Socio-Psychosomatic Dysfunctions: A Case Study Thomas M. Gehring University of Zurich, Switzerland, Department of Child Psychiatry ABSTRACT: Based on an ecosystemic approach to child psychiatry, mental distur- bances are characterized as socio-psychosomatic dysfunctions. The patient is seen as an interdependent part of a larger biosocial, physical, and cultural system. Consequently, therapeutic activities do not focus on the defined patient. Through case study the rele- vance of an integrative, system orientated, problem-solving strategy is illustrated. The city of Zurich provides a large scope of medical and psychosocial facilities. There are numerous public and private institutions which base their activities mainly on the family unit or on interrelations in other ecosystems. Our clinic for childpsychiatry is divided into an inpatient depart- ment, a day clinic and a well-equipped outpatient department. Preven- tive and interinstitutional cooperation with children's hospital, school, youth attorneyship, house for battered women etc. (figure 1) has be- come increasingly important in recent years (11). In the same fashion, clinical work is organized in an interdisciplinary and multimethodical way. Most members of the staff (physicians, psychologists, therapeutic educationalists, social workers) have been trained in individual psy- chotherapy or in family therapy. The trainees are given the possibility to enroll in the respective courses in our own clinic. Our clinical interventions and treatments cover a wide range of indi- vidual symptoms (i.e. cerebral dysfunctions, developmental distur- bances, neuroses, psychoses, addiction and psychosomatic deficien- cies). Concept At this time there is a paradigm controversy (6) in the research and application of clinical concepts. We are not adherents of any particular Requests for reprints should be sent to Thomas M. Gehring, University of Zurich, De- partment of Child Psychiatry, Freiestrasse 15, CH-8028 Zurich, Switzerland Child Psychiatry and Human Development, Vo115(4), Summer 1985 9 Humaa Sciences Press 269