These last few vists to therapist have been somewhat boring. I have spaced them a few months apart because there have been no major issues to work on. difficult child says "there is nothing to talk about" and I have agreed. I have such a poor memory that unless I write something down it is, "Nope, no problems - things are going well." As his anger/frustration is showing more, I haven't been able to pinpoint it down to explain to therapist. Until I can put into words what I think difficult child needs help with (what may be some triggers), this will get worse. If I say, "difficult child has been getting more angry lately" therapist will ask for an example and I can not remember details. I have given it some thoughts and came up with a list of goals for difficult child to work on. Mainly two items. Anger/frustration with school work and anger/frustration with mom. (triggers are school work and mom) Under school work: 1. How to ask for help (no whining, screaming, ect) 2. Listen calmly to help (when I say something is easy I am not saying he is stupid), 3. Take the time needed on each problem (he gets angry at the length of a math problem - steps overwhelm him even though he understands each one) 3. Put everything into backpack when done (nothing more frustrating then leaving a finished assignment at home when one of the teachers will not accept late work - it is an automatic zero) Under mom: 1. It is never o.k. to tell mom to "shut up" 2. It is never o.k. to argue with mom 3. No yelling at mom, EVER. I am going to type this up keeping a copy for myself and give it to difficult child. We will go over it together and I will encourage him to present it to therapist on his own. I believe that this need is so great that if he does not choose to share it, I will bring a copy to therapist and bring it up during the next meeting. I KNOW that if I just give this to therapist without difficult child first seeing it, he will feel betrayed and attacked. It is better to have me discuss with him what my plans to bring up are. I hope he can see that bringing this up himself will be easier than listening to me bring it up. I would think he would want to discuss this with therapist before I come into the room. I think this will make our therapist appts more productive and I will increase visits again for awhile. therapist can document the anger/frustration increases or decreases and the report to psychiatrist will determine a need for medication change (or dosage increase). If difficult child commits to working on these goals (or something similar that he and therapist developes) it will give me something to base my observations/input on. Planner and journal, here I come again!