experts on child euthanasia in the "Reichsausschuss zur wissenschaftlichen Erfassung erb- und anlagebedingter schwerer Leiden" and head of the first "Kinderfachabteilung" in Brandenburg-Görden, Germany. He was one of the experts in the euthanasia "Aktion T4". He became nominated president of the "Deutsche Gesellschaft für Kinderpsychiatrie und Heilpädagogik" after Paul Schröder who died in 1941. The documents about his function exist in five German archives.

During the period of National Socialism in Germany, many "asocial", mentally retarded or disabled minors were persecuted. Several measures had been discussed theoretically before, but the National Socialists put the theoretical proposals into practice. As a result children and adolescents were separated, sterilized or killed. In concentration camps so-called "depraved" minors were selected to get special education. The object of this effort was to adapt minors to the ideology of national socialism. After passing the law to sterilize patients with "hereditary diseases" in 1933 about 375.000 people were sterilized unvoluntarily. In 1939 sterilizations came to an end except for adolescents at "high risk of reproduction". During the second world war more than 160.000 adult psychiatric patients were murdered. In addition to that, also a large number of disabled and mentally retarded minors were killed. This campaign was called child "euthanasia". Physicians tried to determine children's "value of life" by economic criteria. Children with negative ratings (i.e. inability to work or insufficient mental maturing) were killed by fasting "cures" or by barbiturates. Beyond that children were also used as research subjects. Their death was an accepted consequence. Physicians were also very interested in brain research. Finally, the relation to German child and adolescent psychiatry will be analysed. In the special political and social context of the Third Reich the German child and adolescent psychiatry became more significant. As a result of this the German association of child and adolescent psychiatry and allied professions was founded 1940 in Vienna. On this conference, some speakers suggested to persecute "asocial" minors. This suggestion was realized consequently. Up to now, the role of the German child and adolescent psychiatry has not been thoroughly discussed.

Focus of this paper is a description of "child euthanasia" during National Socialism 1939-1945 in the "specialized children's department" of the Ansbach state hospital. The historical and ideological bases for euthanasia and the development of child and adolescent psychiatry are explained. Material was found in public archives and trial records of German courts. 156 case histories of children who were killed in the Ansbach state hospital were evaluated. Child euthanasia in Ansbach was done in the same stereotyped way as in other specialized children's departments. The 156 children were aged between one week and 16 years. 39 children died within the first three months, 31 children died within three to six months in hospital. Most children were autopsied, at least 86 brains were examined neuropathologically. The trials against the involved physicians were quashed finally in 1968.

The notions hitherto existing of the beginnings of child analysis have to be rectified. The meaning of childhood neuroses within the scope of scientific theory, i.e. the sexual genesis of the neuroses can no longer be maintained. The approach of distinguishing between the latent period and the Oedipus complex as the two phases of sexual development can nowadays be considered to be refuted. The personality of the first children's analyst--Hermine Hug-Hellmuth--needs to be redescribed. She fell victim to her father-transference and deceased murdered by her nephew with the help of whom she had satisfied her own scientific ambitions.

Child and juvenile psychiatry first came to be regarded as an independent clinical field after the second world war. Up to that time, research had been concerned with confirming the findings of adult psychiatry among children and juveniles. From the time of Kraepelin, adult psychiatry had made an effort to establish an immediate relationship between pathological anatomical findings and psychopathology based on close observation of the individual. In contrast to this were efforts to overcome subjectivity by using statistics or by defining "types" (Kretschmer), which led to the concept of syndromes. In the field of child and juvenile psychiatry, this doctrine brought to the fore the study of the consequences of low-level brain damage during early childhood in the 1950's. In research in both adult and child and juveniles psychiatry there is a constant alternation between a more organic and a more psychically oriented approach to observation. But there is a fundamental limit to any effort to objectify psychic phenomena, one that is mirrored in microphysics and related borderline areas. Individual case study and statistical, mathematical methods must be used to supplement one another. One main area for future research in child and juvenile psychiatry relates to the application of the insights of developmental psychology to general psychopathology and how to integrate related fields from the social sciences. Child and juvenile psychiatry cannot be limited to "psychiatry" in the narrower sense of the term, either in clinical practice or in research.