As a therapist ( OT) it is crucial to have that communication between parent and provider. Talk about your expectations , and request that dialogue at the end of each session re progress towards goals. Sometimes progress is slow , but there needs to be a " match " between parents, therapist and child. If it isn't a good match and your are paying for services, of course , be honest, say you have concerns and if it can't be worked out, move on. As a therapist , if we don't have experience with behavior management, I think it is only right to explain that , and be honest that you can't meet the needs of the child.