I realize this is easier said than done but you may consider getting a new therapist. Child psychiatrist (vs psychologist). I’m not saying your doctor is wrong or ineffective but it sounds as though his treatment suggestions are just not working. Often, when things are this complicated, having someone new look at the case and the issues with fresh eyes can bring a perspective and new suggestions. I suggest a psychiatrist because they are a medical doctor and can be more skilled at medication effects good or bad and can dig deeper into psychological and physical issues than a psychologist or behavioral specialist can. I’m a big believer that if what you’re doing (in any situation) is not working, you have to change what you’re doing. If changing therapists is not an option, or maybe in addition to changing, you should start seeing a therapist of your own. It will give you a place to release the stress of your situation, and help with your own mental well being which is just as important as helping her. They say you can’t change other people,you can only change how you react to them. Seeing someone for yourself can also help you deal with the strained relationship with her mother. This is hard an kudos to you for trying so hard to make things right.