Social factors include the child's functioning and past experiences within the larger social context. This section of the biopsychosocial formulation should integrate pertinent factors from peers, family, community, ethnic background, economic status, and spiritual and cultural traditions that impact the patient and the family. Patients and families without support systems are particularly vulnerable. Sophisticated consultants consider the family as a social system and consider the role of the child as the identified patient within the family system.

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