Long sorry- Brief history: difficult child was fairly normal kid until he learned his dad had chosen not to ever see him or be in his life- this happened when difficult child was almost 11yo, in fall of 2005. I didn't tell him this outright, but he had questions that I answered honestly and he put 2 and 2 together. Then there was a cancer scare with me and a family friend died of cancer all in the same time period and difficult child was worried about what was going to happen with him. He started acting out at school and a couple of teachers and principal said things to him about being headed to juvy (his acting out at that point was not illegal activity so I felt that was uncalled for). Anyway, he was saying things like he must be bad and that's why his dad didn't want him and I tried over and over to help him see this was a reflection on his dad, not him, and that he wasn't "bad". Also, he was overly emotional over everything. So, I took him to a family therapist. It turned out he was a Christian focused counselor, not that there's anything wrong with this, but we weren't exactly looking for a spiritual healing at that point and I felt he should have told me up-front that this is what he does. He told me just get married and go to church and the problem would be solved. When I asked him to try to address what we were there for, he looked at difficult child and said "ok, so how does it feel to know your dad rejected you". I guess the therapist noticed my jaw on the floor and difficult child about to fall apart so he suggested going to a psychiatrist, that maybe he wasn't the right person. We started with a psychiatrist and therapist in his office. difficult child's behavior got worse in the meantime and along with that, he gave away gifts/toys from Christmas and birthday, and started behaving very erratic and doing things that he could have died or been seriously injured by. (I call this indirect suicide.) neuropsychologist had been scheduled, that therapist was trying to address the "bad behavior" because he said it was more critical, psychiatrist hadn't prescribed any medications yet because he wanted to wait for testing and opinions on whether problem was more conduct related, depression, etc. One therapist we tried said (after 2 to 3 mos) he didn't know what to do about the erratic behavior. Erratic and dangerous behavior got so extreme that I took difficult child to psychiatric hospital who diagnosis'd him with Depression, rule-out bipolar and conduct disorder. They put him on prozac and after 6 weeks, difficult child was a different kid again, back to his old self and maybe a little better. A different therapist kept treating him like a conduct issue, and difficult child hated him, so we stopped that. neuropsychologist testing revealed scores all over the board, mainly problems related to memory and verbal things but above average in some things like problem-solving. Things were going well until winter 2006-2007 when school notified me of escalating behavior issues. Nothing big in itself, but being disruptive often. I started noticing things at home- being overly emotional, etc., so I talk to psychiatrist who decides prozac dosage should be increased. 2 to 3 weeks later, after school district "rejects" difficult child (the way he interprets a long-term suspension), he goes on a 2 hour crime spree and racks up 7 charges. psychiatrist thinks it's prozac induced mania. difficult child was off all medications for 6-8 weeks this summer while psychiatrist evaluates base-line. Now, trying mood stabilizers. He starts seeing a different therapist who is more like a mentor and difficult child really likes him but this one never appears to address anything other than chat about whatever difficult child wants to chat about that day. They play computer games sometimes. I will say difficult child is showing more mature decisions regarding social interactions (friendships, avoiding issues with other kids, etc) and staying out of trouble more. This past fall, he was evaluated by a psychiatrist/Educational Sp/therapist team at teaching hospital. Now, this team had been given all previous records and spoke to current psychiatrist, then interviewed us and gave difficult child a different test (?), so they were well-informed about all history. Someday, I might actually get the written report. Anyway, this psychiatrist said this is not that difficult. She says it was the "dad" issue that caused a serious depression to start out with. He needs a therapist to deal with this first (Adjustment disorder and depression). Second, he is cycling now so keep on mood stabilizer for time being. He needs therapist to work with him about the "I must be bad, therefore, I act bad" and a therapist to work with me/or us about how I can help him and parent him better to stay on track. Because Mainly, she believes it's treating difficult child's bad behavior like he's a major conduct problem that triggers the mania, yet, obviously, it has to be dealt with somehow while trying to get him out of a negative cycle. She believes this is so textbook, one therapist should be able to cover it all. Then, she herself says, who would be the right therapist for that?? She said if we can get a therapist to cover these issues, the cycling might stop and she thinks there is a good chance difficult child could learn to manage/prevent these tendencies in himself and MIGHT be able to try coming off all medications at some point down the road. So, parents, this is my question, who would be the right therapist? And, how do you find them. Calling up asking has only gotten me "of course, we can handle that" then it's that difficult child would have to give up this therapist/mentor he has, which doesn't sound like a good or agreeable idea. And, I'm afraid we're going to end up with another bad experience- someone who really doesn't know how to address these things appropriately and none of them tell you that until they've made things worse. Is it just the area I live in - many of you here seem to have found excellent tdocs. Tdocs here really don't seem to know any more than common sense.