The therapist was doing an intake of an 11 year old male who was in a school program for emotionally disturbed students. He allegedly had a problem with explosive outbursts of aggression and anger. He was being treated with psychoactive medication that apparently had no impact on his behavior. The fellow was born to a drug using mom, tested positive for drugs at birth, was taken at the hospital by a community social worker. He was fortunate because he was adopted.
His adoptive father came in for the first visit. A psychologist needs to ask medical questions because these are infrequently considered significant by medical mental health professionals when treating and diagnosing. Billy had a very significant problem with constipation. His father reported that it was not unusual for him to go longer than a week or two to have a bowel movement. These were difficult events for him. His parents tried to help by providing over-the-counter laxatives. They talked to his pediatrician, who informed them that there were no pediatric gastroenterologists in the area.
The therapist easily convinced the father to take him to one of the closest medical teaching hospitals. A pediatric gastroenterologist diagnosed his problem and has been treating him. He does not have constipation any longer. Here is the surprise (perhaps) - his behavior problems have disappeared.
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