In re D.D. , 2022 IL App (1st) 220410 ( 2022 )


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    2022 IL App (1st) 220410
    No. 1-22-0410
    Opinion filed December 9, 2022
    SIXTH DIVISION
    IN THE
    APPELLATE COURT OF ILLINOIS
    FIRST DISTRICT
    In re D.D., a Minor,                                )      Appeal from the Circuit Court
    )      of Cook County.
    (The People of the State of Illinois,               )
    )
    Petitioner-Appellee,                        )
    )
    v.                                          )      No. 19 JA 1373
    )
    A.C.,                                               )      The Honorable
    )      Patrick Murphy,
    Respondent-Appellant.)                      )      Judge, presiding.
    JUSTICE ODEN JOHNSON delivered the judgment of the court, with opinion.
    Justice Walker concurred in the judgment and opinion.
    Justice Walker also specially concurred, with opinion.
    Presiding Justice Mikva dissented, with opinion.
    OPINION
    ¶1                Respondent, A.C., appeals the trial court’s termination of her parental rights. The trial
    court found her to be an unfit parent and found it to be in the best interests of her 10-year-old
    son, D.D., to terminate A.C.’s parental rights. D.D.’s father is deceased, and D.D. is presently
    in foster care with his father’s parents, or grandparents, who hope to adopt him. The father’s
    parents have stated that they will not permit contact with A.C. if they are permitted to adopt.
    For the following reasons, we reverse.
    No. 1-22-0410
    ¶2                                          BACKGROUND
    ¶3                                      I. Parties and Proceedings
    ¶4             A.C., is the mother of D.D., who was born on February 24, 2012. D.D. is presently 10
    years old and in the fourth grade. In November 2019, when D.D. was seven years old, the State
    filed a petition for adjudication of wardship. On March 11, 2020, a few weeks after he had
    turned eight years old, the trial court found that he was neglected due to a lack of care and an
    injurious environment, and he was adjudged a ward of the court. When D.D. was nine years
    old, the State moved on August 9, 2021, to permanently terminate A.C.’s parental rights and
    to appoint a guardian with the right to consent to adoption. D.D.’s foster parents, who are also
    his paternal grandparents, want to adopt him but will not permit him contact with his mother.
    ¶5             The State alleged that A.C. was an unfit mother on three separate grounds:
    (1) “[f]ailure to maintain a reasonable degree of interest, concern or responsibility as to the
    child’s welfare” (750 ILCS 50/1(D)(b) (West 2020)) (hereinafter, Ground B), (2) “[f]ailure
    *** (i) to make reasonable efforts to correct the conditions that were the basis for the removal
    of the child *** during any 9-month period following the adjudication of neglected *** minor
    *** or (ii) to make reasonable progress toward the return of the child to the parent during any
    9-month period following the adjudication” (750 ILCS 50/1(D)(m) (West 2020)) (hereinafter,
    Ground M), and (3) “[i]nability to discharge parental responsibilities” due to “mental
    impairment, mental illness or an intellectual disability” that “extend beyond a reasonable time
    period” (750 ILCS 50/1(D)(p) (West 2020)) (hereinafter, Ground P). For Ground M, the State
    chose a nine-month period, beginning on March 14, 2020, and ending on December 24, 2020,
    when D.D. was eight years old. The nine-month period began two years prior to the termination
    of A.C’s parental rights.
    2
    No. 1-22-0410
    ¶6              The fitness hearing was held via Zoom on January 25, 2022. The State called (1) Dr.
    Krissie Smith (Dr. Smith), a clinical psychologist, who supervised Dr. Jokae Ingram but had
    no direct contact with A.C. or D.D.; (2) Dr. Ingram, the psychologist who completed the
    parenting capacity assessment on September 4, 2020, for A.C. which concluded that A.C. could
    be an appropriate parent after completion of services; (3) Lashonda Ross, who was involved
    in clinical staffing but had no direct supervision over this case; (4) Regina Ruffin, who held
    monthly staff meetings with Deja Smith (Smith), a caseworker; (5) Gabrielle Ellison, who held
    eight phone therapy sessions with A.C. starting in July 2020, but who terminated that therapy
    as unsuccessful on September 29, 2020, a few weeks after Dr. Ingram’s September 4, 2020,
    assessment of appropriateness; (6) Shannon Stewart, a case aide who observed one in-person
    visit and two virtual visits between mother and child in 2020; (7) Shannon Dolan, who
    supervised the caseworkers in this case from November 2019 to November 2020, but had little
    contact with A.C. or D.D.; and (8) Smith, a caseworker who was first assigned to this case in
    December 2020, when the nine-month period chosen by the State had ended. A.C. testified on
    her own behalf and called Dr. Mohammed Tarawneh, a psychologist, who conducted a clinical
    evaluation of A.C. on March 10, 2021, and held weekly therapy sessions with A.C. from March
    to July 2021.The testimony of all witnesses is described in the section below.
    ¶7              After the evidentiary phase of the fitness hearing was complete, the court and the parties
    adjourned and returned for final arguments on March 9, 2022. After listening to arguments,
    the trial court found A.C. unfit, stating:
    “In this case, the child was found, not only in a filthy, garbage strewn place with drugs
    lying around, he didn’t know how to brush his teeth. He wasn’t potty trained. And
    3
    No. 1-22-0410
    within a week or two of being sent to live with his uncle, he accomplished these
    matters.”
    This finding contradicted the testimony of Dolan, the caseworkers’ supervisor, who testified
    at the fitness hearing that a report from D.D.’s therapy indicated that, in November 2020, or
    almost a year after the case came to the Department of Children and Family Services (DCFS),
    D.D. continued to wear Pull-Ups and sometimes wet himself during the night. The trial court
    stated that it “found the witnesses, particularly Ms. Ellison to be very, very credible,” and the
    court reiterated Ellison’s conclusion that A.C. had “circular thinking” which precluded A.C.
    from forming age-appropriate expectations. When asked under which ground it had found
    unfitness, the trial court replied all three.
    ¶8              After finding unfitness, the trial court proceeded to a best interests hearing. At the best
    interests hearing, also held on March 9, 2022, two witnesses testified: (1) Smith, the
    caseworker who had testified previously at the fitness hearing, and (2) M.K., the paternal
    grandmother and foster mother. Their testimony is also described below in the following
    section. At the conclusion of the best interests hearing, the trial court found:
    “[I]n some ways it’s an easy case and in some ways it’s a difficult case. But, the child
    was living in deplorable circumstances and was years behind his chronological age
    when [he] came in. Now, he is participating in all kinds of activities and on the honor
    roll at school. He shows magnificent improvement.
    It’s clearly in his best interest that I terminate rights and appoint [a guardian] with
    the right to place.”
    The court then entered a goal of adoption.
    ¶9                                               II. Testimony
    4
    No. 1-22-0410
    ¶ 10                                          A. Fitness Hearing
    ¶ 11             At the start of the Zoom fitness hearing, the following 11 exhibits were admitted
    without objection: exhibit No. 1, integrated assessment for the minor and family, dated
    February 5, 2020; exhibits Nos. 2, 3, 4 and 5, four service plans dated, respectively, January 2,
    2020, May 4, 2020, November 10, 2020, and May 18, 2021; exhibit No. 6, juvenile court clinic
    parenting capacity assessment, completed on September 4, 2020, by Dr. Ingram; exhibit No.
    7, records from Advocate Hospital for A.C.; exhibit No. 8, documents from Ellison, A.C.’s
    phone therapist for two months in 2020; exhibit No. 9, a document, dated May 1, 2021, from
    Dr. Tarawneh, who held weekly therapy sessions with A.C. from March to July 2021; exhibit
    No. 10, notes from case aide Stewart; and exhibit No. 11, a document, dated May 29, 2020,
    by Victoria Woodley, from Metropolitan Family Services.
    ¶ 12             We provide the testimony in detail below because it shows an almost bewildering array
    of recommendations, sometimes contradictory, by a shifting assembly of providers and
    caseworkers.
    ¶ 13             The first witness called by the State was Dr. Smith, a clinical psychologist, who was
    associate director of the Cook County Juvenile Court Clinic. The clinic is a partnership
    between Northwestern University and Cook County. Dr. Smith supervised Dr. Ingram, the
    psychologist at the clinic who completed A.C.’s parenting capacity assessment, on September
    4, 2020. In 2020, after the COVID-19 pandemic began, the clinic switched to remote
    assessments. In this case, Dr. Ingram was able to observe remotely as A.C., her son, and a
    caseworker played in-person in a park. Although Dr. Smith reviewed and signed Dr. Ingram’s
    assessment of A.C., Dr. Smith herself had no interactions with either A.C. or D.D.
    5
    No. 1-22-0410
    ¶ 14              Dr. Ingram testified that her first interview of A.C. was on July 2, 2020, via Zoom. Dr.
    Ingram received and relied on A.C.’s prior medical records which showed that A.C. had been
    previously diagnosed with, and hospitalized for, anorexia nervosa, which is an eating disorder.
    During the July 2, 2020, interview, A.C. told Dr. Ingram that D.D., who was eight years old,
    needed to wear “Pull-Ups.” A.C. believed that D.D. needed to wear Pull-Ups for another
    couple of years until he was able to judge when he needed to go to the bathroom. Dr. Ingram
    testified that D.D. was “obviously” developmentally delayed with respect to “potty-training.”
    During the July 2, 2020, interview, A.C. stated that D.D. needed a special diet, that he had
    missed over 20 days of school back when he was in kindergarten, and that he did not interact
    with other children in first grade when he was ill.
    ¶ 15              Dr. Ingram testified that she reviewed D.D.’s medical records and found that, often,
    medical personnel did not corroborate A.C.’s reasons for bringing him to the hospital. For
    example, A.C. reported that D.D. had seizures and that was not corroborated. School records
    indicated that staff reported that he was unclean and that A.C. had called multiple times
    regarding what D.D. ate at school and to make sure that he did not eat the food at school. 1 Dr.
    Ingram had one parent/child observation, which occurred on August 3, 2020, for 78 minutes.
    A caseworker was with A.C. and D.D. in the park, and Dr. Ingram observed the three of them
    through “WebEx,” which Dr. Ingram explained was a video-conferencing application.
    ¶ 16              Dr. Ingram testified about her observations during the August 2020 visit: “[I]t appeared
    that [A.C.] had a loving and caring relationship with her son, [D.D.]; and it was reciprocated.
    1
    Dr. Ingram’s testimony was somewhat confusing because she used the pronoun “they”
    within the same sentence to refer both to A.C. and to medical and school staff. For example, Dr.
    Ingram testified that “they” reported that D.D. had seizures, apparently referring to A.C., but that
    “they” did not corroborate this fact, apparently referring to medical personnel.
    6
    No. 1-22-0410
    He was, [sic] she was attentive to him throughout the observation. They laughed; they talked
    during the whole visit that I observed so it was a very positive visit.”
    ¶ 17             Dr. Ingram memorialized these observations, as well as her recommendations, in her
    report. Dr. Ingram recommended individual long-term therapy, medication management
    sessions, eating disorder treatment, substance abuse treatment, and additional parenting
    services. Dr. Ingram thought it was important that A.C. receive treatment to ensure that both
    A.C and D.D. were receiving proper nutrition. Although A.C. denied drug abuse or overusing
    her prescription medicine, Dr. Ingram noted that there were “allegations that she overused her
    prescribed medications.” However, Dr. Ingram did not specify the source of these allegations.
    ¶ 18             Dr. Ingram testified that she reviewed “D.C.F.S. records” that indicated that A.C.’s
    home was cluttered and unclean. The records included black-and-white photos of the home
    that Dr. Ingram reviewed. In Dr. Ingram’s opinion, the issue was “more towards hoarding.”
    The photos showed clothes and objects on the floor, and that some rooms were “impassable.”
    ¶ 19             On cross examination, Dr. Ingram testified that she believed A.C.’s reporting about her
    history and history of events was reliable. A.C. informed Dr. Ingram that, after D.D. was taken
    into DCFS custody, A.C had obtained a restraining order against her brother to prevent him
    from living in A.C.’s house. Dr. Ingram had no reason to doubt that was true. Dr. Ingram did
    not, herself, diagnose A.C. with anorexia or make any mental health diagnosis of A.C.
    According to the medical records which Dr. Ingram received, A.C. was first diagnosed with
    anorexia when A.C. was 13 or 14 years old. Dr. Ingram testified that her review of A.C.’s
    medical records showed that, although A.C. had been hospitalized several times for anorexia,
    including in her thirties, A.C. had not been hospitalized or treated for it in over 10 years, and
    the last time was before D.D. was born.
    7
    No. 1-22-0410
    ¶ 20              Dr. Ingram testified that D.D.’s medical records indicated that, when he was born, he
    was “[j]aundiced” and had “G-e-r-d.” 2 When D.D. was in the “N.I.C.U.,” someone called
    DCFS concerned about A.C.’s mental health and how it would affect her parenting. When Dr.
    Ingram was conducting her assessment, A.C. had met with her therapist, Ellison, three times.
    Ellison reported that A.C. was “ ‘determined’ ” and “ ‘extremely committed.’ ”
    ¶ 21              During Dr. Ingram’s observation in August 2020 in the park, Dr. Ingram noted that
    A.C. was very affectionate with D.D. and D.D. was very affectionate with A.C. While in the
    park, A.C. and D.D. held hands, A.C. encouraged D.D. to drink water because it was very hot
    outside, and A.C. provided D.D. with snacks. A.C. was concerned with D.D.’s comfort in light
    of the heat. With respect to COVID-19 protocols, A.C. made sure D.D. used hand sanitizer and
    wore a mask. A.C. and D.D. used the swings together, and A.C. gave D.D. a piggyback ride.
    They laughed and talked the whole time. Dr. Ingram did not observe any deficits in A.C.’s
    functioning at that time, and A.C. was responsive to D.D’s needs.
    ¶ 22              Dr. Ingram testified that a caseworker, Robert Hull, was physically present with D.D.
    and A.C. in the park. Hull informed Dr. Ingram that Dr. Ingram’s observations of that particular
    visit were consistent with the agency’s observations of prior visits. Dr. Ingram testified that
    the conduct during the visit gave her no reason for concern. One of Dr. Ingram’s
    recommendations was for dialectical behavior therapy, 3 which she testified could not be
    completed in three weeks or three sessions and required, in her opinion, “at least six months”
    of treatment. Dr. Ingram opined that the therapy required “at least six months to eighteen
    months *** to be effective with people,” such as A.C., who “have more than one mental-health
    2
    This appears to be a reference to gastroesophageal reflux disease. “N.I.C.U” appears to be a
    reference to a neonatal intensive care unit.
    3
    The trial court interjected that this was otherwise known as “[o]ld fashioned therapy.”
    8
    No. 1-22-0410
    diagnosis.” Dr. Ingram stated that she wanted A.C. to make progress first in her individual
    therapy before beginning the other services that Dr. Ingram had also recommended. One of the
    other recommended services was “Medication Management.” Dr. Ingram was aware that A.C.
    had been prescribed several medications by a psychiatrist.
    ¶ 23              In conclusion, Dr. Ingram testified that it was her opinion that, if A.C. “engage[d]
    consistently with the therapeutic services recommended,” A.C. would be an appropriate parent
    for D.D.
    ¶ 24              The State next called Ross, a program director for child welfare cases at Volunteers of
    America (VOA). Although Ross was involved in arranging clinical staffing for this case, she
    had no direct or supervisory authority over this case. 4 The next witness was Ruffin, a VOA
    foster care supervisor since July 2021. Ruffin testified that her only connection with this case
    was supervising D.D.’s caseworker, Smith. Ruffin testified that, prior to July 2021, A.C. had
    texted D.D. about his “Adoption Goal,” and D.D. had texted his grandparents that he did not
    want to be adopted. Based on this information, “the agency” 5 decided that “no unsupervised
    contact should be granted.” Ruffin testified that VOA was not opposed to termination because
    A.C. had “not engaged in the necessary services” required in “the Integrated Assessment.” On
    cross, Ruffin testified that Smith, the caseworker, had told her about the texts.
    ¶ 25              The next witness, Ellison, a therapist at UCAN,6 testified that she had been A.C.’s
    therapist for two months in 2020. Ellison is a licensed professional counselor. After A.C. was
    referred for therapy by DCFS, Ellison held eight phone sessions with A.C. The first phone call
    4
    Ross testified that, from March to July 2020, all visits were virtual, and from July 2020 until
    June 2021, there were bi-weekly in-person visits in addition to virtual visits. After June 1, 2021, VOA
    began all weekly in-person visits.
    5
    Ruffin did not specify who at VOA made this decision.
    6
    Ellison did not testify what the acronym UCAN stood for.
    9
    No. 1-22-0410
    was on July 21, and the last was on September 29, 2020. Ellison opined that, during these eight
    phone calls, A.C. “made no progression. She felt as if everything was happening to her, and
    she played no part in everything that happened.” As a result, Ellison discharged A.C. from
    therapy on September 29 as “unsuccessful.” 7 When asked why therapy was done over the
    phone as opposed to video, Ellison testified that, while typically she honored the client’s
    request or “capabilities,” she did not recall why the phone was utilized in this particular case.
    ¶ 26              In September 2020, Ellison wrote a letter to A.C. informing A.C. that her sessions
    would end. The letter stated: “Your circular thinking showcases an inability to recognize the
    parental expectations for healthy, age-appropriate development, and physical and emotional
    safety of your son.” At the hearing, Ellison explained that what she meant by circular thinking
    was that, instead of accepting “accountability” that could lead to progress, A.C. thought
    “[e]verything is happening to me and we in turn are the victims.” Ellison testified that, although
    both D.D.’s father and one of A.C.’s brothers had died of drug overdoses, 8 A.C. seemed
    unaware that the brother who lived with her was “on drugs.” Ellison noted that the presence of
    drug paraphernalia was what led to this case being brought to DCFS’s attention.
    ¶ 27              In her September 2020 letter, Ellison also wrote that A.C. lacked the “commitment to
    change and intra-personal honesty it takes to successfully make progress” in therapy. At the
    hearing, Ellison explained that whenever the conversation veered to a topic that was
    “substantial or could be of relevance to her progress, she would negate” it or “brush over it or
    shut it down immediately.”
    7
    Ellison’s discharge of A.C. from this particular service occurred only a few weeks after Dr.
    Ingram’s assessment that A.C. could be an appropriate parent upon completion of services.
    8
    A.C. later testified that her brother had not died of drugs.
    10
    No. 1-22-0410
    ¶ 28             Ellison testified that, after the last phone call on September 29, 2020, she had no contact
    with A.C., except for a phone call from A.C. sometime later in 2020. Ellison could not recall
    the month in 2020 when A.C. called. While A.C. was in the office with her permanent
    caseworker, A.C. called to say that she was “totally caught off guard” by Ellison’s termination
    of therapy. On cross, Ellison testified that the call was from both A.C. and A.C.’s caseworker
    and that it occurred on September 29, 2020.
    ¶ 29             On cross, Ellison acknowledged that, although A.C. was referred in February 2020, the
    first phone session was not held until months later, at the end of July. At the time of A.C.’s
    therapy, Ellison had approximately 22 other clients. Prior to Ellison’s conversation with Dr.
    Ingram in which Ellison reported that A.C. was determined and committed to the process,
    Ellison had already held three of the eight phone sessions. Ellison could not recall whether she
    received a copy of the “Parenting Capacity Assessment” that Ellison participated in and that
    Dr. Ingram completed. Ellison agreed that she and A.C. had “not engage[d] in a full series of
    D.B.T. or Dialectical Behavioral Therapy.” Ellison acknowledged that “circular thinking” was
    not a clinical term, and she was using the term “colloquially.”
    ¶ 30             On cross, Ellison acknowledged that, in her discharge letter, she recommended that
    A.C. complete other training, such as domestic violence and drug counseling, before resuming
    individual therapy. Ellison was not aware, at the time, that this contradicted Dr. Ingram’s
    recommendation regarding the sequence of these services.
    ¶ 31             After cross, the trial court examined Ellison, and respondent’s counsel objected to the
    leading questions. The court summarized Ellison’s testimony as opining that A.C. viewed
    herself as the victim, so that there was “no reason *** to get better,” and then asked, “is that
    basically your testimony?” Ellison agreed.
    11
    No. 1-22-0410
    ¶ 32             The next witness, Stewart, a VOA case aide, testified that she observed a visit between
    A.C. and her son, D.D. in a park during the second part of 2020. A.C. provided snacks and
    bottles of water. At one point, A.C. gave D.D. a “PediaSure.” and when Stewart later dropped
    D.D. off at home, the foster parent informed Stewart that D.D. was not supposed to have that.
    Stewart explained that PediaSure helped with nutrition and weight gain, and D.D. was “a
    healthy-sized boy.” Respondent’s counsel objected to the PediaSure testimony on relevance
    grounds. The trial judge agreed that he did not see the relevance, explaining: “She gave him
    one bottle of PediaSure; okay. What’s the big deal?”
    ¶ 33             On cross, Stewart testified that the first visit she observed was on July 6, 2020, in a
    park. Stewart observed A.C. making sure that D.D. had an appropriate amount of water and
    rest, because it was hot outside. Stewart observed A.C. and D.D. praying together and talking
    about how his July 4 holiday went. She observed them playing games together on A.C.’s
    phone. During that visit, Stewart did not observe anything inappropriate or concerning. The
    next visit that Stewart observed was a virtual visit on November 16, 2020. Stewart observed
    A.C. talking with D.D. about specific classes, homework assignments, and activities, including
    karate and video games, and his plans for the upcoming Thanksgiving holiday. A.C. gave D.D.
    some tips for doing his homework, such as showing his work for math problems.
    ¶ 34             Stewart observed another virtual visit on November 30, 2020, where they again talked
    about particular classes and homework. A.C. and D.D. did an activity together, which was
    making a paper airplane. A.C. shared some suggestions about how to make a better plane and
    gave him encouragement to keep trying when his plane did not fly. They discussed COVID-
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    No. 1-22-0410
    19 safety protocols and tips for being in quarantine, Christmas plans, and “The Grinch.” Again,
    Stewart did not observe anything inappropriate or concerning during the virtual visits.9
    ¶ 35              Dolan, a supervisor in VOA’s foster care department, testified that she supervised
    D.D.’s case from November 2019 until November 2020 but she had no direct contact with
    A.C., other than attending one or two court hearings and one mediation. Dolan supervised
    Deaundra Kerby, D.D.’s caseworker, from November 2019 to June 2020, and then again from
    October 2020 to November 2020. From July 2020 through September 2020, Kerby was on
    maternity leave, and during that time, VOA had a “Temp Worker” on the case. 10 During
    Dolan’s supervision of the case, VOA did not recommend unsupervised visits, primarily
    because of reports of “prolong[ed] emotional goodbyes” that left D.D. upset and confused.
    Dolan testified that the reports of these goodbyes came to her from Kerby and some of the case
    aides who supervised visits, but Dolan could not name the case aides.
    ¶ 36              Dolan testified that services “recommended for reunification included [1] Domestic
    Violence Services, [2] a [Juvenile Court Assessment Program (JCAP)] Substance Abuse
    Assessment, and possible follow-up services as needed; [3] Parenting Classes and Coaching,
    [4] Individual Therapy, [5] Psychiatric Assessment, and [6] Parenting Capacity Assessment.”
    Of these services, referrals were made only for (1) parenting classes, (2) individual therapy,
    and (3) the JCAP substance abuse assessment. No referral was made for domestic violence
    services because the decision was made to wait until individual therapy was completed, but
    9
    At the end of her testimony, Stewart testified that she observed approximately five visits
    from July through November 2020, both in-person and virtual. However, she described only three in
    her testimony.
    10
    The “Temp Worker” was Hull. Dr. Ingram had testified that Hull was physically present
    with D.D. and A.C. in the park when Dr. Ingram observed them. Hull was the one who informed Dr.
    Ingram that her observations of that visit were consistent with the agency’s observations of prior
    visits.
    13
    No. 1-22-0410
    that never happened. A.C. successfully completed parenting classes, but no referral was made
    for parenting coaching, although required. No referral was made for coaching because they
    were waiting for “input from the Individual Therapist.” No referral was made for eating
    disorder services because that treatment was generally not covered by DCFS. After Ellison
    terminated A.C.’s therapy, no further referral was made for individual therapy. Dolan’s
    understanding was that Ellison recommended that A.C. complete domestic violence services
    and substance abuse services before restarting individual therapy. However, as noted, Dolan
    testified that no referral for domestic violence services was ever made.
    ¶ 37             Dolan testified that, in November 2020, a meeting was held with Dolan, Kerby and
    Ross, the VOA program director for child welfare cases, and the three of them changed the
    permanency goal for D.D. from reunification to “Substitute Care Pending Termination of
    Parental Rights.” Dolan’s supervision of the case ended in 2020, when Kerby left the office
    and the case was taken over by another caseworker, Smith, who had a different supervisor,
    namely, Ruffin.
    ¶ 38             After direct examination, the court examined Dolan, asking the reason why D.D. came
    into the system in the first place. Dolan answered that there were controlled substances in the
    home that were in reach of the minor. The judge replied that he was “frustrated” because he
    “thought the case came in because the house was a complete mess” and D.D. was in diapers
    and not brushing his teeth. The court observed, “If there’s drugs in the house; there shouldn’t
    be; they could still be a good parent. The question was: was she a good parent when all ***
    this was going on? Did she make steps to improve; isn’t that really why we are here, Miss
    Dolan?”
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    No. 1-22-0410
    ¶ 39             The court then asked Dolan if, in her opinion, A.C. made steps to improve the situation.
    Dolan replied that A.C. did make “some steps to improve” and “did make efforts to engage in
    services.” Dolan observed that A.C. completed parenting classes and attended visits with D.D.
    consistently. However, “there were many areas of care opening *** about the lack of care” for
    D.D. “that appeared to not be comprehended.” The court asked, “She didn’t understand the
    situation; is that correct?” Dolan agreed.
    ¶ 40             On cross, Dolan testified that the case first came into the office in December 2019. A.C.
    complied with all of VOA’s requests to sign consent and release forms, initially and again in
    March and August 2020. Respondent’s counsel then asked Dolan about VOA’s referrals. The
    first referral that VOA made was in February 2020 for the “Nurturing Parent Program.”
    However, that turned out to be an inappropriate referral because D.D. was too old for the
    program. The next referral was for parenting classes in the spring, which A.C. completed
    successfully in June 2020. VOA recommended a JCAP substance abuse assessment on June
    16, 2020, which A.C. completed and which indicated that she did not qualify for substance
    abuse services at that time. Dolan added that JCAP required a “drop” or drug test, which was
    not completed. However, Dolan acknowledged that A.C. had completed a drug test or “drop”
    with her agency prior to the assessment. The test had been positive for benzodiazepines and
    barbiturates, although these substances could be accounted for by A.C.’s documented drug
    prescriptions. 11 A.C. engaged in individual therapy until discharged, and no further referral
    was made during the 2½ months between the discharge and the goal change. No further referral
    was made because the therapist recommended that A.C. engage in domestic violence and
    11
    Smith, the caseworker who was assigned in December 2020, testified that A.C. had one
    positive drug test in November 2020 and, since then, there had been three negative tests.
    15
    No. 1-22-0410
    substance abuse services first.12 Dolan acknowledged that Dr. Ingram’s report recommended
    just the opposite: that A.C. engage in individual therapy before beginning either domestic
    violence or substance abuse services.
    ¶ 41             Next, respondent’s counsel asked Dolan about visitation. The plan, which A.C. signed
    in early 2020, called for a minimum of twice a week in-person visits. The plan changed in
    March 2020 due to COVID-19, and visits became virtual and for less time. Dolan testified that
    there was no other reason than COVID-19 for the restriction of A.C.’s visits in March 2020.
    Twice-a-week in-person visits resumed in July 2020. Dolan agreed that A.C. visited as much
    as she was allowed. If there was a conflict with her work schedule, A.C. was “pretty good
    about communicating with the caseworker” and rescheduling. On September 1, 2020, Dolan
    engaged in a mediation regarding this case, and the result was an agreement that visits would
    be twice a week and in person, plus phone calls. In December 2020, when the goal changed to
    termination, Dolan was not the supervisor at that time. However, Dolan testified that her
    agency would have stopped making referrals at that time because DCFS would have stopped
    paying for services after the goal changed. Dolan stopped being the supervisor in November
    2020, shortly before the goal changed.
    ¶ 42             Dolan testified that a report of D.D.’s therapy indicated that, in November 2020, or
    almost a year after the case came to DCFS, D.D. continued to wear Pull-Ups and sometimes
    wet himself during the night.
    ¶ 43             The next witness was Smith, a VOA caseworker, who became A.C.’s caseworker in
    December 2020 after the former caseworker, Kerby, left the office. Smith did not make any
    12
    However, Dolan had just testified that JCAP had concluded that substance abuse services
    were not warranted.
    16
    No. 1-22-0410
    referrals for A.C. after becoming the caseworker. A.C. asked Smith “about how was she
    supposed to go about doing services” because, once the goal changed to termination, no
    referrals were made. Smith told her to “go through her insurance to possibly get services.”
    ¶ 44              Smith supervised a total of seven visits between A.C. and D.D., with five of those visits
    being in-person. The five in-person visits occurred once a month, from January through May
    2021, at a library, with each visit lasting approximately two hours. Smith asked A.C. to talk to
    Smith prior to the in-person visits concerning what A.C. intended to bring with her, and A.C.
    adhered to that directive. However, during the visit on May 17, 2021, Smith noticed that D.D.
    had an uncomfortable look on his face. Smith testified that D.D. looked “confused,” and he
    looked at Smith and then looked at A.C.’s phone. This action prompted Smith to ask what A.C.
    had shown on her phone, but “he replied nothing.” A.C. stated that she had not shown D.D.
    anything. After the May 17, 2021, visit, the agency moved the visits to Zoom so that nothing
    “could be said or shown without [their] seeing it on the screen.”
    ¶ 45              Smith testified that, during the Zoom visits, Smith had the impression that A.C. was
    going down a list of questions. Smith felt that A.C. talked more about her feelings, saying
    things like “I love you.” rather than talking about D.D.’s feelings. Smith did not discuss these
    impressions with A.C. since A.C. was not doing anything inappropriate.
    ¶ 46              On cross, the assistant public guardian asked what, if anything, did D.D. tell Smith
    about what his mother had told him on May 17, 2020. A.C. told D.D. that he was going to be
    adopted. Smith found that concerning because that should have been raised with D.D. by his
    therapist in a clinical setting.
    ¶ 47              On cross, A.C.’s counsel asked about an in-person visit on February 22, 2021, and
    Smith testified that A.C. brought Valentine’s Day gifts and a birthday present, that they played
    17
    No. 1-22-0410
    the card game “Uno,” and that A.C. asked how school was going. Smith had no issues or
    concerns about that visit. During the March 15, 2021, visit, A.C. brought toys for her son, and
    they colored and did arts and crafts together. Again, Smith had no concerns about that visit.
    During the April 19, 2021, visit, A.C. brought D.D. new clothes and snacks. After VOA
    stopped making referrals, it was left to A.C to find those services on her own.
    ¶ 48             Smith testified that A.C. had one positive drug test in November 2020 and, since then,
    there had been three negative tests. In May 2021, five months after the goal changed to
    termination, VOA indicated that certain services, such as parent coaching, would be required
    for unification, but that those services were not available due to the goal change. Smith agreed
    that there were “no opportunities for [A.C.] to participate in those services at that time.”
    ¶ 49             After the State rested and the trial court denied respondent’s motion for a directed
    verdict, respondent called Dr. Tarawneh, a clinical psychologist, who was A.C.’s therapist after
    VOA terminated services. Dr. Tarawneh completed a mental health evaluation for her and saw
    her on a weekly basis from March 2021, through early July 2021, for a total of 20 visits. During
    those visits, A.C. improved and made progress in her therapy. As evidence of her progress, Dr.
    Tarawneh cited the fact that A.C. was able to find a job and work consistently. Dr. Tarawneh
    had no issues communicating with A.C. and no problems with her communication. Dr.
    Tarawneh agreed that she had progressed “to the point where she was ready to make the [next]
    step,” which he believed was to see a psychiatrist who could assess the medication that she
    was taking. In the mental health evaluation, which he completed in May 2021 of A.C., he
    indicated that she had depression but that her thoughts were coherent, congruent, and logical.
    ¶ 50             The next witness was A.C., who testified that, when her caseworker informed her that
    the agency had changed the goal to termination, the caseworker also told her that she would
    18
    No. 1-22-0410
    have to find her own “community-based” services. The services that A.C. was able to locate
    on her own were Dr. Tarawneh and, subsequently, the “Trauma Recovery Center” (TRC). She
    started services at TRC after her sessions with Dr. Tarawneh ended. A.C. testified that TRC
    provided “Counseling, Psychiatry, and a Caseworker or Social Worker.” TRC provided a 16-
    week program, and A.C. was still seeing the caseworker. Through TRC, A.C. was able to see
    a psychiatrist. A.C.’s first doctor was Dr. Galecky, and A.C. was presently in the care of Dr.
    Alejandra Besterfeldt, whom A.C. had seen twice and was scheduled to see next month.
    ¶ 51             A.C. testified that, since the case started in November 2019, she had been taking
    prescription medicine that had been prescribed by a medical professional. The day after her
    “son was taken,” she obtained a restraining order against her brother who had been living in
    her house. Her brother and his friends had contributed to the mess in the house. First, she
    obtained an emergency order and then a two-year order. When no one came to serve her brother
    with the emergency order, she called the police and he moved out. The town in which she lived
    restricted her ability to live in the house because of its condition, but she received permission
    to enter it in order to clean it up, which she did. A little over a month later, the town inspected
    the house and certified that it was clean. Respondent’s counsel then introduced a letter from
    the town in December 2019 that certified that the house was clean and suitable for occupancy.
    The State stipulated to its admissibility. A.C. testified that a representative from the town
    visited the house again during the summer of 2021 and found no concerns.
    ¶ 52             A.C. testified that, after Kerby was assigned as her caseworker, A.C. made efforts to
    stay in communication with her about the services recommended by VOA. For example, A.C.
    found parenting classes and then asked VOA to send a referral for them. VOA communicated
    with her only by e-mail, and A.C. was not permitted to call. In the e-mails, A.C. always
    19
    No. 1-22-0410
    “c.c.’d” 13 her attorney. In these e-mail exchanges, A.C. asked if they had sent referrals and
    advised them of when services were completed. Respondent’s counsel introduced the e-mails,
    which the court admitted.
    ¶ 53             A.C. testified that her son knew how to brush both his teeth and his hair and that she
    was working with him on his ability to know when he had to go to the bathroom. A.C. stated,
    “I cannot imagine what my son thinks and feels since May 17th. He probably thinks that his
    mommy did not care; that I gave up, and that is not the case.” The picture that she showed her
    son on her phone during an in-person visit was the picture of “a flood” that occurred at her
    work, and the surprised look was “his reaction.” A.C. clarified that her brother who died was
    not on drugs, although he had attempted suicide. The brother who lived with her was the
    brother on drugs. When D.D. started school, A.C. asked the school if he could see a
    psychologist or counselor for therapy.
    ¶ 54             The trial court and A.C. then had the following exchange:
    “THE COURT: Ma’am, I saw pictures of that house; and, when you say you did
    everything you could, how could you live there with a little boy in a house in that
    condition?
    RESPONDENT’S COUNSEL: I would object to the form of the question.
    THE COURT: No; that’s the whole; that’s what this case is about. This case came
    in because this little boy was living in some of the worst circumstances I’ve ever seen
    in photographs and descriptions; and as I’ve said, I have been in terrible homes. I was
    the Public Guardian. I had to go into homes all the time with elderly people who suffer
    13
    Copied.
    20
    No. 1-22-0410
    from Dementia and this; and I could not smell it; but, from what I saw there, ma’am, I
    didn’t understand how you could have a little boy in that house.
    A.C.: And I don’t blame you for feeling that way. I did everything I could to [sic]
    coming home, having my brother have five friends in the house [sic] to making chicken
    grease all over the place. They didn’t, they didn’t care. When my brother would leave,
    I was throwing things away; doing everything I could. I could not stand living like that.
    I could not stand it. I was trying so hard and—
    THE COURT: You did get him out of the house the day after your son was
    removed?
    A.C.: Yeah, and I started, after I came home, I started cleaning. I was at the
    courthouse. Right after I took my drug screen after half of the day waiting to get my
    emergency [restraining order] until I got to see if I could get my two years [permanent
    restraining order] or whatever [time] they were going to give me [sic] for, you know to
    keep my brother away.
    THE COURT: Now, you heard Miss Ellison testify, you know, it’s to me[,] it was
    a terrible situation; but the child was taken away and there was a ruling made that you
    neglect[ed] him; but now we are at a different phase and the question is: should I
    terminate your rights and you heard Miss Ellison testify that you never would admit to
    your role in the blame; that you considered yourself a victim.
    What do you have to say about that?
    A.C.: No; it wasn’t, it wasn’t that I played [the] victim or I blamed everybody else.
    I honestly didn’t feel to a sense that I was hurt, and I was just being judged; and yeah,
    it was bad. It was awful. It was disgusting when my brother—lifting up of couches;
    21
    No. 1-22-0410
    there [were] milk jugs underneath the couch, like little, tiny jugs. It was so bad like it
    was worse than what the pictures [showed] ‘cuz he was just putting stuff underneath
    the couch like he didn’t do anything; no.
    THE COURT: We are, I don’t know that. [Sic.] Now there was a Finding of
    Neglect. Now, the question is: should we terminate your rights? The question I asked
    was: Miss Ellison testified that, that you never seem to admit your fault in the situation;
    and that you were the victim?
    A.C.: No; that’s not—that’s not, I don’t feel that way at all. I mean, I admit my
    faults; but my son is gone. I never had problems; and I did it all by myself with my son
    for seven years. He’s my everything. My home is spotless.”
    ¶ 55             When the court asked about reports that her son did not know how to brush his teeth,
    A.C. responded that was “not true,” and that her son brushed his teeth “every morning and
    every night. However, when he was taken from her, it was “traumatizing to him” because he
    had been with her “every day.”
    ¶ 56             After testimony finished, the court recessed until March 9, 2022, for closing arguments.
    The trial court found A.C. unfit in a ruling described above and proceeded to the best interests
    hearing, described below.
    ¶ 57                                       B. Best Interests Hearing
    ¶ 58             The State recalled Smith, one of the caseworkers, who had previously testified at the
    fitness hearing. Smith testified that D.D. had been placed with his paternal grandparents in
    June or July 2020 and that Smith had last seen him within the last 30 days. Smith opined that
    the placement was safe and appropriate for D.D., who had just turned 10 years old and was in
    the fourth grade and on the honor roll. D.D. was in therapy and had been in therapy since Smith
    22
    No. 1-22-0410
    was assigned the case in December 2020. He was in therapy due to “issues that brought the
    case in,” and Smith stated that it was helpful for him. Smith observed D.D. interact with his
    grandparents twice a month, and he appeared “comfortable” and “playful” with his
    grandparents, who had a lot of time to dedicate to hm. D.D. seemed happy in their home. In
    January 2022, Smith had an opportunity to speak to D.D. alone. At that time, D.D. was opening
    gifts and “very excited about his gifts,” and he told Smith that he liked it there and wanted to
    stay. Smith did not discuss adoption with him because she felt it was better to leave that topic
    to his therapist. In February 2022, Smith participated in a meeting and, as a result of that
    meeting, her agency recommended termination of parental rights and appointment of a
    guardian who could consent to adoption, with the grandparents providing the contemplated
    adoptive home.
    ¶ 59             On cross, Smith testified that, since she was assigned to the case in December 2020,
    the grandparents had refused all communication with the mother. The grandparents told Smith
    that they had received a text from A.C. in December 2020 but A.C. denied sending the text.
    Smith had not seen the alleged text and so had no means of verification. The grandparents did
    not want to have any contact with A.C. and told Smith that they would not allow D.D. to have
    any contact with his mother. Since Smith had been the caseworker, A.C. had repeated contact
    with D.D., but those visits would entirely come to an end if her rights were terminated.
    Although sometimes D.D. asked to end the virtual visits early, he never said to Smith that he
    did not want to see his mother, and he participated in the visits.
    ¶ 60             The next witness was the foster mother and paternal grandmother. When D.D. came
    into the system, she and her husband had been living in Florida since 2006. They moved back
    to Illinois in order to care for D.D., and they want to adopt him. The foster mother testified that
    23
    No. 1-22-0410
    D.D. had “a whole village of family members” here, and he visited regularly with his uncles,
    aunts, and cousins.
    ¶ 61             After the State and respondent rested, the trial court found it was in D.D.’s best interests
    to terminate his mother’s parental rights, in a two-paragraph ruling which we quoted above.
    On March 29, 2022, A.C. filed a timely notice of appeal, and this appeal followed. On appeal,
    the State adopted the Public Guardian’s brief. 14
    ¶ 62                                                  ANALYSIS
    ¶ 63             On appeal, respondent A.C. argues that the trial court’s findings are against the
    manifest weight of the evidence and should be reversed. We examine, first, the trial court’s
    unfitness finding because it serves as the basis for the subsequent best interests ruling. “The
    bifurcated nature of termination proceedings calls for the court to make a determination
    regarding the parent’s fitness first, without considering the child’s best interests or the
    likelihood of eventual adoption.” In re Tyianna J., 
    2017 IL App (1st) 162306
    , ¶ 89.
    ¶ 64                                            I. Standard of Review
    ¶ 65             The State alleged three separate grounds of unfitness. Although any one ground, if
    properly proven, is sufficient to support a finding of parental unfitness, the State bears the
    burden of establishing unfitness by clear and convincing evidence. Tyianna J., 
    2017 IL App (1st) 162306
    , ¶ 88. On appeal, the reviewing court considers whether the trial court’s “clear
    and convincing” finding was against the manifest weight of the evidence. Tyianna J., 
    2017 IL App (1st) 162306
    , ¶ 88. Findings are against the manifest weight of the evidence when an
    opposite conclusion is clearly apparent from the record. McAllister v. Illinois Workers’
    Compensation Comm’n, 
    2020 IL 124848
    , ¶ 30. Although reviewing courts are reluctant to
    14
    As a result, when discussing their collective arguments, we refer to them as “the State.”
    24
    No. 1-22-0410
    conclude that a determination is against the manifest weight of the evidence, we will not
    hesitate to do so when the clearly evident weight of the evidence compels an opposite
    conclusion. McAllister, 
    2020 IL 124848
    , ¶ 30.
    ¶ 66             “Decisions rendered in other cases are of limited assistance” in termination cases, as
    “ ‘[e]ach case concerning parental unfitness is sui generis, unique unto itself.’ ” Tyianna J.,
    
    2017 IL App (1st) 162306
    , ¶ 88 (quoting In re Adoption of Syck, 
    138 Ill. 2d 255
    , 279 (1990)).
    As a result, factual comparisons to other cases are of little value. In re Nicholas C., 
    2017 IL App (1st) 162101
    , ¶ 25.
    ¶ 67             In the case at bar, the trial court stated that it relied heavily on the testimony of Ellison,
    the mother’s therapist for two months. On appeal, respondent argues that the conclusions of
    Ellison’s phone therapy are not entitled to much weight
    ¶ 68             Courts have often stated that appellate courts generally owe deference to a trial court’s
    evaluation of evidence because trial courts are in a unique position to observe witnesses’
    demeanor and hear their tone of voice, in contrast to a reviewing court that has only a cold,
    lifeless transcript before it. E.g., People v. Parker, 
    2016 IL App (1st) 141597
    , ¶ 29 (a reviewing
    court owes deference to a trial court’s assessment of a witness’ credibility where the trial court
    is in a superior position to observe the witness’ demeanor); People v. Herman, 
    407 Ill. App. 3d 688
    , 708 (2011) (“we give great deference to the trial court’s assessment of the [witnesses’]
    demeanor”); Ayers v. Ayers, 
    142 Ill. 374
    , 375 (1892) (per curiam) (no certificate of evidence
    “can reproduce fully and accurately the countenance, tone of voice and manner of the witness
    while testifying”).
    ¶ 69             However, in an age of distant connections, the question arises: do we owe the same
    level of deference when a trial court evaluates by Zoom a therapist’s assessment by phone?
    25
    No. 1-22-0410
    Respondent argues against placing too much weight on phone therapy, and we have all heard
    the old adage about “playing telephone.” While Zoom is certainly better than a paper record,
    how many degrees of separation are needed before we, the reviewing courts, adjust our level
    of deference? Cf. People v. Shaw, 
    2015 IL App (1st) 123157
    , ¶ 29 (“a trial court does not
    occupy a position superior to the appellate courts in evaluating evidence that is not live
    testimony” (citing People v. Radojcic, 
    2013 IL 114197
    , ¶ 34)); Addison Insurance Co. v. Fay,
    
    232 Ill. 2d 446
    , 453 (2009) (“Without having heard live testimony, the trial court was in no
    superior position than any reviewing court to make findings, and so a more deferential standard
    of review is not warranted.”). However, even applying the manifest weight standard of
    deference, we find we must reverse.
    ¶ 70             The evidence cited by the trial court was substantially drawn from the initial reasons
    for the child’s removal from the home, which was principally the unkempt condition of the
    home itself. In fact, the court stated that this was the “whole” case. However, if this was the
    whole case, then there would have been no reason for all the proceedings and services that
    subsequently occurred in the following two years: after all, courts presume that judicial
    proceedings and required services are not a meaningless exercise. There is no question that
    A.C. completely turned her life around after her son was removed: she obtained a court order
    against her brother; she kept her home clean as certified by her town; she found and kept a job;
    and she located therapy on her own, even after services were cut off, and attended therapy, at
    least until the day of her testimony.
    ¶ 71             It is difficult to say that someone is an unfit parent for failing to progress if the
    recommendations and referrals are confusing, contradictory, and at times unavailable, and the
    staff in charge of the case cannot agree on the order in which the services should proceed.
    26
    No. 1-22-0410
    Admittedly, these are just overarching observations at this point, but we discuss each of the
    grounds, separately and in detail, below.
    ¶ 72                                 II. Interest, Concern, and Responsibility
    ¶ 73              The first alleged ground was Ground B: “[f]ailure to maintain a reasonable degree of
    interest, concern or responsibility as to the child’s welfare” 750 ILCS 50/1(D)(b) (West 2020).
    The disjunctive “or” means that a finding of unfitness may be found based on a failure of any
    one of the three elements in the list: interest, concern, or responsibility. Nicholas C., 
    2017 IL App (1st) 162101
    , ¶ 24.
    ¶ 74              Ground B does not focus on the parent’s success but, rather, on the reasonableness of
    her efforts and takes into account the parent’s difficulties and circumstances. Nicholas C., 
    2017 IL App (1st) 162101
    , ¶ 24; In re Daphnie E., 
    368 Ill. App. 3d 1052
    , 1065 (2006). Examples of
    unfitness under this ground include noncompliance with an existing service plan, a continuing
    addiction to drugs, a repeated failure to obtain treatment, and infrequent or irregular visitation.
    Nicholas C., 
    2017 IL App (1st) 162101
    , ¶ 24; Daphnie E., 368 Ill. App. 3d at 1054, 1065 (unfit
    under this ground where the mother was infrequent in attending both child visits and outpatient
    therapy and was noncompliant in taking her prescribed psychotropic medication for
    schizophrenia). 15 In Nicholas C., for example, the reviewing court found that the trial court’s
    unfitness finding under Ground B was not against the manifest weight, where the mother’s
    urine drops began testing positive again for drugs, where the mother refused to obtain a
    psychiatric evaluation and was terminated from therapy due to her failure to attend, and where
    15
    The State argued that “a failure to engage in those [mental health] services, despite visiting,
    supported a finding of unfitness of ground (b)” in Daphnie E., 368 Ill. App. 3d at 1065-66. Actually,
    in that case, the schizophrenic mother failed to attend both therapy and visits.
    27
    No. 1-22-0410
    the mother never remedied the risks associated with her living situation. Nicholas C., 
    2017 IL App (1st) 162101
    , ¶ 29.
    ¶ 75             In support of its finding on all three grounds, the trial court cited primarily: (1) the
    initial conditions of the home which led to D.D.’s removal and (2) A.C.’s “circular thinking,”
    as described by Ellison. However, the trial court did not apportion its findings among the three
    grounds or address the three grounds separately. As a result, with respect to Ground B, the
    court did not specify whether it found a lack of interest, concern or responsibility, or all three.
    In its brief to this court, the State headlined its section on Ground B as A.C. “failed to show
    responsibility” and focused its arguments on that particular element of Ground B. “Failure to
    maintain a reasonable degree of *** responsibility as to the child’s welfare” (750 ILCS
    50/1(D)(b) (West 2020)), by itself, is sufficient to support a finding of unfitness. Nicholas C.,
    
    2017 IL App (1st) 162101
    , ¶ 24.
    ¶ 76             In support of its argument that initial conditions may sustain a trial court’s finding
    under this ground, the State cited In re J.B., 
    2014 IL App (1st) 140773
    , ¶ 47. In J.B., the mother
    severely beat her eight-year-old child, resulting in several fractures, including fractures of his
    pelvis and femur bones. J.B., 
    2014 IL App (1st) 140773
    , ¶¶ 18-21. As the doctor in J.B.
    observed, the femur is a very big bone and needs a substantial impact to break. J.B., 
    2014 IL App (1st) 140773
    , ¶ 19. After this beating, the mother was incarcerated, a no-contact order was
    entered, and DCFS did not provide any services toward reunification. J.B., 
    2014 IL App (1st) 140773
    , ¶¶ 4, 47. Based on the beating, the trial court found the mother unfit on several
    grounds, including depravity. J.B., 
    2014 IL App (1st) 140773
    , ¶ 26. This court affirmed the
    trial court’s finding based on the severe beating that brought the child into the system. J.B.,
    
    2014 IL App (1st) 140773
    , ¶ 54 (although this case was respondent’s first contact with DCFS,
    28
    No. 1-22-0410
    the trial court’s finding was affirmed, where her beating of her eight-year-old son “entailed
    such force that it broke [his]” femur and pelvis bones).
    ¶ 77              As the State must realize, the J.B. case is to our case like night is from day, and it
    illustrates the problem with comparing one case to another in this context. In J.B., the mother
    beat her child severely, the trial court entered a no-contact order, and no services were provided
    by DCFS toward reunification. J.B., 
    2014 IL App (1st) 140773
    , ¶¶ 4, 47.
    ¶ 78              By contrast, in the case at bar, Dr. Ingram testified that, in her opinion, if A.C.
    “engage[d] consistently with the therapeutic services recommended,” A.C. would be an
    appropriate parent for D.D. Dr. Ingram gave this opinion, fully aware of the reasons that
    brought D.D. into the system. Not a single professional who looked at the original conditions
    found those conditions to be an insurmountable barrier to reunification. Knowing full well
    what the original conditions were, the social service professionals in this case provided
    referrals and services toward a goal of reunification. Unless we were to find that all these
    professionals were completely misguided and their recommended services worthless, we must
    conclude that a finding of unfitness based on initial conditions is against the manifest weight
    of the evidence. 16
    ¶ 79              In addition to the initial conditions, the trial court also found Ellison’s testimony
    credible and quoted part of Ellison’s report, dated October 2, 2020, which stated, “the client’s
    circular thinking showcases an inability to recognize the parental expectations for a healthy,
    age appropriate development and physical and emotional safety of the client’s son.”
    16
    As noted above, the trial court noted, as part of its finding on initial conditions that, “He
    wasn’t potty trained. And within a week or two of being sent to live with his uncle, he accomplished
    these matters.” This finding was contradicted by the testimony of Dolan, the caseworkers’ supervisor,
    who testified at the fitness hearing that a report from D.D.’s therapy indicated that, in November
    2020, or almost a year after the case came to DCFS, D.D. continued to wear Pull-Ups and sometimes
    wet himself during the night.
    29
    No. 1-22-0410
    Immediately after quoting, Ellison, the trial court added, “I find the mother’s testimony, again
    to be indicative of some serious issues. I’m not a therapist. I don’t know what they are. But,
    obviously, they demonstrated themselves in the way her child was living and the way he was
    acting.” At the hearing, Ellison testified that what she meant by “circular thinking was that,
    instead of accepting accountability” that could lead to progress, A.C. thought “[e]verything is
    happening to me and we in turn are the victims.”
    ¶ 80              However, the manifest weight of the evidence shows that the minute her son was taken
    from her, instead of posing like a passive and helpless victim, A.C. acted like the protagonist
    in her own story and took responsibility to turn her life around. The undisputed testimony
    showed that (1) she obtained a protective order, the very next day, to get her brother out of the
    house; (2) she personally went to work cleaning her house, as soon as her brother was out of
    it, and kept it clean, as certified by her town; (3) she located a job and kept it; (4) she regularly
    and consistently attended whatever visitation was allowed her; (5) she regularly attended the
    services for which referrals were made; 17 and (6) after referrals were denied her, she located
    therapeutic services, including psychiatric therapy as was recommended, on her own and
    continued with it.
    ¶ 81              In August 2020, approximately eight months after this case came into the system, Dr.
    Ingram testified about her observations during an in-person visit between A.C. and D.D.: “[I]t
    appeared that [A.C.] had a loving and caring relationship with her son, [D.D.]; and it was
    reciprocated. He was [sic], she was attentive to him throughout the observation. They laughed;
    17
    Referrals were made only for (1) parenting classes, (2) individual therapy, and (3) the JCAP
    substance abuse assessment. A.C. completed parenting classes and the JCAP substance abuse
    assessment and attended individual therapy with Ellison until discharged, when A.C. then sought out
    and attended further therapy.
    30
    No. 1-22-0410
    they talked during the whole visit that I observed so it was a very positive visit.” Dr. Ingram
    testified that she did not observe any deficits in A.C.’s functioning in August 2020 and that
    A.C. was responsive to D.D’s needs. Dr. Ingram testified that a caseworker, Hull, who had
    been physically present with D.D. and A.C. in the park, indicated that Dr. Ingram’s
    observations of that visit were consistent with the agency’s observations of prior visits. Dr.
    Ingram testified, while she was doing her assessment, A.C. had three phone sessions with her
    therapist, Ellison, and Ellison had reported to Dr. Ingram that A.C. was “ ‘determined’ ” and
    “ ‘extremely committed.’ ” Dr. Ingram opined that the therapy required “at least six months to
    eighteen months *** to be effective with people,” such as A.C., who “have more than one
    mental-health diagnosis.” When Dr. Ingram completed the parenting capacity assessment for
    A.C. on September 4, 2020, Dr. Ingram concluded that if A.C. “engage[d] consistently with
    the therapeutic services recommended,” A.C. would be an appropriate parent for D.D.
    However, on September 29, 2020, after only two months and eight phone calls of therapy,
    Ellison terminated A.C.’s therapy as unsuccessful. The termination occurred just a few weeks
    after Dr. Ingram completed the parenting assessment opining that A.C. would be an appropriate
    parent after completion of services. For her part, Ellison recommended that A.C. complete
    other services before restarting therapy. However, despite the recommendations of both Dr.
    Ingram and Ellison, referrals for required services were almost immediately denied.
    ¶ 82             Courts must consider a parent’s efforts in the context of the circumstances in which
    they occur, including any difficulties that hinder those efforts. Daphnie E., 368 Ill. App. 3d at
    1064 (citing Syck, 
    138 Ill. 2d at 278-80
     (reversing the trial court’s finding of unfitness after
    considering, among other things, the obstacles that the mother faced, such as the foster parents’
    refusal to enable contact)). A.C. faced a catch-22—actually, a number of them. For example,
    31
    No. 1-22-0410
    although A.C. regularly attended individual therapy until discharged, no further referral was
    made during the 2½ months between the discharge and the goal change. Dolan, the
    caseworkers’ supervisor, testified that no further referral was made because the therapist
    recommended that A.C. engage in domestic violence and substance abuse services first. Dolan
    acknowledged that Dr. Ingram’s report recommended just the opposite: that A.C. engage in
    individual therapy before beginning either domestic violence or substance abuse services. 18
    However, Dolan also testified that JCAP had already concluded that substance abuse services
    were not warranted. Dolan testified that, after VOA recommended a JCAP substance abuse
    assessment, A.C. completed it and the resulting assessment indicated that A.C. did not warrant
    and, thus, did not qualify for substance abuse services at that time.
    ¶ 83              On appeal, the State argues that A.C. was resistant to both drug treatment and domestic
    violence services. However, A.C. completed the JCAP substance abuse assessment, which
    concluded that further drug abuse services were not warranted, and VOA refused to issue
    referrals for either drug or domestic violence services. Dolan testified that the services
    “recommended for reunification included [1] Domestic Violence Services, [2] a J.C.A.P.
    Substance Abuse Assessment, and possible follow-up services as needed; [3] Parenting
    Classes and Coaching, [4] Individual Therapy, and [5] Psychiatric Assessment [6] Parenting
    Capacity Assessment.” Of these services, referrals were made only for (1) parenting classes,
    (2) individual therapy, and (3) the JCAP substance abuse assessment. A.C. completed
    parenting classes and the JCAP substance abuse assessment and attended individual therapy
    until discharged, when she sought and obtained therapy on her own. No referral was made for
    18
    On cross, Ellison acknowledged that, in her discharge letter, she recommended that A.C.
    complete other training, such as domestic violence and drug counseling, before resuming individual
    therapy. Ellison was not aware, at the time, that this contradicted Dr. Ingram’s recommendation
    regarding the sequence of these services.
    32
    No. 1-22-0410
    domestic violence services because the decision was made to wait until individual therapy was
    completed, but that never happened. A.C. successfully completed parenting classes but no
    referral was made for parenting coaching, although required. No referral was made for parental
    coaching because they were waiting for “input from the Individual Therapist.” After Ellison
    terminated A.C.’s therapy, no further referral was made for individual therapy. Dolan’s
    understanding was that Ellison recommended that A.C. complete domestic violence services
    and substance abuse services before restarting individual therapy. However, as noted, Dolan
    testified that no referral for domestic violence services was ever made.
    ¶ 84             In light of the uncontested evidence that the initial conditions were no longer a barrier
    to reunification, that A.C. turned her life around when faced with the loss of her son (see supra
    ¶ 80), and that the referrals that she was tasked with following were confusing, contradictory,
    and often denied, we have no choice but to conclude that the trial court’s finding that A.C.
    failed to maintain reasonable efforts to assume responsibility is against the manifest weight of
    the evidence. See Nicholas C., 
    2017 IL App (1st) 162101
    , ¶ 24 (Ground B does not focus on
    the parent’s success but, rather, on the reasonableness of her efforts and takes into account the
    parent’s difficulties and circumstances); 750 ILCS 50/1(D)(b) (West 2020) (the parent must
    “maintain a reasonable degree of *** responsibility as to the child’s welfare”).
    ¶ 85                                       III. Reasonable Progress
    ¶ 86             The second alleged ground was Ground M:
    “[f]ailure *** (i) to make reasonable efforts to correct the conditions that were the basis
    for the removal of the child *** during any 9-month period following the adjudication
    of neglected *** minor *** or (ii) to make reasonable progress toward the return of the
    33
    No. 1-22-0410
    child to the parent during any 9-month period following the adjudication.” 750 ILCS
    50/1(D)(m) (West 2020).
    The nine-month period chosen by the State was March 14 to December 24, 2020. 19 We may take
    judicial notice of the fact that, on March 13, 2020, the President of the United States declared the
    COVID-19 pandemic to be a national emergency, causing the courts and most service providers
    to discontinue or curtail the provision of services and contact with the public. See Notice on the
    Continuation of the National Emergency Concerning the Coronavirus Disease 2019 (COVID-19)
    Pandemic, The White House (Feb. 18, 2022), https://www.whitehouse.gov/briefing-room/
    presidential-actions/2022/02/18/notice-on-the-continuation-of-the-national-emergency-
    concerning-the-coronavirus-disease-2019-covid-19-pandemic-2/ [https://perma.cc/7K59-TENN]
    (“On March 13, 2020, by Proclamation 9994, the President declared a national emergency
    concerning the coronavirus disease 2019 (COVID-19) pandemic.”). This most certainly
    contributed to A.C.’s alleged inability to progress.
    ¶ 87              Since the trial court did not apportion its findings among the three grounds or address
    the three grounds separately, the trial court did not specify, with respect to Ground M, whether
    it found a lack of reasonable efforts or a lack of reasonable progress In its brief to this court,
    the State headlined its section on Ground M as A.C. “failed to make reasonable progress in
    services.” The State quoted only this element and devoted its arguments to this element.
    ¶ 88              Our supreme court has defined reasonable progress as “ ‘demonstrable movement
    toward the goal of reunification.’ ” In re C.N., 
    196 Ill. 2d 181
    , 211 (2001) (quoting In re J.A.,
    
    316 Ill. App. 3d 553
    , 565 (2000)). “Under the statute’s express language, a parent’s progress
    19
    We note that this period is actually 10 days over nine months. However, this extra 10-day
    period does not seem to make a difference in the case at bar.
    34
    No. 1-22-0410
    toward this goal is judged under the familiar ‘reasonableness’ standard.” C.N., 
    196 Ill. 2d at 211
    . In considering whether reasonable progress has been made, a court may consider both
    progress with respect to correcting the original conditions and progress with respect to
    completing the service plan. See C.N., 
    196 Ill. 2d at 213-14
     (rejecting both the view that a court
    may look for progress only in correcting the original situation and the view that a court may
    look only to compliance with a service plan).
    ¶ 89              With respect to a service plan, Ground M provides, in relevant part, that “[i]f a service
    plan has been established *** and if those services were available, then, for purposes of the
    Act, ‘failure to make reasonable progress ***’ includes the parent’s failure to substantially
    fulfill his or her obligations under the service plan.” 750 ILCS 50/1(D)(m) (West 2020). Per
    the express words of the statute, a parent’s fulfillment is contingent on the availability of
    services, and the issue is whether she substantially fulfilled her obligations under the plan. 750
    ILCS 50/1(D)(m) (West 2020).
    ¶ 90              The State stresses, first, A.C.’s discharge from therapy by Ellison. However, individual
    therapy was just one component of a complex service plan that included a number of
    recommended services, forms, and assessments, as well as regular visitation. As noted above,
    A.C. completed the services for which referrals were made, 20 took advantage of whatever
    visitation was allowed, and attended therapy with Ellison until that was terminated. 21 In light
    of A.C.’s regular and substantial efforts to comply with the service plan and the visitation that
    20
    As A.C. argues in her brief, during this same nine-month period, A.C. completed parenting
    classes in June 2020 and participated in a parenting capacity assessment with Dr. Ingram, which
    included an over 2-hour interview with A.C. on July 2, 2020, and a 1½-hour parent-child observation
    in August 2020.
    21
    In addition, A.C. sought out another therapist and continued therapy on her own, after
    Ellison discharged her. However, that occurred outside the nine-month period chosen by the State,
    which ended on December 24, 2020, and thus we do not consider it here.
    35
    No. 1-22-0410
    it offered, we cannot agree that this discharge was clear and convincing evidence that A.C.
    failed to substantially fulfill her obligations under the plan. See 750 ILCS 50/1(D)(m) (West
    2020). The manifest weight of the evidence establishes reasonable and demonstrable progress
    with respect to her obligations under the plan. See C.N., 
    196 Ill. 2d at 211
    .
    ¶ 91             In addition, A.C. argues on appeal that the discharge cannot even be considered under
    this ground, since this ground requires that the service be available and this service was so
    clearly withdrawn. However, we do not need to reach this question to find that A.C.
    substantially complied.
    ¶ 92             The State argues that this case is analogous to In re C.E., 
    406 Ill. App. 3d 97
     (2010).
    In C.E., a 20-month-old infant was so severely beaten that she had multiple rib fractures,
    multiple finger fractures, a femur fracture, lower vertebrae fractures, and a spinal cord
    contusion. C.E., 406 Ill. App. 3d at 98. The trial court found that the infant had been physically
    abused and tortured. C.E., 406 Ill. App. 3d at 98. Additionally, the mother was convicted of
    endangering the infant’s life by allowing her to be abused and by failing to seek any medical
    treatment. C.E., 406 Ill. App. 3d at 98. The trial court found the mother unfit on multiple
    grounds, including Ground M, in that she “demonstrated minimal capacity to internalize the
    parenting instruction she received.” C.E., 406 Ill. App. 3d at 111. A psychologist opined that,
    as a result of having suffered gross neglect as a child herself, the mother suffered from complex
    mental health issues, including an attachment disorder. C.E., 406 Ill. App. 3d at 102.
    ¶ 93             We cannot find “analogous” the severe beating and spinal cord injury in C.E., with
    A.C.’s unkempt house. In fact, it is difficult to find any part of the C.E. facts analogous to the
    facts at hand. The State argues that the cases are “analogous” because A.C., like the mother in
    C.E., failed to internalize services, specifically, the therapy that Ellison was providing. Even if
    36
    No. 1-22-0410
    we were to overlook most of the extreme differences in facts between the two cases, we cannot
    overlook the fact that the mother in C.E. had been in individual therapy for several years, as
    opposed to the two months of individual therapy in the case at bar. See C.E., 406 Ill. App. 3d
    at 104, 112 (a trauma support specialist worked individually with the mother for two years but
    “despite several years of therapy” the mother was “incapable of safely and effectively
    parenting”).
    ¶ 94             The State argues under this ground, as it did under Ground B (supra ¶ 84), that A.C.
    was resistant to domestic violence and substance abuse treatment and that this is evidence of a
    lack of reasonable progress. As we noted above, A.C. completed the JCAP substance abuse
    assessment, which concluded that further drug abuse services were not warranted, and VOA
    refused to issue referrals for either drug or domestic violence services. Supra ¶ 83. The State
    also argues that there is no evidence that A.C. participated in a psychiatric evaluation; however,
    that assertion overlooks A.C.’s own testimony.
    ¶ 95             For the foregoing reasons, we find that the manifest weight of the evidence establishes
    reasonable and demonstrable progress by A.C. in substantially fulfilling the obligations under
    her service plan.
    ¶ 96             Although the State does not appear to argue this element of Ground M, we also find
    that the manifest weight establishes reasonable efforts toward correcting the conditions that
    led to the child’s removal. The undisputed testimony shows that: (1) A.C. obtained a protective
    order the next day to remove her brother from the house; (2) she cleaned her house and kept it
    clean, as certified by her town; and (3) she located a job and kept it.
    ¶ 97                                        IV. Mental Impairment
    37
    No. 1-22-0410
    ¶ 98              The third and last alleged ground was Ground P: “[i]nability to discharge parental
    responsibilities” due to “mental impairment, mental illness or an intellectual disability” or
    “developmental disability” that “extend[s] beyond a reasonable time period.” 750 ILCS
    50/1(D)(p) (West 2020). The alleged mental impairment, mental illness, or intellectual or
    developmental disability must be shown “by competent evidence from a psychiatrist, licensed
    clinical social worker, or clinical psychologist.” 750 ILCS 50/1(D)(p) (West 2020). However,
    this ground “shall not be construed so as to permit a licensed clinical social worker to conduct
    any medical diagnosis to determine mental illness or mental impairment.” 750 ILCS
    50/1(D)(p) (West 2020).
    ¶ 99              The closest thing to a mental impairment cited by the trial court was Ellison’s
    description of A.C. as having “circular thinking.” However, Ellison admitted that this was not
    a diagnosis or a diagnostic term, and the State does not argue this factor on appeal to support
    this ground.
    ¶ 100             The State argues this ground primarily based on A.C.’s prior diagnosis of anorexia and
    Dr. Ingram’s testimony regarding it. However, Dr. Ingram testified that she did not diagnose
    A.C. with anorexia or make any mental health diagnosis of A.C. Dr. Ingram testified that,
    according to A.C.’s medical records, A.C. was first diagnosed with anorexia when she was 13
    or 14 years old. Dr. Ingram further testified that her review of A.C.’s medical records showed
    that, although A.C. had been hospitalized several times for anorexia, including in her thirties,
    A.C. had not been hospitalized or treated for it in over 10 years, and the last time was before
    D.D. was born.
    ¶ 101             Neither party disputes that anorexia is a mental impairment or mental illness. As such,
    a “medical diagnosis” is required “to determine mental illness or mental impairment.” 750
    38
    No. 1-22-0410
    ILCS 50/1(D)(p) (West 2020). Although evidence under this ground is generally permitted
    “from a psychiatrist, licensed clinical social worker, or clinical psychologist,” social workers
    are excluded from the diagnosis of mental illness or impairment, thereby requiring a diagnosis
    from a psychiatrist or clinical psychologist. 750 ILCS 50/1(D)(p) (West 2020). The State,
    which bears the burden of providing clear and convincing evidence, did not seek a current
    diagnosis from a psychiatrist or clinical psychologist. Dr. Ingram, who is a clinical
    psychologist, testified that she did not diagnose A.C. with anorexia or make any mental health
    diagnosis of A.C.
    ¶ 102             The State argues that this case is similar to In re S.K.B., 
    2015 IL App (1st) 151249
    . In
    S.K.B., the mother was diagnosed with severe mental health issues while she was in the hospital
    giving birth, and a DCFS case was opened immediately. S.K.B., 
    2015 IL App (1st) 151249
    ,
    ¶ 3. During the pendency of the case, the mother was involuntarily psychiatrically hospitalized
    three times. S.K.B., 
    2015 IL App (1st) 151249
    , ¶ 32. All three clinical psychologists treating
    the mother opined at the fitness hearing that she was delusional. S.K.B., 
    2015 IL App (1st) 151249
    , ¶ 19. The appellate court found that “[t]here was really no dispute that, should [the
    mother] stop taking her mediation, there would be reason for concern for the well-being” of
    the child and that she had past inconsistency of remaining medicated. S.K.B., 
    2015 IL App (1st) 151249
    , ¶ 31. Unlike the case at bar, there was a diagnosis in S.K.B., provided
    contemporaneously with the opening of the case and again in the testimony of three separate
    clinical psychologists at the fitness hearing.
    ¶ 103             The State argues that the S.K.B. case was similar in that “[t]he mother in S.K.B. was
    also fixated on her child’s supposed weight problems.” However, to suggest or hint that this
    was a major factor in the trial court’s finding in S.K.B., or that the issue there was weight,
    39
    No. 1-22-0410
    misrepresents that case. In S.K.B., the mother accused the foster mother of trying to starve her
    son, and this accusation came toward the end of a long list of about 20 delusional behaviors,
    which began with threatening to kill her own mother and accusing her own husband of trying
    to poison her. S.K.B., 
    2015 IL App (1st) 151249
    , ¶ 20.
    ¶ 104             There is no question that A.C. had food issues. But the question under this ground is
    whether she had a clinically or medically diagnosed present mental impairment that rendered
    her unable or unfit to parent her child and which “shall extend” into the future. 750 ILCS
    50/1(D)(p) (West 2020). Stewart, one of the case aides, testified that D.D. was “a healthy-sized
    boy,” and there was no testimony or evidence at the hearings that D.D. was too thin or, in any
    way, nutritionally impaired. In its appellate brief, the State summed up its argument under
    Ground P by saying: “Based upon [A.C.’s impaired sense of reality through insisting [D.D.]
    still needs to wear pull ups and by bringing a Pediasure to a visit, the trial court properly relied
    upon the expert testimony of Dr. Ingram to find [A.C.] unfit under ground p.” However, we do
    not find this argument persuasive. First, the trial court specifically ruled that the one PediaSure
    was not relevant; second, Dolan’s testimony established that D.D. still needed to wear pull ups
    a year later; and third, Dr. Ingram concluded that A.C. could be an appropriate parent.
    ¶ 105              First, with respect to the PediaSure incident, Stewart, a VOA case aide, testified that
    she observed a visit between A.C. and D.D. in a park, where A.C. provided snacks, bottles of
    water, and one PediaSure. When Stewart later dropped D.D. off at home, the foster parent told
    Stewart that D.D. was not supposed to have the PediaSure. Respondent’s counsel objected to
    the PediaSure testimony on relevance grounds, and the trial judge agreed. Stating that he did
    not see the relevance either, the trial judge ruled, “She gave him one bottle of PediaSure; okay.
    What’s the big deal?” The State cannot rely on evidence that the trial court ruled was irrelevant.
    40
    No. 1-22-0410
    Second, as for the pullups, Dolan testified that a report of D.D.’s therapy indicated that, in
    November 2020, or almost a year after the case came to DCFS, D.D. still needed Pull-Ups.
    ¶ 106             Lastly, Dr. Ingram testified that she did not observe any deficits in A.C.’s functioning
    at the time of her observation and that A.C. was appropriately responsive to D.D’s needs. Dr.
    Ingram testified that Hull informed her that her observations were consistent with prior visits,
    and Dr. Ingram concluded that A.C. could be an appropriate parent.
    ¶ 107             For all the foregoing reasons, we cannot find that the State provided clear and
    convincing evidence under this ground.
    ¶ 108                                           CONCLUSION
    ¶ 109             In short, we find that the trial court’s finding that A.C was unfit was against the manifest
    weight of the evidence, particularly where A.C. made reasonable efforts to assume
    responsibility, the initial barriers were no longer a barrier to reunification, the evidence
    established reasonable and demonstrable progress with respect to her obligations under the
    plan, and Dr. Ingram concluded that A.C. could be an appropriate parent for D.D.
    ¶ 110             Reversing the finding of unfitness, we remand this case for further proceedings
    consistent with this opinion.
    ¶ 111             Reversed and remanded.
    ¶ 112             JUSTICE WALKER, specially concurring:
    ¶ 113             I fully concur in the reasoning and results reached by Justice Oden Johnson. I write
    separately to provide additional support for this court’s majority decision to reverse. First, I
    note that “[i]t is beyond discussion that parents have a fundamental liberty interest in the care,
    custody, and control of their children.” In re M.M., 
    2016 IL 119932
    , ¶ 26. The United States
    Supreme Court recognized:
    41
    No. 1-22-0410
    “[A] natural parent’s ‘desire for and right to “the companionship, care, custody, and
    management of his or her children” ’ is an interest far more precious than any
    property right. [Citation.] When the State initiates a parental rights termination
    proceeding, it seeks not merely to infringe [upon a] fundamental liberty interest,
    but to end it. ‘If the State prevails, it will have worked a unique kind of
    deprivation… [Hence,] [a] parent’s interest in the accuracy and justice of the
    decision to terminate his or her parental status is, therefore, a commanding one.’ ”
    Santosky v. Kramer, 
    455 U.S. 745
    , 758-59 (1982).
    ¶ 114             A thorough review of the record shows the trial court’s findings that respondent did not
    (1) maintain a reasonable degree of interest, concern, or responsibility as to D.D.’s welfare
    under section 1(D)(b) (750 ILCS 50/1(D)(b) (West 2020)); (2) make reasonable efforts to
    correct the conditions that were the basis for D.D.’s removal and/or did not make reasonable
    progress toward the return of the child under section 1(D)(m) (750 ILCS 50/1(D)(m) (West
    2020)); and (3) could not discharge her parental responsibilities due to her mental impairment
    and/or mental illness under section 1(D)(p) were all against the manifest weight of the evidence
    (750 ILCS 50/1(D)(p) (West 2020)).
    ¶ 115             There are several grounds upon which a trial court may find a parent to be unfit. See
    750 ILCS 50/1 (West 2020). In this case, the State alleged unfitness based on section 1(D)(b),
    reasonable degree of interest, concern, or responsibility; section 1(D)(m), reasonable efforts to
    correct the conditions/reasonable progress toward return of the child; and section 1(D)(p),
    mental impairment or mental illness. I will address each allegation in turn.
    ¶ 116                    1. Reasonable Degree of Interest, Concern, or Responsibility
    42
    No. 1-22-0410
    ¶ 117             The trial court’s finding that respondent did not maintain a reasonable degree of
    interest, concern, or responsibility as to D.D.’s welfare under section 1(D)(b) was against the
    manifest weight of the evidence because section 1(D)(b) “does not focus on the parent’s
    success but, rather, the reasonableness of her efforts and takes into account the parent’s
    difficulties and circumstances.” In re Nicholas C., 
    2017 IL App (1st) 162101
    , ¶ 24. “[A] court
    is to examine the parent’s efforts to communicate with and show interest in the child, not the
    success of those efforts.” (Internal quotation marks omitted.) In re M.I., 
    2016 IL 120232
    , ¶ 28.
    ¶ 118             Here, respondent consistently attended parent/child visits. Dr. Ingram testified that,
    during the August 2020 visit, respondent and D.D. appeared to have a “loving and caring
    relationship,” respondent “was attentive to him,” and “it was a very positive visit.” During the
    November 2020 visits, respondent and D.D. played together and talked about D.D.’s
    homework and school activities. Dr. Ingram did not observe anything inappropriate or
    concerning during the visits. Respondent consistently took her prescribed medications to
    manage her mental illness. She completed parenting classes and a substance abuse assessment.
    Respondent had other uncompleted recommended services; however, they were not completed
    because she never received a referral to participate in the services. Respondent was “good
    about communicating with the caseworker” and rescheduling.
    ¶ 119             The evidence shows that respondent was discharged from therapy as “unsuccessful.”
    However, the evidence also provides an explanation for respondent’s discharge that is
    unrelated to her degree of interest, concern, or responsibility. While she did not receive the full
    series of dialectical behavioral therapy as recommended by Dr. Ingram, she did nonetheless
    attend alternative therapy. Thus, the circuit court’s finding of unfitness under section 1(D)(b)
    was against the manifest weight of the evidence.
    43
    No. 1-22-0410
    ¶ 120             2. Reasonable Efforts to Correct Conditions/Reasonable Progress Toward Return of
    Child
    ¶ 121             The trial court’s findings that respondent did not make reasonable efforts to correct the
    conditions that were the basis for D.D.’s removal and/or did not make reasonable progress
    toward the return of D.D. under section 1(D)(m) are against the manifest weight of the evidence
    because respondent showed reasonable progress toward the goal of reunification.
    ¶ 122             “[T]he benchmark for measuring a parent’s ‘progress toward the return of the child’
    under section 1(D)(m) of the Adoption Act encompasses the parent’s compliance with the
    service plans and the court’s directives, in light of the condition which gave rise to the removal
    of the child, and in light of other conditions which later become known and which would
    prevent the court from returning custody of the child to the parent.” In re C.N., 
    196 Ill. 2d 181
    ,
    216-17 (2001).
    ¶ 123             According to the State’s petition for adjudication of wardship, D.D. was removed from
    respondent’s home because it was uninhabitable, and heroin was found inside the residence
    (respondent’s brother was transported to hospital due to drug overdose). Respondent made
    reasonable efforts to correct the conditions by (1) presenting a certificate that her home was
    certified clean and suitable for occupancy and (2) removing her brother, who was a heroin user,
    from the home and filing a restraining order against him.
    ¶ 124             Respondent also made reasonable progress toward the return of D.D. by (1) completing
    her parenting classes; (2) completing a substance abuse assessment; (3) consistently attending
    parent/child visits; (4) taking her prescribed medications; (5) regularly communicating with
    caseworkers; and (6) exhibiting care, attention, and concern for D.D. during visits by
    monitoring D.D.’s food intake and water, ensuring D.D. used hand sanitizer and wore a mask,
    44
    No. 1-22-0410
    engaging in activities with D.D., and showing concern for D.D.’s comfort in the hot weather.
    See In re J.A., 
    316 Ill. App. 3d 553
    , 565 (2000) (“At a minimum, reasonable progress requires
    measurable or demonstratable movement toward the goal of reunification.”).
    ¶ 125             While there is evidence regarding respondent’s inappropriate behavior during her
    visits, the totality of the evidence largely shows support for her progress. The witnesses
    testified that respondent’s overall behavior was appropriate and that there was no concern.
    Although D.D. sometimes asked to end the virtual visits early, he never stated that he did not
    want to see his mother. It was clear that respondent made reasonable progress toward the return
    of D.D., and therefore, the circuit court’s finding of unfitness under section 1(D)(m) was
    against the manifest weight of the evidence.
    ¶ 126                               3. Mental Impairment or Mental Illness
    ¶ 127             The trial court’s finding that respondent could not discharge her parental
    responsibilities due to her mental impairment and/or mental illness under section 1(D)(p) was
    against the manifest weight of the evidence because the evidence lacks sufficient justification
    to conclude that her inability will extend beyond a reasonable time. “Section 1(D)(p) does not
    *** allow a finding of unfitness based on a mere showing of mental impairment, illness, or
    retardation. Rather, the person’s mental condition must render him unable to discharge his
    parental responsibilities and the inability to discharge parental responsibilities must ‘extend
    beyond a reasonable time period.’ ” In re R.C., 
    195 Ill. 2d 291
    , 305 (2001) (quoting 750 ILCS
    50/1(D)(p) (West 1994)). Hence, to find a parent unfit on the grounds of mental impairment or
    mental illness (1) it must be shown by competent evidence that the parent suffers from a mental
    impairment, illness, or disability that prevents the parent from discharging parental
    responsibilities, and (2) there must be sufficient justification to conclude that inability will
    45
    No. 1-22-0410
    extend beyond a reasonable period. In re C.M., 
    319 Ill. App. 3d 344
    , 360 (2001); 750 ILCS
    50/1(D)(p) (West 2020).
    ¶ 128             Generally, courts find sufficient justification where there is conclusive evidence, such
    as expert testimony, that a respondent’s inability will extend beyond a reasonable period. See
    C.M., 319 Ill. App. 3d at 359-60 (finding sufficient justification where psychologist testified
    that respondent’s personality disorder prevented her from discharging her parental
    responsibilities and that “this inability extends to the future, ‘limiting the likelihood that she
    would respond to treatment in any reasonable time frame’ ”); In re M.M., 
    303 Ill. App. 3d 559
    ,
    567 (1999) (finding sufficient justification where psychologist testified that respondent “would
    never have the capability to be an effective parent”); In re A.J., 
    269 Ill. App. 3d 824
    , 828 (1994)
    (finding sufficient justification where psychiatrist testified that respondent “needs a prolonged
    course of treatment in the future”); In re J.A.S., 
    255 Ill. App. 3d 822
    , 824-25 (1994) (finding
    sufficient justification where psychologist testified that respondent would be “incapable of
    assuming a parenting role within the foreseeable future”).
    ¶ 129             Here, the record is devoid of any conclusive evidence that respondent’s inabilities will
    extend beyond a reasonable time. In fact, the record presents the opposite conclusion. Dr.
    Ingram testified that during the August 2020 visit, she did not observe any deficits in
    respondent’s functioning and respondent was responsive to D.D.’s needs. Further, Dr. Ingram
    opined that, if respondent “engage[d] consistently with the therapeutic services
    recommended,” she would be an appropriate parent for D.D.
    ¶ 130             It is true that the evidence need not be absolutely conclusive to satisfy section 1(D)(p).
    J.A.S., 255 Ill. App. 3d at 824. Nonetheless, given Dr. Ingram’s testimony regarding the extent
    of respondent’s mental condition and the effects it had on D.D., it cannot be inferred that she
    46
    No. 1-22-0410
    will have issues parenting beyond a reasonable time. According to Dr. Ingram, respondent
    would be “an appropriate parent for D.D.” with about 6 to 18 months of therapy. Based on the
    foregoing, the trial court’s ruling that respondent was unfit under section 1(D)(p) is against the
    manifest weight of the evidence because the opposite conclusion is clearly apparent. The
    judgment of the trial court must be reversed because the State did not establish by clear and
    convincing evidence that respondent was an unfit parent for D.D. I recognize the emotional
    and psychological effects on all involved with this matter, but fit, able, and loving “parents
    have a fundamental liberty interest in the care, custody, and control of their children.” M.M.,
    
    2016 IL 119932
    , ¶ 26. This matter must be remanded to the trial court so that a hearing may
    be held to create a plan for reunification with respondent (D.D.’s biological mother).
    ¶ 131             PRESIDING JUSTICE MIKVA, dissenting:
    ¶ 132             The trial court in this case found that A.C. was an unfit parent on three different grounds
    and terminated her rights on the basis that this was in D.D.’s best interests so that he could be
    adopted by his foster parents, who were his paternal grandparents. The majority in this case
    reverses all findings on unfitness and remands this case for further proceedings. I respectfully
    and strongly disagree.
    ¶ 133             The standard for our review on the factual findings by the trial court that A.C. was an
    unfit mother on three different grounds is manifest weight of the evidence. As our supreme
    court has made clear:
    “[A] finding of unfitness will not be reversed unless it is against the manifest weight of
    the evidence *** [because] the trial court’s opportunity to view and evaluate the parties
    *** is superior to that of a reviewing court. [Citation.] A court’s decision regarding a
    parent’s fitness is against the manifest weight of the evidence only where the opposite
    47
    No. 1-22-0410
    conclusion is clearly apparent.” (Internal quotation marks omitted.) In re M.I., 
    2016 IL 120232
    , ¶ 21.
    ¶ 134              I reject the suggestion (see supra ¶ 69) that we owe some lesser level of deference
    because the termination and best interests hearings were on Zoom and the therapy A.C.
    received was on the telephone. The pandemic has forced the courts and mental health
    professionals to use different communication tools to avoid in-person contact. I do not agree
    that the use of these tools impacts our standard of review.
    ¶ 135              I would also note that in this case, as is common in child protection cases, by the time
    this judge terminated A.C.’s parental rights on March 9, 2022, he had presided over this case
    for more than two years, since at least November 26, 2019, when he set a date for the
    adjudicatory hearing, and had conducted several evidentiary hearings regarding this family.
    The court also took a recess of several weeks between the end of the evidence presented during
    the fitness hearing and the argument and ruling so that he could review the voluminous
    documents in this case. We must defer, as always, to the trial court’s factual findings in this
    case.
    ¶ 136              I cannot agree that each of the trial court’s three findings on unfitness are against the
    manifest weight of the evidence. I will focus on failure to make progress during the nine-month
    period of March 14 through December 24, 2020, and inability to discharge parental
    responsibilities because of a mental impairment. As the statute makes clear, any one ground is
    a sufficient basis on which to find a parent unfit under the Adoption Act. See In re C.W., 
    199 Ill. 2d 198
    , 217 (2002) (“Although the State may rely on several grounds in its petition, a
    finding adverse to the parent on any one ground is sufficient to support a subsequent
    termination of parental rights.”(Emphasis in original.)).
    48
    No. 1-22-0410
    ¶ 137              I focus on these two grounds because, in my view, this is where the evidence was
    strongest. I express no view on the other grounds alleged and suggest that trial courts would
    aid us in the appellate process if they would explain their findings in more detail than the trial
    court did in this case.
    ¶ 138              In reference to ground (m), failure to make reasonable progress, the majority takes issue
    with the trial court’s findings because the court focused heavily on the conditions that D.D.
    was found to be living in when the case was first filed. In my view, however, this focus was
    appropriate because A.C. did not make progress on the real problems that brought the case in.
    ¶ 139              Yes, the house was so dirty that it had been condemned by the City, and eventually
    A.C. cleaned it, at least to the point it was no longer condemned. Yes, A.C. got a job. Yes,
    A.C. got an order of protection against her brother who was a heroin user. However, the real
    issue was that A.C. was not caring for her son in an even minimally satisfactory manner. The
    dirty house and lack of food were symptoms of her inability to meet his basic needs. In addition
    to D.D. being in a filthy home, he had missed weeks of school, he was not toilet trained
    although he was eight years old, and he had not learned to groom himself. There was also
    evidence that A.C. had taken D.D. to doctors reporting symptoms that did not exist, behaved
    inappropriately at his school, and appeared oblivious to the fact that her brother, who lived
    with them, was a heroin addict.
    ¶ 140              While, as the majority points out, A.C. did engage in some appropriate and loving
    behavior with D.D. during visits, the caseworkers who observed visits also spoke about some
    inappropriate behavior that continued into the nine-month period. There was testimony that
    A.C. gave D.D. PediaSure during one visit—something that she had apparently been asked not
    to do and suggested her ongoing need to infantilize him. There was also testimony about overly
    49
    No. 1-22-0410
    emotional goodbyes that caseworkers testified left D.D. upset and confused. Caseworkers
    observed that D.D. appeared uncomfortable with his mother at times and wanted to end visits
    early. One of the caseworker supervisors testified that, based on her observations, there
    continued to be “many areas” about the “lack of care for [D.D.]” that A.C. “appeared” not to
    comprehend. A.C. never progressed to unsupervised visits, which is the natural progression
    toward overnights and then a return home.
    ¶ 141             Ms. Ellison, A.C.’s therapist at UCAN, testified explicitly that A.C. made no progress
    in addressing the baseline reasons that brought the case in. According to the therapist, A.C.
    expressed the view that she was not at fault for anything that had occurred. In Ms. Ellison’s
    opinion, this made progress in addressing the real problems in the case impossible. According
    to Ms. Ellison, A.C. engaged in “circular thinking” instead of accepting accountability that
    could lead to progress. The trial court specifically noted that it found Ms. Ellison very credible.
    ¶ 142             As the majority points out, A.C. sought and obtained therapy from Dr. Tarawneh. This
    is certainly evidence of A.C.’s desire to have her son returned home. However, while Dr.
    Tarawneh testified in a conclusory way that A.C. made “progress” in therapy, the only specifics
    he could point to were that she found a job and that she was ready to take the next step which
    he testified was to see a psychiatrist. He had not reviewed the clinic report about A.C.’s mental
    health issues. Certainly nothing in his testimony supported an argument that A.C. had accepted
    responsibility for the problems in her mothering of D.D. Moreover, Dr. Tarawneh saw A.C.
    from March to July 2021, so he had no basis for testifying about her progress during the
    relevant nine-month period which ended in December 2020.
    ¶ 143             Even if I were to assume that the testimony of these two treaters—Ms. Ellison and Dr.
    Tarawneh—created a conflict in the evidence, this is no basis for rejecting the trial court’s
    50
    No. 1-22-0410
    conclusion that A.C. failed to make progress. Where, as here, there may be conflicts in the
    evidence, we defer to the trial court’s credibility findings. In re A.B., 
    308 Ill. App. 3d 227
    , 240
    (1999). As the court noted there, we defer to the trial court “particularly where evidence is in
    conflict.”
    ¶ 144             There was also ample evidence to support the trial court’s finding on ground (p), the
    inability to discharge parental responsibilities because of a mental impairment. It is clear from
    the record that the primary source for this finding is the Cook County Juvenile Court Clinic
    parenting capacity assessment and the testimony of Dr. Ingram, who did that assessment, as
    well as Ms. Ellison’s testimony.
    ¶ 145             Unfitness under ground (p) requires a finding, by clear and convincing evidence, that a
    parent has the:
    “Inability to discharge parental responsibilities supported by competent evidence from
    a psychiatrist, licensed clinical social worker, or clinical psychologist of mental
    impairment, mental illness or an intellectual disability as defined in Section 1-116 of
    the Mental Health and Developmental Disabilities Code, or developmental disability
    as defined in Section 1-106 of that Code, and there is sufficient justification to believe
    that the inability to discharge parental responsibilities shall extend beyond a reasonable
    time period. However, this subdivision (p) shall not be construed so as to permit a
    licensed clinical social worker to conduct any medical diagnosis to determine mental
    illness or mental impairment.” 750 ILCS 50/1(D)(p) (West 2020).
    ¶ 146             Although Dr. Ingram noted that A.C. clearly loved her son, the doctor also noted in the
    clinic report several risk factors that suggested A.C. would not be able to adequately care for,
    parent, or protect her son. The risk factors included her history of anorexia so severe that at
    51
    No. 1-22-0410
    one point she weighed 74 pounds, the unhealthy boundaries she had displayed with school staff
    and DCFS workers, and her “inaccurate beliefs” about her son’s needs. Dr. Ingram observed
    in the clinic report that “it is my clinical opinion that [A.C.] continues to present with mental
    health needs that are not being adequately managed with services.” Dr. Ingram testified during
    the fitness hearing that A.C.’s “unmet mental-health needs included things such as her extreme
    focus and obsession; her impaired sense of reality; her lack of judgment for certain things; ***
    and anxiety.” Dr. Ingram also opined that those mental health issues impacted her son.
    According to the clinic report, A.C. “has difficulty applying her parenting knowledge to [D.D.]
    because of her own mental health needs that need to be addressed.” Ms. Ellison’s testimony
    also supported this finding in that she found that A.C.’s “circular thinking showcases an
    inability to recognize the parental expectations for healthy, age appropriate development, and
    physical and emotional safety for the client’s son.” The trial court also had before it A.C.’s
    extensive hospitalization records, which reflected a lengthy history of mental health concerns.
    ¶ 147             The majority points out that, under the Adoption Act, the mental illness must be shown
    by competent evidence from a psychiatrist, a licensed clinical social worker, or clinical
    psychologist, and the statute does not permit a social worker to provide a medical diagnosis.
    Dr. Ingram is a licensed clinical psychologist with a Ph.D. Thus, she was certainly competent
    to testify. The majority also notes that the diagnosis of anorexia was made some time ago and
    not by Dr. Ingram. Nothing in the statutory language requires that there be a current diagnosis
    as to a specific mental illness. Rather, the statute requires “sufficient justification to believe
    that the inability to discharge parental responsibilities shall extend beyond a reasonable time
    period.” To the extent that the majority suggests there was insufficient evidence that A.C.’s
    52
    No. 1-22-0410
    inability to discharge parental responsibilities would extend beyond a reasonable period of
    time, I disagree.
    ¶ 148             Dr. Ingram testified that A.C.’s “symptoms are chronic in nature.” Dr. Ingram had
    reviewed A.C.’s hospitalization records and noted the following:
    “Advocate hospital records note a consistent history of [A.C.] being focused and
    ‘obsessed, much like others with an eating disorder diagnosis, with food intake and
    gastrointestinal issues. During majority of [A.C.’s] hospitalizations, medical staff
    strongly recommended [A.C.] receive either inpatient psychiatric services or inpatient
    eating disorder programs, which [A.C.] consistently refused. At the age of 30, [A.C.]
    weighed 74 pounds and was not eating on her own due to her diagnosis of Anorexia
    Nervosa.’ ”
    ¶ 149             Dr. Ingram’s testimony and the record as a whole support the trial court’s finding that
    A.C. was unfit on the basis of ground (p). That finding was not against the manifest weight of
    the evidence.
    ¶ 150             The majority does not reach “best interests” because, as it recognizes, this is only
    relevant if A.C. is unfit. Because I would affirm on unfitness, I would reach the best interests
    finding. Again, we can overturn only where the trial court’s finding that it was in D.D.’s best
    interests to terminate A.C.’s rights and free him for adoption was against the manifest weight
    of the evidence. In re N.B., 
    2019 IL App (2d) 180797
    , ¶ 43. There was ample evidence that the
    paternal grandparents, who had moved to Chicago from Florida to take care of D.D. and hoped
    to adopt him, would offer him a loving and supportive home. The grandparents were
    transparent in advising the court that it was not their intent to allow A.C. to have a continued
    role in her son’s life. While I would hope that they would have a change of heart on this issue,
    53
    No. 1-22-0410
    it is surely not a sufficient basis on which to overturn the trial court’s finding. I would affirm
    the trial court’s best interests finding, as well.
    ¶ 151              I dissent.
    54
    No. 1-22-0410
    In re D.D., 
    2022 IL App (1st) 220410
    Decision Under Review:     Appeal from the Circuit Court of Cook County, No. 19-JA-1373;
    the Hon. Patrick Murphy, Judge, presiding.
    Attorneys                  Sharone R. Mitchell Jr., Public Defender, of Chicago (Suzanne A.
    for                        Isaacson, Assistant Public Defender, of counsel), for appellant.
    Appellant:
    Attorneys                  Kimberly M. Foxx, State’s Attorney, of Chicago (Enrique
    for                        Abraham, Gina DiVito, Assistant State’s Attorney, of counsel), for
    Appellee:                  the People.
    Charles P. Golbert, Public Guardian, of Chicago (Kass A. Plain,
    Elise Melrose, of counsel), guardian ad litem.
    55