8/21/2023 EnchantaVaughn Approved Behavior: Client did not show interest in today’s session. Client chose to distance himself from the QMHP when reflecting on his bad experiences in the home. Client uses a lot of non-verbal cues to express how he feels. Client continues to express and elaborate on the negative relationship between him and his guardian. At this time, client behaviors were viewed as aggravated, impolite, and troubled. Client was annoyed with mom correcting him every time he did something wrong. Client shared his reasons for not following through with instruction, which caused more drama in the house. Client fails to cooperate or contribute to discussion and this behavior was confronted immediately. Behavior: Client spoke in an aggressive tone, “I don’t want to do this” (referring to the session). Client was inquired why he felt this way. Client did not respond. Client displayed poor communication and was given a moment to cool off. Client appeared to be in a downward mood. Client have had multiple issues within the home from outside resources that have been addressed numerous of times. Mom expressed that client often acts like this when things don’t go his way. Client made inappropriate comments under his breathe that sounded like he was making threats. Client continues to avoid answering any of the questions and have a hard time following along in the session. Intervention: QMHP verbally identified the client's impulsiveness to the client and encouraged the client to use self-control strategies (i.e. decrease hyperactive behaviors. QMHP reviewed several strategies for conflict resolution and positive social behaviors with client in efforts to increase client’s awareness. The client was encouraged to use good judgement, and respect authority figures. QMHP provided client with a release of energy by walking to get a drink of water to help him relax and open up more. QMHP provided simple praises to client for his commitment to his progress. Intervention: QMHP went through program overview with family to reiterate key points and program objectives that would pertain to their specific situation and helping to build a new therapeutic relationship with the family and client. QMHP used the basic listening sequence to clearly draw out the point of view that the client was feeling and get beyond his aggressive language and behaviors. QMHP talked to client about his confidence levels and how they can affect his thoughts and behaviors. QMHP encouraged client to utilize positive self-talk as a means of decreasing anxiety and managing frustration when encountering difficult or challenging circumstances. Response: Client reviewed ISP objectives with mental health professional. Client said he was aware of his expectations and what he is expected to do each day. It was at this time, client’s actions suddenly altered. Client was a little more verbal when talking about himself. Client seem to switch moods a lot depending on what is being asked. Client practiced some of the examples of alternate behaviors (e.g. putting his head on his desk, color or draw, think about happy moments, repeat positive “I-statements” 5-10 times, and ask questions that will help him understand things better) when he found himself getting off task. Response: Client informed QMHP that he has been learning a lot in each session. Client thanked QMHP for helping his family communicate with each other in a more positive and productive way. Client stated that talking and sharing things in his life helped him to evaluate his poor choices and correct his mistakes. Client went on to report that he will practice therapeutic techniques with his family when he feels that it is the right time and place. Client shared that he believes he will be able to master his feelings soon and control his anxiety with more practice. Client demonstrated he can accept a compliment and act civilized.