Risk Factors

Client could have a serious medical condition, yet she is not consulting a doctor.

Does client have an eating disorder?

Client could be over-medicating herself with vitamins and homeopathic medicines.

Is boyfriend a threat to client?

Other Issues

Stress from recent break-up.

Past history may include physical and/or sexual abuse:

-- Boyfriend/girlfriend relationship ("can't talk about the reasons").

-- Parent/child relationship ("blank-outs").

-- Doctor/patient relationship (mistrust of doctors).

Does client have a support system?

Possible Diagnoses

Mental disorder due to medical condition.

Fictitious disorder; somatization disorder.

Posttraumatic stress disorder.

Substance abuse/dependence; substance intoxication. (In this case with vitamins and homeopathic medicines.)

Risk Factors

Possible domestic violence.

Possible child abuse/neglect.

Possible physical illness causing child's toileting problems.

Other Issues

Numerous stresses during past year.

Lack of adequate financial resources.

Both parents may have poor coping skills from childhood.

Does family have adequate social supports?

Possible Diagnoses

Varies by family member:

          Child -- Encopresis and/or enuresis; sibling relational problem.

          Wife -- Bereavement; major depressive disorder.

          Husband -- Adjustment disorder; occupational problem.