Client complaint of behavior issue ↓ 1. Take thorough history (including video if possible) ↓ 2. Complete physical exam + minimum database (CBC, chem, UA, T4) ↓ 3. Medical cause found? → YES → Treat medical condition → Reassess ↓ NO 4. Behavioral diagnosis (anxiety, compulsive, normal but undesirable) ↓ 5. Environmental modification + behavior modification plan ↓ 6. If severe or not improving → Consider psychopharmacology or referral