Common ground is critical when you are making a change in your child's life. Please discuss and return with areas of agreement and disagreement which will enable me to help you set priorities. You may fax this to 847-234-7227, or mail to me at 111 Fallstone, Lake Forest 60045.

Areas of common concern in order of priority: Could include respect for authority, addictive behaviors, anger management (verbal or physical), isolation, school performance, etc.

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For each of the above, indicate what you have attempted in order to diminish the behaviors, and how well it has worked:

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Areas of disagreement:

Often a couple's areas of disagreement come from the methods they have used in attempting to correct behaviors. These areas of disagreement often create a power play for the child, who can use your own behaviors against you in trying to divide and conquer. Please describe any major ways in which this may be operating in your own situation.

In what ways has individual counseling helped, or been ineffective?

Anything else you think I have to know which may not be a part of the referral record: