Consultation between child psychiatry and otolaryngology: a case of esophageal stenosis

In contrast to traditional 'interdisciplinary' methods of consultation where independent assessment and treatment are carried out by different treating agencies, the 'ecological' approach involves continuing cooperation between all systems affecting the maintenance of the symptom in the patient: biological, psychological, individual, familial, social and community. The present case demonstrates how such an ecological approach resulted in the effective removal of symptoms in a 9 year old child with intermittent esophageal stenosis. While there had been earlier consultations in the 'interdisciplinary' sense by both the Department of Ear, Nose and Throat and the Department of Child Psychiatry, it was only when the family and all disciplines working with them were brought together on the same physical premises face to face that directives became fused and united. This enabled the family to mobilize its resources and effectively deal with its problems, resulting in the alleviation of the manifest symptoms.