James is a sociable, loving, and athletic 7-year-old White boy. His mother, Mary, brought him to the office to be evaluated for mood and conduct disorders after a referral from his pediatric neurologist. Currently, James is experiencing anxiety, problems concentrating in school, staring spells, and obsessive behaviors (e.g., needing to have his socks and house “just right”), on and off. His symptoms may be the result of a long history of poor regulation, defiant demeanor, and Attention Deficit/Hyperactivity Disorder. Generally, James symptoms build up over time and may be exacerbated in part by James’ parents’ frequent disputes over setting limits at home, with Mary being more flexible than John, the father.
James’ biological mother was
James’ biological mother was