10/19/2023 EnchantaVaughn Approved Behavior: Client was not in a good mood, indicating she wasnât going to enjoy the session today. Client had on pajamas and her hair was messy, demonstrating poor hygiene. Client home was unorganized as she kept throwing stuff on the floor and walking over trash. Clientâs mom asked her to pick it up, but she refused. Client continues to show disrespectful manners when sheâs not given the attention she desires. Client refused to listen to what anyone had to say. Client shrugged her shoulders, indicating she didnât care at all. Behavior: Client continues to express and elaborate on the negative situations in the home. Client communicated with QMHP that she does not feel as if she need psychotherapy to cope with her symptoms or conditions and can fix her own problems. Client communicated that she understands that she has anger issues at times but have good reasons for it. Client continues to state that she doesnât want any additional assistance or support with her behaviors or feelings and wished everyone would leave her alone. Intervention: QMHP prompted client to refrain from impulsive, hyperactive, defiant, and aggressive behaviors especially running, refusing authority instruction, and interrupting others. QMHP helped client problem solve when she began displaying negativity towards herself and others. QMHP encouraged client to listen to her mom. QMHP reminded client of things she can receive if she does what sheâs supposed to do (i.e. chores, homework, watch over her little brother, clean up behind herself) on a daily basis. Intervention: QMHP assisted with reducing anger-provoking situations through self-talk and role play scenarios in order to prevent escalation and dealing with anger assertively. QMHP utilized behavior modification strategies including removing client from the stimulant environment in efforts for her to reduce inappropriate behaviors. QMHP intervened to aid in explaining behaviors to client and what she needs to work on if she wants to meet her goals and objectives more consistently. Response: Client has difficulty staying focused when distracted by others who are off task and has to be reminded to get back on track or consequences will follow. Client understands that her actions have consequences. Client made a comment that she hates sharing her toys with her little brother because he always breaks her stuff. Client anger is moderate to intense, 3-4x per week. Client is working on walking away and telling an adult before responding to anger provoking situations. Response: Client is having challenges with certain activities and needs some help. Client is witnessed talking and being disrespectful to everyone in the home. Client discloses she was wrong and apologizes. Client recognizes areas she needs to work on, including but not limited to relationship building skills. Client acknowledges she needs to work on her temper and controlling her anger when she doesnât get her way. Client admits that she can be nicer to people, especially those apart of her community and family/home setting.