2/12/2023 EnchantaVaughn Approved Behavior: Upon arrival to the home setting, QMHP-C introduced herself to client and family. QMHP-C informed the family of the reason for today’s session. QMHP-C informed mother as well as client services would consist of client receiving about 6-8 hours of services on a weekly basis and if there an extension needed, QMHP-C would communicate with mother about the process. QMHP-C engaged mother in a discussion to determine behaviors she would like for QMHP-C to assist with client to work on while in services. Mother reports client needs assistance with managing her anger as well as learning how to respect those who are in authority. Behavior: Client appeared to be in a positive mood evident by her facial expressions such as a smile on the face. Client displayed on-task behaviors needing no redirection from QMHP-C. QMHP-C informed client as well as mother on how to continue to implement what has been taught during sessions to continue to work with client on implementing her goals. Intervention: QMHP-C observed Client in the living room in efforts to determine whether she required assistance. QMHP-C determined Client was on task and did not require assistance. QMHP-C provided positive gestures to encourage Client on her positive behaviors in the home. QMHP-C reminded Client of ISP objectives and what she needs to do in order to achieve them. QMHP-C reviewed examples of alternative appropriate behaviors she could engage in to stay on task without causing disruption. Intervention: QMHP-C engaged Client in a conversation regarding her recent behaviors, progressions and setbacks. QMHP-C explored Client’s responses and responded accordingly. QMHP-C talked with Client about the importance of adhering to rules and expectations in school, at home and in the community. QMHP-C provided age-appropriate understanding of her mental illness and encouraged her to utilize her coping strategies during social and non-social environments. QMHP-C informed Client that misbehaving carries consequences and that making good choices results in good reward. QMHP-C encouraged Client to refrain from displaying negative behaviors towards her mom, to talk calmly, and express herself without yelling or getting upset. Response: Client smiled as she saw QMHP-C's positive gestures. Client was able to process making good choices with QMHP-C and her mom. Client appeared to be receptive to receiving positive reinforcement from her mother, as demonstrated by her smiling and warm inviting body language. The frequency and intensity of Client's defiant affect decreased. Client continued to work on the psycho-educational activity. Response: Client reduced impulsive behaviors after 3-4 prompts from her mom and QMHP-C. Client began to show greater control of her anger. Client appeared to decrease the intensity of her anger and frustration. Client was pleasant and cooperative and demonstrated a willingness to discuss the factors contributing to her undesirable mood. Client acknowledged that she tends to engage in disruptive behavior when she is frustrated with schoolwork or feels mistreated. Client accepted responsibility for her angry outbursts and aggressive behaviors. Client stated she will display anger control and not threaten or intimidate others.