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 To highlight the relationship between family issues and child psychiatry cases. To present real cases with such issues from the Saudi culture. To list some of the good questions which can help in such cases. 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 9 years old girl with moderate anxiety disorder. Marital life issue. Risk of divorce. Excessive abuse by father. So Marital conflict can cause anxiety and also depression in children Case 9 yrs old. ADHD symptoms. Mother has cancer treated 2 yrs ago. So Mother illness can cause anxiety in children and significant behavioral problems Case 12 yrs old girl. Ideal child. Developed eating disorder symptoms. So Ideal child is imposed by the family causing difficulties for children Case 13 yrs old boy. Obese. Has decline in school performance and eats alooooooooot. So Pathologizing a child cause him to have a pathology Questioning Take good family history. Do not relate the symptoms to family issues directly. Ask indirect questions. Parenting style. Open question: Tell me about ur self. Who fights the most? Who talk the most? Interventions Mother time off. Enabling parents to see the problem differently: redefining. Father child shared time. Mother child shared time. Endless advices.