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The case of Ann: a sleep disturbance in a 3-year-old child
Insights
A 3-year-old girl's chronic sleep disturbance, linked to separation issues and unresolved grief, was successfully treated. The intervention untangled family relationships, resolving the sleep problem and family crisis.
Area of Science:
- Pediatrics
- Child Psychology
- Family Therapy
Background:
- A 3 1/2-year-old girl presented with chronic, severe sleep disturbance causing family crisis.
- A developmental interactional approach was employed for evaluation.
- The initial problem formulation identified a reciprocal separation issue between the child and mother.
Observation:
- A 2-month dynamic casework intervention focused on the behavioral problem.
- The casework revealed an underlying unresolved grief reaction in the child.
- The child's sleep disturbance was the primary presenting behavior.
Findings:
- The intervention successfully resolved the child's chronic sleep disturbance.
- The casework facilitated an untangling of the child's relationship with both parents.
- The resolution of grief was central to overcoming the sleep issue.
Implications:
- This case highlights the importance of addressing underlying emotional issues, such as grief, in pediatric behavioral problems.
- A multidisciplinary approach involving pediatricians and social workers can effectively manage complex child behavior and family dynamics.
- Early identification and intervention for separation issues and grief can prevent escalation into family crises.
Abstract:
Ann, a 3 1/2-year-old girl, was brought to a pediatric clinic for a chronic, severe sleep disturbance which had precipitated a serious family crisis. A developmental interactional approach was used by the pediatrician and a social worker who evaluated her case; the problem formulation included a reciprocal separation issue between Ann and her mother. Over a 2-month period, dynamic casework around the behavior problem revealed an unresolved grief reaction. Intervention resulted in resolution of the sleep disturbance and an untangling of the relationship between Ann and each of her parents.