They then react with extreme aggressive behavior toward others, and in some instances they may already have been suspended from nursery school and later from classrooms. Sometimes they have even been expelled from school altogether. Other children may present problems in a group because they show signs of serious depression and anxiety, or because they dissociate.

In milieu therapy, an established structure is important at a variety of levels, because it provides the children and those who work with them a safe and protected environment. In addition, it guarantees that everyday life on the unit functions smoothly, and it enables all who are involved to manage crisis situations. Multidisciplinary cooperation is especially important in crises. The professional personnel must be supported by colleagues at all levels. Intensive information exchange about, but also with, the patients is critical to developing individually tailored strategies on the unit. Coregulation and intensive one-on-one contact help to overcome an acute crisis and make it possible for the child to return to the group. The children then come to experience the group not as a place of threat; rather, they internalize the group experience as a support and the community in the group as an additional source of emotional security. This process will be demonstrated in this presentation based on a variety of examples.