The case of Ann: a sleep disturbance in a 3-year-old child.

Ann, a 3 1/2-year-old girl, was brought to a pediatric clinic for a chronic, severe sleep disturbance which had precipitated a serious family crisis. A developmental interactional approach was used by the pediatrician and a social worker who evaluated her case; the problem formulation included a reciprocal separation issue between Ann and her mother. Over a 2-month period, dynamic casework around the behavior problem revealed an unresolved grief reaction. Intervention resulted in resolution of the sleep disturbance and an untangling of the relationship between Ann and each of her parents.