Family issues in child 

psychiatry practice

Dr Omar Almodayfer 
MD, FRCPC, ABAPDiplomat
Head of Mental Health 
Director of Family Therapy Program
KAMC-C
modayfero@ngha.med.sa

objectives

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To highlight the relationship between family 
issues and child psychiatry cases.

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To present real cases with such issues from 
the Saudi culture.

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To list some of the good questions which can 
help in such cases.

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To list some office based strategies to help in 
such cases.

In every child mental 

health issue there is a 

family issue

Which is which?

Child can cause a 

problem

A family can cause a problem

Also both react to 

each other

Maintenance of symptoms can 
be dual

Case 

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9 years old girl with moderate anxiety 
disorder.

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Marital life issue.

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Risk of divorce.

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Excessive abuse by father.

So 

Marital conflict can cause anxiety 
and also depression in children 

Case 

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9 yrs old.

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ADHD symptoms.

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Mother has cancer treated 2 yrs ago.

So 

Mother illness can cause anxiety 
in children and significant 
behavioral problems

Case 

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12 yrs old girl.

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Ideal child.

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Developed eating disorder symptoms.

So 

Ideal child is imposed by the 
family causing difficulties for 
children

Case 

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13 yrs old boy.

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Obese.

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Has decline in school performance and eats 
alooooooooot.

So 

Pathologizing a child cause him 
to have a pathology

Questioning 

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Take good family history.

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Do not relate the symptoms to family issues 
directly.

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Ask indirect questions.

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Parenting style.

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Open question:

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Tell me about ur self.

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Who fights the most?

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Who talk the most?

Interventions 

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Mother time off.

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Enabling parents to see the problem 
differently: redefining.

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Father 

– child shared time.

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Mother 

– child shared time.

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Endless advices.