3/21/2023 EnchantaVaughn Approved Behavior: Upon arrival, Client was very intolerant with QMHP-C and mom during the beginning of the session. Client spoke in a hostile tone, “I don’t want to do this” (referring to the session). Client was inquired why she felt this way. Client did not respond when inquired about her feelings. Behavior: During the second portion of the session, Client displayed management of individualized behaviors. Client was hyper when discussing her challenges with her being able to learn how to express her feelings more as evident by her getting excited with QMHP-C when discussing how she handles her emotions with others. Intervention: QMHP-C facilitated an individual psycho educational exercise which consisted of Client identifying 3 positive ways to deal with anger and frustrations. QMHP-C explored Client’s responses and responded by reminding Client to refrain from self-alarming and negative statements. QMHP-C reiterated Client safety plan by identifying coping skills she can utilize. QMHP-C engaged Client in conversation. QMHP-C practiced calming techniques by modeling examples for Client to follow, such as walking away and cooling off and counting to ten. QMHP-C prompted Client to refrain from impulsive, hyperactive, defiant, and aggressive behaviors especially running, refusing authority instruction, and interrupting others who are trying to learn. Intervention: QMHP-C utilized behavior modification strategies including removing Client from the stimulant environment in efforts for her to reduce inappropriate behaviors. QMHP-C will monitor effects of meditation and coping practices daily and document progress. QMHP-C utilized role playing to demonstrate the calming effects of predicting the thoughts, feelings and actions of self and others prior to the outbreak of a conflict. QMHP-C prompted Client to share anticipated thoughts and feelings and to indicate how this process reduces angry reactions. Response: Client understood how communicating effectively and assertively could help her resist negative peer influence and pressure to be the perfect daughter. Mother verbalized that she had a positive start to her day. Client also understood the examples that were provided by counselor. Mother verbalized that she will work on not blaming Client’s misbehaviors on her surroundings and upbringing. Mother verbalized that she will work on focusing on Client’s behaviors, the good and the bad. Client’s mom verbalized that she will increase the level of communication with Client to find out what is bothering her, in order to inquire with Client what is causing her to act out so often. Client verbalized positive feelings about evening and morning. Client said she was feeling good and plans to have a good evening. Response: Client has not overreacted with anger to minor frustrations or irritants. Client responded in a pleasant manner acknowledging the positive reinforcement that QMHP-C provided. Client was able to reevaluate herself and display a more positive attitude toward peers and authority. Client has become more involved in age appropriate social activities while being supportive of others. Client demonstrated expectations and responded well to feedback. Client reported a decreased stress level due to her modulation of social contact, and the success of this was reviewed.