That sounds really tough.

One thing I've been told from behaviour 'specialists' within the education department (I'm a teacher) is to pick one thing to work on at a time. Pick one thing that stresses you the most at the moment and work on that. When I do this for the kids in my class I make a little Velcro chart with 3-4 tokens. Each time they show the desired behaviour that you're working on a token is taken off. When they've had all tokens taken off they get a short reward (for one student in particular its 10-15 mins of computer time). The key with this is to try to catch them doing the right things really often and get the tokens off quickly. It's also important that you don't put them back on if they don't shown the desired behaviour.

I don't know if the above will work for you, but it could be worth a try?