He refused to get out of the car when we got to the therapist's today! The morning went fine. He finished his biology assignment before the tutor arrived, did some work for her, then after she left, he needed to use the restroom. While he was in there I told him that when he finished he needed to get dressed so we could go grab some lunch, pick up easy child from school and then go to his therapist appointment. He immediately started complaining about the appointment and said he didn't want to go. And that was the beginning of the end today. He refused to eat lunch (and combined with the fact that he didn't eat much for breakfast probably just made things worse). He wouldn't talk to me on the drive over. And he refused to get out of the car when we arrived. I explained what was going on to the therapist when he came out to get us, and without missing a beat, the therapist went out to the car to see if he could talk to difficult child 1 and persuade him to come in. He came back after about 5 min and said he couldn't even get him to unlock the door. So he and I talked for a little bit, then the two of us went to the car and sat in the front seat to continue our "talk". This essentially forced difficult child 1 to hear what needed to be said, even if it wasn't directed specifically to him. We paused periodically to see if difficult child 1 would respond to some of the things we were talking about, but he persisted in his silence. therapist sees this as a passive coping mechanism when difficult child 1 feels afraid or unhappy about something, and the car conversation was mostly about how difficult child 1's behavior affects everyone around him and whether it results in positive things or not, who or what is really in control of him while this is going on, pointing out which situations seem to trigger this behavior the most, etc. Mostly to give him something to think about. I went back to the office to schedule the next appointment, and when I came out, difficult child 1 was gone. I sent him a text and as I'd guessed, he was in the bathroom. His very next message to me was "I'm sorry" -- he usually does apologize later on. We just need to work on helping him cope better and not get stuck in this rut that ends up pushing everyone away. I was really glad therapist got to see him like this! So for now, no appointment until the week after his uro procedure on the 21st. Hopefully by then he'll be feeling better physically and then maybe we can start to more openly tackle some of his issues.