10/30/2023 EnchantaVaughn Approved Upon arrival to the home setting, QMHP engaged mother in a discussion to determiine behaviors since last session. Mother verbalized understanding to QMHP on how client continues to struggle with not following directives the first time they are given to her at least 2-3 times within a day causing her to become frustrated. During the second portion of the session, client was unable to a demonstrate good coping skills thoruhgout the session evident by her smacking her teeth at QMHP when role playing positive coping skills to manage her anger at least 3 times within the session. QMHP observed client complying with rules and expectations. QMHP utilized empathetic listening skills as client expressed her understanding of stressful situations. QMHP provided age appropriate understanding of the mom’s perspective of the situation and why she is there to help resolve any issues, including but not limited to her mental health. QMHP supported client with working on herself and trying her best to understand the purpose of each session. QMHP informed client that refusing to listen to her mom was not acceptable and she should take small personal breaks and then process forward. QMHP reminded client of ISP objectives. QMHP processed client thoughts and feelings. QMHP engaged client in conversation regarding her recent behaviors, progressions, and setbacks. QMHP explored client’s responses and provided appropriate feedback. QMHP explained the importance of being on task and refraining from talking in order to complete her assigned task. QMHP reviewed examples of alternative appropriate behaviors she could engage in. QMHP supported client making good decisions and having positive behaviors in the home. Client demonstrates she can accept compliments and constructive criticism and act civilized if she tries hard enough. Client exhibits good attention skills and remained focused. Client reviewed ISP objectives with mental health professional. Client said she was aware of her expectations and what she is expected to do each day. Client practiced some of the examples of alternate behaviors (e.g. closing her eyes and thinking about happy memories, coloring/drawing pictures, repeat positive “I-statements”, and asking questions that will help her understand things better). Client was observed in session adhering to rules and regulations and being respectful to staff. Client displayed self-control in her seat by keeping her hands in her lap and sitting calmly without impulsive or hyperactive behaviors while counselor reviewed her objectives and expected her to give an example of how she displayed each one in the home today. Client did a good job ignoring distractions and maintaining appropriate behavior in the session. Client transitions well between one on one discussion and family discussions, utilizing the correct voice volume and displaying positive body language the entire time.