Less orthodox psychological interventions.

A large number of children present to paediatricians with psychological problems caused by the ordinary viscissitudes of development and of modern day family life, with its high rate of family breakdown and divorce. The paediatrician needs ways of intervening that can unlock or undo hold ups in successful treatment and ensure that the patient with abdominal pain, food refusal, or constipation does not develop chronic illness behaviour and invalidism. The paediatrician also has to be able to distinguish between the child who is changing and moving out of a current difficult phase of development, and the one who is going to need a specific psychiatric referral.1 We know that a number of agencieseducational, social work, community health, general practice, or paediatricians-see a great many of the disturbed children and their families in the community. It is essential to find a systematic approach to helping these families rapidly, effectively, and in such a way that we can determine which need specialist assistance.