Disruptive Mood Dysregulation Disorder Treatment Plan: Goals, Objectives, & Example for Mental Health Professionals

Treatment plans are one of the most important clinical documents completed in behavioral health. They provide a structured roadmap that connects a client’s diagnosis, symptoms, strengths, and treatment needs to measurable goals, evidence-based interventions, and ongoing progress monitoring. Because Disruptive Mood Dysregulation Disorder (DMDD) is a pediatric diagnosis involving severe temper outbursts and persistent irritability, a well-written treatment plan helps ensure therapy remains intentional, developmentally appropriate, and closely coordinated with caregivers and schools.

Creating an effective Disruptive Mood Dysregulation Disorder Treatment Plan involves much more than listing a few goals. It requires a comprehensive understanding of the child’s specific outburst pattern, the settings where impairment occurs, family and caregiver functioning, and the therapeutic approaches most likely to support the child and family. A strong treatment plan also demonstrates medical necessity, facilitates communication between providers, schools, and caregivers, and creates objective benchmarks that make it easier to evaluate progress over time.

In this guide, we’ll walk through how to create an evidence-informed DMDD treatment plan, discuss what information should be included, provide practical examples of treatment goals and objectives, and review common documentation considerations for mental health professionals. Whether you’re a student, intern, or experienced clinician, these examples can serve as a starting point for developing individualized treatment plans that reflect each child’s unique presentation.

Key Takeaways

• DMDD treatment plans should be individualized. Effective plans connect assessment findings, diagnosis, functional impairment across settings, family functioning, and evidence-informed interventions rather than relying on generic documentation.
• DMDD is a pediatric diagnosis. It can only be diagnosed between ages 6 and 18, with symptom onset before age 10, and it cannot be diagnosed alongside oppositional defiant disorder, intermittent explosive disorder, or bipolar disorder.
• Medical necessity documentation should connect the child’s symptoms to clinically significant functional impairment across home, school, and peer settings, treatment needs, and the rationale for the selected level of care.
• Treatment goals should follow SMART principles. Parent management training and CBT-based approaches adapted for irritability are typically considered first-line, with family and caregiver involvement central to treatment rather than optional.
• DMDD is a relatively new diagnosis, added to the DSM-5 in 2013, and DMDD-specific treatment outcome research remains more limited than for many other pediatric conditions; clinicians should represent this evidence accurately.

View our Counseling Treatment Plan Template, which corresponds with this guide.

Why Treatment Planning Matters for DMDD

DMDD is characterized by severe, recurrent temper outbursts alongside a persistently irritable or angry mood between outbursts, and it can cause significant distress and impairment across a child’s home, school, and peer relationships. While children with DMDD often share common features—including outbursts disproportionate to the triggering situation and chronic irritability observable by parents, teachers, or peers—every child’s specific triggers, family context, and pattern of impairment are different. Effective treatment planning helps clinicians organize assessment findings into a personalized course of treatment that reflects the child’s diagnosis, developmental stage, functioning, and family needs.

A comprehensive treatment plan also serves several important clinical and administrative purposes. It supports continuity of care, promotes collaboration between providers, caregivers, and schools, documents medical necessity for third-party payers, and creates measurable outcomes that can be reviewed throughout treatment. Rather than functioning as a static document completed during intake, treatment plans should be reviewed and updated regularly as the child’s symptoms change, new challenges emerge, or treatment priorities shift.

Whenever possible, treatment planning should be a collaborative process involving the child (to the extent developmentally appropriate) and their caregivers. Involving families in selecting meaningful goals often increases engagement and treatment adherence, and reinforces consistent responses to outbursts across settings. Instead of focusing solely on symptom reduction, treatment plans should also build upon the child’s existing strengths and the family’s protective factors.

Complete a Thorough Clinical Assessment Before Writing the Treatment Plan

A treatment plan should never be developed in isolation. Before identifying goals or selecting interventions, clinicians should complete a comprehensive assessment to better understand the child’s presenting concerns, symptom history, developmental history, family functioning, and diagnostic picture. Information gathered during the intake assessment provides the clinical foundation for every section of the treatment plan.

For children presenting with possible DMDD, this assessment often includes a detailed clinical interview with the child and caregivers, developmental and family history, school information and, when possible, teacher input, risk assessment, and standardized behavioral or emotional measures appropriate to the child’s age. Because DMDD requires symptoms to be present in at least two settings, gathering information from multiple informants—caregivers, the child or adolescent, teachers or other school personnel when appropriate, and other treating providers when clinically indicated—is particularly important. Reports often differ across informants and settings; these discrepancies are clinically informative rather than automatically invalidating, and should be explored rather than resolved by simply favoring one informant’s account. Clinicians should also carefully evaluate how irritability and outbursts affect functioning at home, at school, and with peers, and rule out other conditions that can present similarly, including bipolar disorder, oppositional defiant disorder, ADHD, anxiety, autism spectrum disorder, and trauma-related presentations.

If you are looking for additional guidance on collecting assessment information before creating a treatment plan, our guides to the Counseling Intake Assessment and Biopsychosocial Assessment provide more detailed recommendations for conducting comprehensive evaluations.

Develop a Clinical Formulation Before Creating Treatment Goals

One of the most valuable steps in treatment planning is developing a clinical formulation before writing goals and objectives. While a diagnosis identifies what condition a child meets criteria for, a clinical formulation explains why the outbursts and irritability are occurring, what factors are maintaining them, and why the selected interventions are appropriate. A thoughtful formulation helps ensure that treatment remains individualized rather than relying on generic behavioral goals that could apply to nearly any child.

For children experiencing DMDD, a thorough formulation typically considers several interacting factors, since no single mechanism explains every child’s presentation: the specific antecedents or triggers that tend to precede outbursts; the consequences that may be maintaining the behavior (for example, escape from a demand, or increased attention); the child’s underlying capacity for emotion regulation relative to their developmental level; caregiver responses to outbursts and broader family interaction patterns; school demands and classroom expectations; co-occurring conditions such as ADHD, anxiety, or learning difficulties; and, when clinically relevant, sleep or other physiological contributors. DMDD was added to the DSM-5 in 2013 specifically to provide a diagnostic home for children with chronic, non-episodic irritability who had frequently been misdiagnosed with pediatric bipolar disorder, a diagnostic practice associated with escalating use of atypical antipsychotic medication in this population (Tapia & John, 2018). This history is clinically relevant: formulation should carefully distinguish DMDD’s chronic, non-episodic irritability from the episodic mood changes characteristic of bipolar disorder.

A strong clinical formulation naturally guides treatment planning. For example, if outbursts are frequently triggered by academic frustration and appear connected to underlying ADHD or a learning difficulty, treatment planning should address both the irritability itself and the underlying contributing factor. If caregiver responses to outbursts appear to be inadvertently reinforcing the behavior, parent management training addressing those interaction patterns becomes directly relevant to the formulation.

Many treatment plans remain superficial because they list symptoms and interventions without explaining the clinical reasoning connecting the two. A strong formulation demonstrates why specific goals were prioritized, why certain interventions were selected, and how the child’s diagnosis, history, strengths, and family context influence the treatment approach.

Establish Medical Necessity Through Functional Impairment

Treatment plans should document more than the presence of temper outbursts. They should clearly explain how those outbursts and the child’s irritable mood interfere with functioning across settings. Documenting clinically significant functional impairment can help support medical necessity determinations, but requirements vary by payer, jurisdiction, service type, and clinical setting, and documenting impairment alone does not automatically establish or guarantee medical necessity for every payer.

Rather than simply documenting that a child “has tantrums,” describe the observable consequences of their symptoms across settings. Examples may include suspension or disciplinary action at school, strained sibling or peer relationships, family conflict and caregiver distress, or exclusion from activities due to unpredictable outbursts. These examples create a stronger clinical picture than documenting symptom frequency alone.

Whenever possible, establish a measurable baseline before treatment begins. Standardized behavioral or emotional rating scales appropriate to the child’s age and completed by multiple informants (caregiver and teacher) can assist clinicians in assessing symptom severity and monitoring changes over time when used as part of a broader clinical evaluation.

Creating SMART DMDD Treatment Goals

Effective treatment goals should be individualized, collaborative, and measurable. One of the most common documentation mistakes is writing goals that are too broad to evaluate objectively. Statements such as “reduce tantrums” or “improve behavior” provide little guidance for future treatment sessions and make it difficult to determine whether meaningful progress has occurred.

Instead, treatment goals should follow SMART principles whenever clinically appropriate. Goals should be specific, measurable, achievable, relevant, and time-bound. Objectives should identify observable behaviors or changes that demonstrate movement toward the larger treatment goal, for both the child and, where parent management training is used, the caregiver.

Breaking larger goals into smaller objectives also allows clinicians to recognize incremental progress throughout treatment. These measurable objectives become valuable reference points during treatment plan reviews and progress note documentation.

DMDD Treatment Goal Examples

The following DMDD treatment goal examples are designed to help mental health professionals develop individualized treatment plans based on each child’s diagnosis, symptoms, functional impairment, strengths, and treatment needs. Effective treatment goals should be collaborative, measurable, and connected to specific objectives and interventions that support meaningful clinical progress. These examples can be adapted based on the child’s age, family context, and co-occurring conditions.

Goal 1: Reduce the Frequency and Severity of Temper Outbursts

Long-Term Goal: Reduce the frequency and severity of temper outbursts to a level that no longer significantly interferes with functioning at home, school, or with peers.

Possible Objectives:

• Attend scheduled therapy sessions consistently.
• Complete a daily outburst log documenting triggers, duration, intensity, and setting.
• Identify at least two early warning signs that an outburst is building.
• Practice at least one coping or calming strategy during identified early warning signs.
• Reduce the time needed to return to baseline functioning following an outburst, tracked via caregiver log.

Possible Interventions:

• Psychoeducation for the child and family regarding DMDD and the outburst cycle.
• CBT-based interventions adapted for irritability, including emotion identification and coping skills.
• Skills training in recognizing and responding to early warning signs.
• Routine progress monitoring using outburst logs and standardized measures.

Goal 2: Strengthen Caregiver Behavior Management Skills

Long-Term Goal: Increase caregivers’ ability to respond consistently and effectively to outbursts and reinforce the child’s use of adaptive coping strategies.

Possible Objectives:

• Attend parent management training sessions consistently.
• Implement at least two specific behavior management strategies at home, tracked via caregiver log.
• Demonstrate consistent, calm responses to outbursts across caregivers in the household.
• Identify and reduce specific antecedents that reliably trigger outbursts.

Possible Interventions:

• Parent management training targeting consistent limit-setting, planned ignoring of appropriate low-level attention-seeking behaviors (not escalating or aggressive behavior), and positive reinforcement.
• Coaching on responding to outbursts calmly and consistently.
• Collaborative identification of household triggers and environmental modifications.
• Between-session practice and review of specific parenting strategies.

Goal 3: Improve Functioning at School and with Peers

Long-Term Goal: Increase the child’s ability to manage frustration and irritability in the school setting, reducing disciplinary consequences and improving peer relationships.

Possible Objectives:

• Identify specific school-based triggers for outbursts, in coordination with teacher report.
• Reduce office disciplinary referrals connected to outbursts.
• Practice at least one classroom-appropriate coping strategy identified collaboratively with the child.
• Increase participation in previously avoided or disrupted peer activities.

Possible Interventions:

• Coordination with school staff regarding triggers, accommodations, and consistent behavioral expectations.
• Skills training generalized to the school setting.
• Social skills support as clinically indicated.
• Ongoing communication between clinician, family, and school regarding progress.

Remember that these examples are intended as starting points rather than standardized treatment plans. Effective treatment planning requires ongoing collaboration with the child and family and should reflect the child’s diagnosis, developmental stage, strengths, cultural considerations, and family circumstances. Objectives, interventions, and review dates should be modified as the child makes progress or new treatment priorities emerge.

What to Include in a DMDD Treatment Plan

A comprehensive DMDD treatment plan should do more than identify outbursts and list interventions. Effective treatment planning creates a clinical roadmap that connects the child’s diagnosis, presenting concerns, functional impairment, strengths, treatment goals, measurable objectives, and selected interventions.

While treatment plan requirements vary depending on clinical setting, payer expectations, state regulations, and organizational policies, many evidence-informed treatment plans include several core elements that support clinical decision-making, continuity of care, and ongoing measurement of treatment progress.

A comprehensive DMDD treatment plan template typically includes the following clinical documentation sections:

The following sections provide a detailed overview of each component and explain how clinicians can use these elements to create treatment plans that are clinically meaningful, individualized, and responsive to the child’s and family’s needs.

1. Client and Plan Information

The first section establishes essential identifying and administrative information while creating a clear record of the treatment episode. Clinicians typically document the child’s and caregivers’ information, treatment plan dates, review dates, plan type, clinician information, practice details, session format, session frequency, and the anticipated duration of treatment.

Documenting this information helps establish when treatment began, who is responsible for care, how frequently services are provided, and when the plan should be reviewed. A treatment plan should be considered a living clinical document that changes as the child develops, symptoms change, or treatment needs evolve over time.

2. Coordinating Providers and Services

Many children receiving treatment for DMDD also have contact with other providers or systems, including pediatricians, psychiatric providers, school counselors or special education staff, and case managers. This section documents other providers and agencies involved in the child’s care, relevant releases of information (ROIs), referral information, and plans for coordination when clinically appropriate.

Effective care coordination is particularly important for DMDD given the diagnostic requirement that symptoms be present across multiple settings; ongoing communication with school personnel often provides essential information for both diagnosis and treatment planning.

3. Diagnostic Summary

The diagnostic summary documents the child’s current diagnosis, applicable ICD-10-CM code, diagnostic considerations, and clinical evidence supporting the diagnosis, consistent with DSM-5-TR criteria for DMDD (American Psychiatric Association, 2022). DMDD is coded as F34.8 and can only be diagnosed in children between ages 6 and 18, with symptom onset before age 10 by history or observation.

A strong diagnostic summary extends beyond simply listing a diagnosis. It should clearly connect the diagnostic conclusion with observable clinical evidence: the frequency, severity, and setting of temper outbursts, the persistence of irritable or angry mood between outbursts, and the duration of symptoms (DMDD requires at least 12 months of symptoms without a symptom-free period of 3 or more consecutive months). Clinicians should also document differential diagnostic considerations. DMDD cannot be diagnosed alongside oppositional defiant disorder, intermittent explosive disorder, or bipolar disorder—if criteria for both DMDD and oppositional defiant disorder are met, only DMDD should be diagnosed—but it can co-occur with ADHD, major depressive disorder, and anxiety disorders. Because DMDD is a relatively new diagnosis introduced specifically to distinguish chronic, non-episodic irritability from pediatric bipolar disorder, careful attention to this distinction supports diagnostic accuracy (Stringaris, Vidal-Ribas, Brotman, & Leibenluft, 2018).

4. Clinical Formulation and Treatment Rationale

Clinical formulation is one of the most important components of a comprehensive treatment plan because it explains the clinician’s understanding of why the child is experiencing outbursts and irritability and why specific treatment approaches were selected.

Rather than documenting isolated symptoms, clinicians should synthesize relevant developmental, family, school, and environmental factors that contribute to or maintain outburst patterns. A strong formulation connects assessment findings to treatment goals, interventions, and expected outcomes.

This section should also identify the child’s and family’s existing strengths and resources—caregiver motivation for treatment, the child’s insight (developmentally appropriate) into their own patterns, supportive relationships, prior periods of better functioning, or school-based supports—alongside realistic barriers that may interfere with treatment participation or progress, such as caregiver stress, inconsistency between caregivers or settings, or limited access to school-based coordination. A strong formulation demonstrates why specific goals were prioritized, why certain interventions were selected, and how the child’s diagnosis, history, strengths, and family context influence the treatment approach.

5. Medication and Concurrent Treatment

Behavioral and psychosocial interventions, including parent management training and CBT-based approaches, are generally considered first-line treatment for DMDD, with medication considered when these approaches are ineffective or only partially effective, or to address a co-occurring condition such as ADHD. When children receive psychiatric medication, treatment plans should document medication names, dosages, prescribing providers, treatment response, adherence concerns, and recent medication changes.

This section may also include other concurrent treatments such as psychiatric consultation, school-based services, or medical care. Documenting concurrent services provides a more complete picture of the child’s treatment landscape and supports coordinated clinical decision-making.

6. Presenting Problems and Functional Impact

The presenting problems section describes the child’s primary concerns and explains how outbursts and irritability affect functioning across settings. Effective documentation goes beyond stating that a child “has outbursts” by describing how symptoms interfere with important areas of life.

Clinicians may document impairment related to school performance and behavior, peer relationships, sibling and family relationships, and participation in activities. Whenever possible, documentation should include observable examples of impairment. For example, noting specific disciplinary consequences at school or documented family conflict following outbursts provides stronger clinical evidence than documenting only general behavioral concerns.

7. Treatment Goals and Objectives

Treatment goals identify the primary clinical outcomes the child, family, and clinician are working toward throughout treatment. Effective DMDD treatment goals should be individualized, developmentally appropriate, and connected to the specific outburst patterns and functional concerns identified during assessment.

Each goal should include its own baseline severity and current functioning—the child’s starting point on relevant behavioral measures and functional indicators across settings—since establishing this reference allows clinicians to evaluate whether interventions are producing meaningful improvement over time. Short-term objectives then break the larger goal into measurable steps, describing observable changes in the child’s behavior and, where parent management training is used, the caregiver’s responses. Each goal should also document the specific interventions being used to pursue it and the clinical rationale connecting those interventions to the child’s diagnosis, formulation, and presentation, along with how progress toward that goal will be tracked over time.

8. Treatment Modality and Interventions

This section documents the primary therapeutic modality (or modalities) being used during treatment and explains how those approaches support the child’s and family’s treatment goals. Interventions should be individualized based on the child’s specific presentation, developmental stage, and any co-occurring conditions rather than applied as a fixed protocol. Commonly used approaches for DMDD include parent management training and other caregiver-focused behavioral interventions; CBT-based emotion regulation and coping skills training for the child; psychoeducation for the family regarding the outburst cycle; behavioral reinforcement strategies; school coordination; broader family-based work when relevant to the presentation; treatment addressing any co-occurring conditions (such as ADHD or anxiety); and psychiatric evaluation when clinically indicated, particularly if behavioral interventions are insufficient on their own. Parent management training and CBT-based approaches adapted for irritability are commonly used, often in combination, given DMDD’s presentation across the child’s behavior and the family system (Tourian et al., 2015).

This section should also document between-session assignments designed to extend therapeutic work beyond scheduled appointments—caregiver practice of specific behavior management strategies, child practice of identified coping skills, or outburst-tracking logs completed by caregivers or teachers.

9. Risk Assessment and Safety Planning Summary

Although a treatment plan does not replace a comprehensive risk assessment or standalone safety plan, documenting relevant safety considerations is an important component of comprehensive clinical documentation. DMDD does not automatically indicate elevated suicide risk or a heightened risk of violence, but because outbursts can involve aggression, risk documentation should distinguish several related but separate considerations: current and historical suicidal ideation or self-harm; aggression directed at other people; aggression directed at property; and general environmental safety during escalation (for example, access to objects that could cause injury during an outburst).

This section may include protective factors, overall risk level, and whether a separate safety plan has been completed. Risk should be reassessed whenever clinically appropriate, including following significant symptom changes, escalating aggression, or changes in functioning.

10. Family, Support, and Collateral Involvement

Family and caregiver involvement is typically central to DMDD treatment rather than a supplementary consideration, given the diagnostic emphasis on functioning across settings and the well-established role of parent management training. Treatment plans should document caregiver participation, school involvement, cultural considerations, and other resources involved in treatment.

Given that DMDD is diagnosed in children and adolescents, involvement of parents or guardians, and coordination with schools and other relevant professionals, should be guided by informed consent, confidentiality requirements, and clinical appropriateness for the child’s age and family context.

11. Transition and Discharge Planning

Transition planning helps clinicians and families identify what successful treatment progress may look like and establish criteria for moving toward discharge or a lower level of care. Discharge criteria may include reduced frequency and severity of outbursts, improved functioning at home and school, consistent caregiver use of behavior management strategies, and the child’s demonstrated use of coping skills.

Aftercare planning may include referrals to additional providers, school-based supports, community resources, or periodic follow-up based on the child’s and family’s ongoing needs.

12. Plan Review and Signatures

The final section documents treatment plan review, caregiver and, when developmentally appropriate, child participation, signatures, and required approvals. Including family participation reinforces that treatment planning is a collaborative process developed between the family and clinician.

Documenting signatures, review dates, updates, and progress summaries provides a clear record that the treatment plan has been discussed, evaluated, and modified as clinically appropriate throughout treatment.

Disruptive Mood Dysregulation Disorder Treatment Plan Example

The following example demonstrates how the clinical sections of a DMDD treatment plan connect together for a child presenting with frequent temper outbursts and chronic irritability. This example follows the clinical structure of the TherapyByPro Counseling Treatment Plan template, including diagnostic summary, clinical formulation, functional impairment, measurable treatment goals, baseline severity, treatment objectives, evidence-informed interventions, clinical rationale, risk assessment, and progress monitoring.

This example is provided for educational purposes only and should be adapted based on the individual child’s symptoms, diagnosis, developmental stage, family context, and applicable documentation requirements.

DMDD Treatment Plan Template

The images below provide a preview of TherapyByPro’s Counseling Treatment Plan template, designed for mental health professionals who need a structured framework for documenting DMDD treatment goals, measurable objectives, clinical formulation, interventions, risk considerations, and treatment progress.

The template follows a comprehensive clinical structure that can be adapted for children and adolescents diagnosed with DMDD, including cases with co-occurring ADHD, anxiety, or depressive symptoms. It includes sections for client and plan information, care coordination, diagnostic summary, clinical formulation, medication and concurrent treatment, presenting problems and functional impairment, treatment goals, objectives, interventions, treatment modality, risk assessment, family and support involvement, discharge planning, and plan review documentation.

Organized across 15 dedicated pages, the editable Word document and fillable PDF allow clinicians to customize documentation based on their practice setting, clinical approach, and documentation requirements while maintaining a consistent treatment planning workflow.

Clinicians seeking a complete treatment planning solution can access TherapyByPro’s Counseling Treatment Plan template. For clinicians who need a streamlined tool focused specifically on documenting treatment goals, objectives, and interventions, the Treatment Plan Goals template provides a simplified format for tracking progress across multiple treatment goals.

Common Documentation Mistakes When Writing a Treatment Plan for DMDD

Even experienced clinicians can develop documentation habits that reduce the clinical usefulness of a DMDD treatment plan. A strong treatment plan should do more than identify that a child “has outbursts”—it should explain the child’s specific symptom pattern, functional impairment across settings, treatment goals, selected interventions, and measurable indicators of progress.

The following examples highlight common DMDD treatment planning mistakes, why they create documentation challenges, and how clinicians can strengthen their documentation approach.

Clinical Note: One of the most common documentation challenges in DMDD treatment planning is describing outbursts without connecting them to the persistent irritability, multi-setting impairment, and family context that distinguish this diagnosis. A strong DMDD treatment plan connects triggers, mood state, functional impairment across settings, family involvement, treatment goals, interventions, and measurable outcomes into a cohesive clinical roadmap.

Conclusion: Creating Effective Disruptive Mood Dysregulation Disorder Treatment Plans That Support Meaningful Clinical Progress

An effective Disruptive Mood Dysregulation Disorder treatment plan is more than a documentation requirement. It connects the child’s diagnosis, specific outburst patterns, functional impairment across home and school, and family context with evidence-informed interventions designed to address the child’s and family’s needs.

Because DMDD is a relatively new diagnosis with more limited DMDD-specific outcome research, treatment plans should represent the evidence accurately while drawing on the broader, better-established research base for parent management training and CBT-based approaches to childhood irritability (Stringaris, Vidal-Ribas, Brotman, & Leibenluft, 2018; Tourian et al., 2015). Treatment plans are living documents and should be reviewed and updated as the child’s symptoms, functioning, and family needs evolve.

References

• American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text revision; DSM-5-TR). American Psychiatric Association Publishing. Resource
• Stringaris, A., Vidal-Ribas, P., Brotman, M. A., & Leibenluft, E. (2018). Practitioner review: Definition, recognition, and treatment challenges of irritability in young people. Journal of Child Psychology and Psychiatry, 59(7), 721–739. Resource
• Tapia, V., & John, R. M. (2018). Disruptive mood dysregulation disorder. The Journal for Nurse Practitioners, 14(8), 573–578.e3. Resource
• Tourian, L., LeBoeuf, A., Breton, J. J., Cohen, D., Gignac, M., Labelle, R., Guile, J. M., & Renaud, J. (2015). Treatment options for the cardinal symptoms of disruptive mood dysregulation disorder. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 24(1), 41–54.