After another draw on Sunday in the Wear-Tyne derby, questions are starting to be asked about how we can turn one point into all three. It could be argued that significant personnel changes are required to get us over the hump, but will Martin O'Neill be willing to do that?
When Martin O'Neill breezed into Sunderland, he brought with him an enthusiasm and sense of optimism that had drained away in the latter stages of Steve Bruce's time in charge. The Black Cats were a team devoid of ideas, playing without an obvious plan week in week out, and had become a very poor team to watch.
O'Neill's impact was incredible, as we all know, but following our defeat against Everton in the FA Cup, everything went flat, and although we were safe from relegation, and grudgingly accepted that our players' mentality seemed to be that of a group ready to go on a summer holiday, the end of the season was still tough to accept.
We were filled with optimism ahead of this term, and with Adam Johnson and Steven Fletcher signing, we had the makings of a potentially attacking and exciting team. But - and even the biggest SAFC fans would surely agree with me here - our football has been poor at times this season, and Sunday's match just emphasised how toothless our attacking play has become.
There is no question that we have more quality in the attacking third than we have had for many years, Steven Fletcher, Adam Johnson, Stephane Sessegnon and James McClean are all wonderful, talented players. But, how long should O'Neill persist in playing them in the same system if it is clearly not working?
It could be argued that Sessegnon, Johnson and McClean are all just short on confidence - although Johnson receives mitigation as he has been either slightly injured or ill for almost every game at the club so far - and the only way to remedy that is to leave them in the team in order to build that confidence. But that is surely a double-edged sword, and it seems unlikely that Sess' will be on top of the world having been replaced by Louis Saha after yet another poor showing on Sunday.
What too for the likes of the afore-mentioned Saha, Fraizier Campbell, Connor Wickham and co? How long will they be happy to witness their team-mates underperforming from the comfort of the bench?
Of course, O'Neill is up there with the best when it comes to man-management, but we should remember that he told Sessegnon weeks ago that he was coming to the end of his patience with below-par performances, while James McClean would probably be wise to avoid Twitter for a while, at least until he has sorted his game out on the pitch.
It is difficult to see the answer for Martin O'Neill, but the non-performance against Newcastle should have put a few doubts in his mind about sticking with the system that he is desperate to see come good. It would take a shift in mentality for him to play with two strikers instead of just Fletcher, but Sunderland have had the least attempts on goal in all of Europe's top divisions, and something needs to change.
Perhaps Saturday's clash with Stoke City could see Sess' miss out in place of Louis Saha, or Craig Gardner could move into his position, with Phil Bardsley returning at right back. It would certainly guarantee us a few more shots at goal, although with Gardner it is difficult to predict where they would end up. Admittedly it would seem a shame to lose Gardner from right back, where he has excelled in Bardsley's absence, but his threat further up the field is something that O'Neill has mentioned recently, and he looks a different player altogether than his last appearances in midfield, which were admittedly disappointing.
Personally, I would start Adam Johnson on the left, which admittedly isn't where he has made his name, but it opens up opportunities for the former Manchester City man to get down the line and put a cross straight in, rather than having to come back on to his left foot. Whether he would provide enough defensive cover for Danny Rose is something that would have to be taken into consideration.
With Cattermole returning from suspension, he will slot straight back into the team, meaning that we could utilise Seb Larsson on the right hand side. He may not be able to boast the kind of pace that McClean and Johnson can, but we all know that he has the ability to deliver deadly balls into the area, and with two frontmen to aim for, rather than Fletcher casting an isolated figure, we may just get some joy - something that has been missing all term (barring Wigan and a couple of League Cup clashes).
This piece isn't intended to sound like I'm having a go at Martin O'Neill. I'm as fully in support of the gaffer as much as anyone else, I just hope that his insistence on playing the same players in the same positions, with the same gameplan each week, isn't costing us vital points. Plus, well, I'm still a bit bitter after Sunday.