Hi, We visited an ED room this week and are thinking about placing difficult child there. Overall, we liked the program and we were quite impressed with the teacher. But, we were concerned about the use of a point system for grading behavior and granting rewards/privileges. Our difficult child is diagnosis'd with BiPolar (BP) 1 and he is cycling badly these days. His psychiatrist is aware of this and we will be adjusting his medications this week. difficult child probably can handle the point system when he is stable. He has some challenging behaviors even when stable, so the behavior management program could be very helpful at that point. However, we have yet to acheive real stability. We get a few good days or maybe a couple of good weeks with each medication adjustment. When difficult child is unstable, I have trouble seeing him making much progress with a point system. Our fear is that he will be unable to meet the point goals because of mood issues and will never make progress on earning rewards or privileges. Plus, seeing others get a reward when he does not is a HUGE trigger for him. So, it could just become a very, very bad never-ending cycle of failure, massive fit, and more failure. Any thoughts?