9/18/2023 EnchantaVaughn Approved Behavior: Upon arrival, client was reported in a displeasing mood. Client did not welcome QMHP when confronted about his attitude and negative disposition. Mom stated client got in trouble and had a hard time accepting the punishment that was given. Client reframed from talking to QMHP and attempted to ignore everyone until he got the attention he desired. Client displayed mean facial expressions when communicating his feelings to QMHP about why he got in trouble. Client was not in the mood to talk about his feelings, as evidenced by his dialogue with QMHP. Client displayed disrespectful behaviors toward his mom, as evidenced by him yelling when he was expected to explain himself. Behavior: Client lacked respect for both mom and QMHP, as evidenced by client's aggressive behaviors when confronted about his attitude. Client shared that he was not happy about being on punishment. Client reframed from engaging in conversation or contributing to the session. Client refused to pay attention in session, as observed. Client behaves poorly in the home setting, as observed. Client reacts negatively to feedback and fails to conduct himself in the appropriate manner. Client required 2-3 prompts to acknowledge his wrong doing. Client realizes that he’s causing more harm than good and wants to begin changing those habits. Intervention: QMHP reflected with client behaviors that will not be acceptable and what the consequences are. QMHP isolated client from distractions to decrease disruptive behaviors and to reduce episodes. QMHP assisted client in normalizing the changes that are occurring in his household regarding his place of residence and family situation. QMHP will implement a routine that will encourage client to be responsible and promote self-confidence and self-determination in all parts of his life. The client was encouraged to use good judgement in the home, and respect authority figures. QMHP educated client about using good manners and showing respect. Intervention: QMHP observed client negative and positive behaviors to see what new techniques and skills can be taught during psycho educational. QMHP taught client anger management, education, problem-solving, and conflict resolution, skills. QMHP instructed client to reiterate his ISP objections in efforts to trigger a desire to achieve them by improving his current attitude. QMHP went over ISP objectives and techniques to achieve them with client. QMHP encouraged client not to hesitate to reach out, ask questions, or to request for one on one without parent present. QMHP offered empathy and support to client to ensure his needs were being met. Response: Client was fidgety and required one on one attention. Client practiced some of the examples of alternate behaviors to switch his mood around. Client understood that when he becomes agitated he needs to refrain from taking it out on people and to communicate how he is feeling to others. Client blames his mental illness for his attitude, mood, and behaviors. Client stated that he doesn’t intend on being negative and agrees he need to work on controlling and channeling his anger. Client stated that he would try to listen more so that he is able to understand what he needed to do in order to achieve his goals and objectives on a consistent basis. Response: Client recognized his anger triggers and is working to improve them daily. Client reviewed his expectations with QMHP. Client stated he would avoid distractions and stay on task with no problem. Client stated he would respect adult figures and do what he is told. Client chose to get back on task, as observed by him listening and following directions well. Client appeared to be learning from his mistakes and correcting them throughout the day. Client agreed to go to bed on time, eat a healthy meal, read and complete his chores. Client seemed to be coping with his stressors and utilizing his therapeutic skills effectively.