[Distance and closeness in the doctor-patient relationship among child and adolescent psychiatrists].

BACKGROUND

The therapeutic relationship is an important predictor of the effectiveness of psychotherapy. Within this relationship, the balance between distance and closeness plays a crucial role. However, within child psychiatry, little is known about the conceptual scope and clinical interpretation of these concepts.

AIM: To investigate how child and adolescent psychiatrists, in their contact with minors, give meaning to distance and closeness in the therapeutic relationship and what considerations they make in clinical practice.

METHOD: In this qualitative study, semi-structured interviews with ten child psychiatrists explored various perspectives that describe the experience of distance and closeness in clinical practice. Thematic analysis identified meaningful patterns and themes from the interviews.

RESULTS

The following themes emerge: 1. Space, time and availability as regulators of distance and closeness; 2. Physical contact: the tension between providing good care and maintaining professional boundaries; 3. Emotional involvement as a source of professional tension; 4. Personal and professional identity in the therapeutic relationship; 5. The doctor as a human being; 6. Professional role and clinical assignment as a framework for establishing distance and closeness.

CONCLUSION

Distance and closeness take shape in various ways in the therapeutic relationship with children and adolescents. Child psychiatrists seek an appropriate balance in their own way. This article offers an initial thematic framework to support further dialogue and research.