John,” age 7, (who is the “identified patient”), was referred

John,” age 7, (who is the “identified patient”), was referred to you by his pediatrician.  The “identified patient” presented with behavioral problems – specifically acting in an overly aggressive manner at school and “clinging” to his mother while at home.  Mom (Jennifer, age 38)  states that the only time he is not being a problem is “when he is sleeping.”  Mother reports that she is a “stay at home mom,” not particularly happy in her marriage – since her “husband  (Bob age 39) works all the time” as the general manager of a car dealership, owned by her father. 
She reports unplanned weight gain, fatigue, disinterest,  and a lack of sexual interest.  She fears her husband may be having an affair with his secretary.  What is your assessment and how might you proceed in helping John?

 

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