"Families are often targeted by the authorities for trivial matters - such as parenting styles, school problems or incomplete
documents - while serious cases of violence and abuse in homes, residential groups or other
institutional contexts are not consistently prosecuted."
Prof. Dr. Uwe Tewes is a qualified psychologist and was head of the Department of Medical
Psychology at Hanover Medical School for many years.
He is also a forensic expert in family and criminal law proceedings and a mediator for family courts.
Through his work as a court-appointed expert witness and in criminal proceedings involving children as victims of
violence, he has an insight into the whole subject and accurately and extensively highlights the abuses.
What about the proportionality of the measures?
Is the cost-benefit factor correctly weighed up for this serious intervention in the family?
The negative effects, such as stress or attachment disorders, which should not actually be greater
than the expected benefits, are also highlighted.
Prof. Dr. Uwe Tewes sheds light on all of this and more in his lecture: "Psychological stress and consequential
health damage in children after being taken into care."
We would like to thank Axion Resist for making this important lecture available, which was recorded as part of
their congress on the topic of "What does state protection for families look like in reality?" was recorded.
Help us, dear viewers, and spread the word about this program.
Dear Mr. Christidis and Mrs. Christidis, we have known each other for quite a while.
Thank you very much for your kind words. A small correction:
I didn't study medicine, I had a chair in medical psychology, but I am a psychologist by profession.
I can say little from my own expertise about what you have reported here in the introduction.
But the common background - and you are absolutely right - is the problem of secondary
child endangerment and state child endangerment.
In other words, the problems that are created for the children who should actually be helped are created
by those who pretend to want to help these children.
I say that completely impartially. And I also see my task now as initially providing a brief overview of the scenario as far as
the children are concerned, not so much the parents in this case, although that has of course always been my professional concern.
Why can I allow myself to talk about it?
This is due to the relevant professional experience I have had.
I worked in psychiatry, clinical psychology and finally also in medical psychology for most of the
years - mainly at the Medical University in Hanover.
That was full-time, part-time, as I said, as a forensic expert, then also as a lecturer in statutory
training for children and adolescents and psychotherapists.
Also in the further training of specialists in family law, in particular judges, lawyers, experts and youth welfare services.
It has always been important to me to bring the various specialist disciplines together.
And we have also held some events that went very well, in which all parties, all political groups were involved.
The subject-specific expertise, as I said, as a court-appointed expert witness for a - specifically for this subject, I
meant to say - expert witness in child custody cases and in criminal proceedings involving child victims of violence.
Then in counseling parents and children in cases of domestic violence. We had a counseling center at our institute.
In advising foster care facilities on how to make the conditions there child-friendly and in training professionals
on issues relating to secondary child endangerment.
What can they do to avoid this?
They are often not even aware of what they are doing there in detail.
The challenge when the question arises as to the necessity of taking a child into care due to a risk to the
child's welfare is that professionals from the following areas usually have to work together to find solutions:
On the one hand, there are specialists from the family court system, i.e. judges, the public prosecutor's office and the
police, the administrative courts and child protection, i.e. the youth welfare offices and the health system,
for example forensic medicine or psychological assessment.
It's a very diverse spectrum and they don't have much in the way of joint training.
There is also little common literature for these groups.
The core problem I am concerned with here is that the measures taken by the help system always create
additional, i.e. secondary, burdens for the children affected.
I am referring in particular to the stress caused by measures that often have to be implemented under
difficult circumstances and which can be a traumatizing experience for the children concerned.
This does not have to be the case in every instance. But it can be.
What is always associated with this is the breakdown of bonds and relationships, which can have a particularly negative impact on
the further development of these children and the ongoing anxiety and insecurity of the
children with regard to their future expectations.
That's not all, but there are a few highlights.
When you have to or want to weigh up such different things against each other, you are always faced with the
dilemma of having to assess different risks and relate them to each other, which are not independent of each other.
For every measure, it must first be considered whether the hoped-for benefit is in reasonable proportion to the
consequential burdens that are always associated with it.
If children then react conspicuously under these circumstances, it is often difficult to identify and substantiate
the actual causes of the children's conspicuous behavior.
And if these consequential burdens become too great, then we also speak of a secondary risk to the child's welfare
due to incorrect action on the part of the support system.
Let's first take a look at the target group we're talking about here. What kind of children are they?
In 2024, around 40,000 children and young people were taken into care in Germany due to child endangerment.
In addition, the help system responsible for this was challenged by around 30,000 unaccompanied arrivals of underage migrants.
That's perfectly reasonable, I'm not being critical, but it's something that has to be taken into account.
According to the Federal Statistical Office, 215,000 children were living in residential or foster care in 2023.
What is psychologically important, however, is that around half to two thirds of the children in this target group
are acutely, and in some cases chronically, affected by severe psychological problems into adulthood.
The rules of the game, according to which the actions are structured in this helper system, are laid down by law.
First of all, there are the constitutionally prescribed fundamental rights positions with
different rights and obligations of the actors involved.
First of all, the fundamental right of children to be raised and cared for by their parents.
That's the way it is, you can't negotiate about it.
Then the parents' right to their children, because according to the Constitutional Court, it is generally in
the best interests of the child if children live with their parents and not with strangers.
And finally, thirdly, the state's duty to protect children and also to ensure that failing
parents are encouraged to fulfill their duties.
The legal requirements for taking children into care are also actually quite transparent.
There's not much to discuss.
First of all, it must be clear that there is a sustainable risk.
This means that significant damage must exist or be reasonably likely to occur.
Furthermore, the measure must be proportionate.
This means that there must be no possibility of intervention by milder means, for example
outpatient measures or transfer to relatives.
And finally, the costs and benefits must be weighed up.
This means that the potential for negative effects such as stress and attachment disorders must
not outweigh the expected or hoped-for benefits.
And finally, and this is always overlooked, this measure must be necessary in the specific
individual case. And it must also be suitable.
These are legal terms, not psychological ones.
These are also operationalized in case law.
It is also overlooked where the burden of proof lies in such cases.
The burden of proof for the necessity of taking a child into care lies with the youth welfare office or the family court.
According to the Federal Constitutional Court, the authorities may not require parents to
provide positive proof of their parenting skills.
I don't want to get lost in specific examples right now.
You nod that this is rarely the case in everyday court life, I don't need to emphasize that here.
And finally, according to the Federal Constitutional Court, the state may not substitute its own ideas of
suitable child-rearing for parental responsibility.
Sometimes you are amazed to read the court decisions that are made.
But these are legal requirements, it's not something I made up or some psychologists in their ivory tower.
The Federal Constitutional Court summarizes this by saying that parents and their socio-economic living
conditions are part of a child's fate and life risk.
However, such measures are always associated with decision-making risks.
And these risks naturally also encourage regulatory failure.
Let me explain two types of failure by way of example.
I don't want to discuss this too deeply now.
On the one hand, interventions that would actually have been urgently needed have been avoided.
That is what always generates a lot of resonance in the press.
Hamburg 2005: Seven-year-old Jessica starves to death at home, despite repeated reports of neglect from third parties.
2007 Darry, Schleswig-Holstein: Five children died because the authorities did not follow up on information
from third parties about the mother's mental illness.
2012 Hamburg: The girl Claudia Chantal died of an overdose of methadone after years of ignoring information from third parties.
In the Black Forest in 2015: Three-year-old Alessio died because the authorities ignored medical reports of mistreatment.
Just a personal comment. So these are also my own experiences, which I will never get rid of for the rest
of my life, and which were on my mind again tonight.
Where were you a witness, part of this system that could not prevent it?
Because even if you are involved, you have no authority as an expert to act.
And these are deaths, and in some cases under certain circumstances - that's just the tip of the iceberg.
I could tell you about it for hours. But let's leave it at that for now.
You can also discuss this. I don't want to go into it in depth here.
Then, of course, there is also a failure on the part of the authorities when it comes to frivolous, premature
interventions that lead to irreversible damage to the children.
I'll limit myself here to an example that you probably all know.
The so-called Worms abuse scandal in the 1990s also caused quite a stir in the press.
Most people will know what is meant by this, in which numerous children were taken into care on the basis of false statements
made by an unqualified daycare center employee, a self-appointed expert, and the court proceedings then dragged on for years.
That also drives you to despair. You get a case on the table.
Yes, how is it that the child is now in the home, in appalling circumstances?
Yes, because a teacher once called the youth welfare office for whatever reason, nothing dramatic, and the youth welfare office
employee, instead of turning to professional support, for example to child and adolescent psychiatry, simply called a
self-appointed counseling center, what do you do in such cases?
Yes, we always recommend taking the child into care.
And then facts are created that can hardly be resolved and that have become entrenched.
Let's take a quick look at other gray areas that increase the risk of misjudgments.
In recent years, there has been an increasing focus on emotional child endangerment due to emotional abuse.
I don't want to deny that children can also be mentally abused or psychologically mistreated. That's not the point at all.
But the more difficult ones in this field are really poorly defined.
There is enormous discretionary scope for all professional players involved to interpret this as they see fit.
And the legal certainty of the children and parents concerned is almost zero in this area in particular.
This usually leads to an inflationary use of psychiatric diagnoses for children and parents by
professionals who have no diagnostic competence at all.
A youth worker who once did a weekend training course said.
She gave the mother a diagnosis, histrionic personality disorder and so on.
If necessary, a medical opinion is then obtained from a psychiatrist who is not familiar with forensics.
Simply asked and she talks to the woman for fifteen minutes and confirms a diagnosis for the sake of the youth
welfare office, which normally can and may only be made.
Not at all today, but it can and should still be asked if you have spent months getting to grips with this personality.
Then there is the lack of expertise to expertly review such references. That's what I just anticipated.
And finally, there is also the assertion of interpretative sovereignty by self-appointed experts and lobby groups.
That's a broad field. Perhaps we'll come back to it.
To what end, I'll say it anecdotally, where does such a pathologization of the people involved lead?
This leads, for example, to children who reject a parent being diagnosed with parental alienation
syndrome even if they have good reasons for this rejection.
Or that children who have a particularly close and high-quality relationship with a parent are then labeled as parentified.
It's quite difficult, especially for some mothers, to find a sensible balance.
And that there is too much love, too much love, even from one's own mother, has only become clear to me in my
old age in recent years. I mean that ironically, sorry.
Or mothers and fathers who might be colloquially referred to as helicopter parents,
which is not so nice for these children either.
But just because these parents are very concerned about their children's health, they are
suddenly diagnosed with Munchausen-by-proxy syndrome.
You have to take the children into care.
What must also be taken into account in such cases is the vulnerability of the children concerned.
I said that earlier, they are not just any children.
The risk group is heavily burdened by possible previous damage, which was not always caused by the parents.
But there are epidemiological studies on children, on neglected or abused children.
The following disorders are then frequently observed:
Anxiety, depression, aggressive-dissocial disorders, hyperkinetic disorders such as ADHD, attachment disorders, post-traumatic
stress disorders, self-harming behavior, suicidal tendencies, substance abuse or psychosomatic complaints such as
sleep disorders and increased pain perception, for example.
The frequency is 50 to 75 percent of these children.
The diagnostic dilemma, however, is that each of these disorders can also have completely different causes.
This is not proof of mistreatment.
The disorder may also have been triggered or exacerbated by separation from the family, for example.
This disorder often disappears after a year or two after being taken into care.
And then everyone says, aha, it's good that we've taken the child into care.
No, because this disorder after being taken into care is not proof of an experience of maltreatment, because
such symptoms often lead to spontaneous remissions even if they have not been caused by maltreatment.
Let's take a brief look at the actual objective stress factors involved in custody.
So the conditions are predominantly, or almost always, traumatizing.
The acute measures in each case.
Some of the children are picked up from school by the police or suddenly strangers stand in
the doorway and say, we're taking you away now.
Furthermore, there is always a separation. And a separation always leads to subsequent disturbances.
Even if the children suffer from their parents, it must be taken into account that separation
from these parents can lead to separation disorders.
This must be clearly separated and evaluated separately.
After the separation, there is usually a lack of sufficient relationship and bonding opportunities for the
children. This means that they fall into a deep hole.
Then inadequate medical or therapeutic care.
Harmful environmental influences from other children in the institution are often overlooked, as the
children who are to be protected from the environment of origin then end up in this environment.
Or through stigmatization at school, for example, you're a home child or something, the role assignment.
There are also a number of concomitant disorders for these subsequent psychological reactions.
Broadly speaking, these are mainly adjustment disorders.
According to the diagnostic manual, adjustment disorders are now understood to be acute disorders
caused by stressful life events or drastic life changes.
Typical symptoms of such subsequent reactions are fears, anxiety, feelings of helplessness, disorders of social behavior, dissocial
behavior, aggressiveness, grief reactions up to hospitalism, regressive behavior, thumb sucking, bedwetting, baby talk.
A second collective term for typical subsequent reactions is trauma-related disorders.
Many of these children are also traumatized by the measure.
Trauma sequelae are reactions to extraordinary threats experienced by the child as catastrophic, which lead to profound despair.
Typical symptoms are intense experiences of fear, helplessness and horror, which are often
associated with agitated behavior in the children.
This behavior is then again blamed on the parents as culpable failure, although it was caused by the measure.
I have often noticed this during the assessment.
It is difficult to make this clear to the youth welfare office or the help system in general, or even to the court.
What do these vulnerable children need? They need a well-organized emergency response.
This is not to be denied.
They need a trusting relationship with a reliable caregiver after being taken into care.
And they need a life perspective that meets their personal needs and abilities.
Whenever I have been involved in these cases, I have always visited them on site, in the foster families,
in the care facilities. I also advised such facilities.
There are certainly good institutions that are not resistant to advice and want to work on themselves.
But I have gotten to know circumstances. I also know milieus from the parental areas that are sometimes frightening.
But what I got to know in homes would be worth a book of its own.
And then, of course, to clarify the planned duration of the measure as quickly as possible and to ensure that
the necessary therapeutic measures are taken promptly.
Just a few years ago, three children had been taken into care. The reasons were silly.
I then visited them in a home and all three of these children had a hereditary medical disorder.
They had been taken away because the parents did too little to counteract this.
In the three years, they say we are still trying, nothing has happened.
I would like to briefly break it down like this.
There are two sources of deficient action.
One is systematic errors that the individual areas involved generate due to their particular working conditions.
And the second part, the second area, are systemic errors.
This means that if they also work together to look for solutions, things can become even more complicated.
Let's stick to the subject-specific deficits for a moment.
In the case of the courts, that is of course now very summarized and very simplified, but essentially it is true in this episode.
The deficits in the courts are often that the constitutional requirements for risk assessment are insufficiently
taken into account or that they are misinterpreted.
And that the responsibility for the legal normative assessment of the individual case, which only lawyers, i.e. only courts,
are allowed to carry out, is then gladly delegated to others.
For example, to the youth welfare office or to psychological experts who cannot and are not allowed to do this.
But the court then takes over their legal assessment.
Then with youth welfare offices, which claim unilateral sovereignty of interpretation for themselves.
Who know exactly what is best. And they don't let you talk to them about it.
And who, in connection with the allocation of children to care facilities, do not primarily have the needs of the children in
mind, but often also the business interests of the providers.
A topic all of its own. Of course.
There are children who are paid 30,000 euros a month.
And they change facilities every six months.
Then there are guardians ad litem. Procedural advisors - you know what they are, I don't need to
explain - come from different professional groups.
And therefore also have different points of view.
However, their assessments of parental parenting skills and support competence often lack factual justification.
Instead of relying on verified facts, they then rely on subjective opinions.
Whereby occasionally irrelevant considerations also play a role.
For example, the desire to sanction parental misconduct.
And some of the judges delegate a lot of responsibility.
At a congress I once held, a judge came arm in arm with a young lady and introduced her:
"And this is my guardian ad litem," he was supposed to give a lecture.
"I no longer do anything without my legal advisors."
I couldn't help but make the remark, which he then said in front of the audience.
"Oh, I thought it was always in the guardian ad litem, in the guardian of the child and not the judge."
It's not quite that simple, but essentially it hit a sore spot.
Experts, namely experts without professional experience, with such risk groups.
So we don't call that field competence.
This often leads to faulty diagnostics and incorrect risk assessments and prognoses.
Clients, i.e. youth welfare offices and courts, naturally prefer experts who are more inclined to confirm the
preconceived opinions of the help system retrospectively.
Whereby they limit themselves to rather superficial pseudo-tests and generally ignore contradictory results.
So this area in particular is a grateful one for people who would like to become expert witnesses but don't yet have any specialist
expertise because they also know that if they write after the mouth of judges or the youth
welfare office, they will get new assignments.
Then there are the child protection professionals who are not adequately trained to work with severely stressed
or even traumatized children and therefore do not understand at all what is going on in the children.
How to build a supportive relationship with them in order to either accompany them through the difficult
transition phase or, if necessary, how to prepare them for a return to their family of origin.
And finally, care facilities that focus on business interests and often allocate their places to children with whom
they themselves are overburdened due to special requirements.
As I said earlier, this often leads to paradoxical situations in which children with particularly severe impairments who are
removed from their families because the children have not made use of therapeutic help or have not received it
- it's not easy to find it - are then also left without therapeutic care in the foster home.
And finally, the weaknesses in the system.
So when ex officio investigations are carried out into the endangerment of a child's welfare, a wide-ranging support system
is activated, some of whose players are inadequately qualified and which is also susceptible to hidden consensus building
or battles for interpretative sovereignty, so that the further fate of the children concerned often resembles a lottery.
Children who need help are neglected.
Other children are overwhelmed or even traumatized without need.
Measures that were actually intended to ease the burden on children tend to become additional burdens.
I will come - I need another five minutes to summarize the essential points - to a summary.
First of all, there is the agonizing slowness of the procedures.
The current institutional and legal framework conditions are so inadequate that heavy additional burdens
on these vulnerable children can hardly be avoided.
After the children have been taken into care, there are often long delays in the decision and the start of support measures
because the processing by the youth welfare offices and the courts sometimes takes too much
time due to overload and a lack of resources.
Psychological experts then also need several months to carry out their assessment.
This often means that the children have to change foster homes several times: from the standby foster home
to a first foster home, which is then overwhelmed, then there is a second foster home.
This often leads to further delays, with additional burdens arising when criminal proceedings are also pending, criminal
proceedings against the parents or third parties, and the family courts then have to
await the outcome of the criminal investigation.
For older children, psychological evaluations may be necessary.
During this time, the professional helpers are not allowed to discuss the stress factors in detail with the children.
You get into trouble with the public prosecutor's office.
The opportunities for cooperation, they are also not allowed to have support discussions with the children during this time.
The opportunities for cooperation with the parents for sustainable planning of care and
support measures are then always very limited.
And if the suspicions against the parents later turn out to be unfounded, irreversible alienation may have already
occurred in the meantime, especially in the case of small children, as in the Worms abuse scandal, for example.
They didn't come home again, most of the children.
The second point is the overflowing helper system.
Several people and institutions with different qualifications are usually involved in clarifying the
question of necessary and suitable measures for the child.
In particular, the parents as affected parties in the proceedings with their parties to the proceedings. That is one party.
Then there are the courts, youth welfare offices, children's legal advisors, psychological experts,
family support and child protection specialists.
Delays can then arise due to differences of opinion, which often lead to a competition for interpretative sovereignty.
On the other hand, hidden consensus-building can often be observed, which is then implemented in the regulation, even in
those regulations that are oriented less towards the needs of the children than towards the advantages of the professional actors.
After all, you have to keep in mind that guardians ad litem, experts, care facilities, family
support, they all earn money from the proceedings.
Such dependencies then encourage the willingness to accept arrangements that do not
primarily serve the best interests of the child.
Meanwhile, reports in the media are piling up, pointing to failures in all areas, with substantial criticism of the
authorities, whose actionism occasionally seems less like care and more like paternalism, because staff are often poorly trained
and then fall back on the narratives of lobby groups or standard arguments in informal consensus-building, which no
longer do justice to the specifics of the individual case.
These are all fundamental decisions with text modules that you now know by heart if you read the explanatory memoranda.
Then we have insufficient consideration for the vulnerability of children.
For every child, being taken into care is associated with severe psychological stress and impairment.
Up to two thirds of these children already have a high level of stress and are
therefore particularly sensitive to these measures.
It should not be questioned that taking children into care may be necessary for their protection.
However, such measures are only justifiable if, on the one hand, the children can be provided with long-term safety and if it is
ensured that these measures meet the requirements that these special children place on their caregivers in individual cases.
Under the current conditions, the fate of these children is more of a lottery, because the results of such measures are not
very encouraging and the weaknesses of the system are obvious.
And in addition to or after the already heavy burdens in their previous environment, many of these children are then
additionally confronted with the shortcomings of a system that cannot fulfill its mandate to help in this form at all.
And last but not least, this has also been my field of work in medicine, my area of interest: quality management.
So you cannot expect quality awareness in these areas.
That is, judges say anyway, our quality benchmark is the appeal process.
They tell us when we've messed up, which of course is not usually expected in these areas.
In other words, a lack of quality awareness.
There is currently no sign of any great reform zeal in this area.
There is no quality control at all.
The big earners in this non-transparent business are inadequately qualified experts with unusually high incomes.
Hammer has extrapolated this and comes up with total expert costs of more than two billion euros
a year, not just for taking children into care.
I don't need to explain to you that this is not generated by a large number of individuals,
but is the result of very targeted lobbying.
Another cost factor is of course the care facilities, which are particularly interested in highly stressed children
because of the higher care rates and naturally keep these children with them for as long as possible.
They then also have their own psychologists, and they work in this institution and of course write what
is convenient for the interests of the institution.
And they also have little interest, if I may say so, in supporting these children's
contacts with their families of origin in any way.
Well, thank you for your attention and I wish you continued success.
Do you know of any cases of unlawful detention?
Then enter them at vetopedia.org/en/reception.
You will find the link below this program.