When parents bring their child or adolescent for consultation with a mental health professional, they are usually frustrated, worried, and confused. They may have a litany of complaints about symptoms and problematic behaviors exhibited by their son or daughter, and the entire family is likely to feel bewildered, caught up in intense, conflicting emotions. One of the most important services a clinician can offer in this situation is to provide a clear formulation of the presenting problems so that all involved can grasp underlying problems in the context of stresses and strengths of the child and family. The author has developed a simple graphic that seems useful as a tool to organize his diagnostic formulations. This graphic consists of two separate squares within which are overlapping circles of a Venn diagram. It can be used to present a clinician's view of the patient's present life situation and to focus conversation between patient, family members, and clinician about how best to understand, prioritize, and respond to the current dilemmas of the patient and family. This simple graphic organizer is useful not only in facilitating communication with the patient and family but also in providing a structure for thinking about comorbidity of diagnoses in the present context of the specific patient and family.