3/23/2023 EnchantaVaughn Approved Behavior: Upon arrival to the home setting, Client was impolite toward mental health professional refusing to process her emotions by walking off and exhibiting increased frustration as evidenced by slamming things and cursing. Client ignored several prompts that was issued to get her back on track. Behavior: Client was not listening or trying to resolve conflict exhibited during the session. Client continued to display a negative attitude. Client avoids participating in age appropriate leisure activities (i.e. reading time and quiet time) during the session and continues to make unnecessary noises interrupting QMHP-C. Intervention: QMHP-C probed about any angry feelings or the inclination of safe and unsafe behaviors. QMHP-C utilized active listening as information was conveyed. QMHP-C communicated with Client on displaying appropriate control. QMHP-C probed Client about certain behaviors and how she sometimes feels like the only way to respond is in a negative manner. QMHP-C continued to engage with Client and provided positive reinforcement as she participated in the session. QMHP-C challenged Client to identify any situation she has experienced that makes her feel defeated or misunderstood. QMHP-C further explained different situations that can cause anxiety. QMHP-C provided feedback regarding Client inquiries. Intervention: QMHP-C continued to elaborate on ways Client can cope and manage stressors. QMHP-C commended Client for her participation and honesty. QMHP-C educated Client that most children her age are not as mature as her and that alone gives her an advantage and confirmation that she’s headed in the right direction and to believe in herself. QMHP-C processed Client positive behaviors. QMHP-C assisted Client in developing more social skills. QMHP-C inquired about possible challenges Client can experience with applying this skill. QMHP-C provided positive feedback. QMHP-C reflected on Client goals and objectives. QMHP-C isolated Client from distractions to decrease disruptive behaviors and to reduce episodes. QMHP-C assisted Client in normalizing the changes that are occurring in and out the home. Response: Client would not talk about any of her feelings as it relates to anger or unsafe behaviors. Client was not in a good mood at this time. Client had difficulty relaxing and following QMHP-C prompts. Client continued aggressive behaviors. Client did not extend a sociable rapport back to QMHP-C. Client required redirecting from QMHP-C to reduce her voice volume 2-3 times. Client self-esteem and confidence remained low. Client continued to display hyperactive behaviors for 10 minutes prior to declining them. Client required to be re-focused by QMHP-C as she waited for her mom to speak on behalf. Client communicated understanding by nodding her head. Client acknowledged that she tends to engage in disruptive behavior when she begins to become frustrated with her psycho educational work. Response: Client was reluctant and hesitant. Client did not offer any forms of social or friendly rapport back to QMHP-C, remaining unemotional displaying an unresponsive and nonchalant attitude throughout the session. Client took an additional 10 minutes to reduce hyperactive behaviors. Client became more impulsive and started to cause more disruptions. Client explored numerous ways to express her anger and negative behaviors during the role play with QMHP-C. Client stated her difficulties in certain situations but displayed a negative tone. Client required assistance as she was unable to lower her voice. Client showed lack of concern and empathy in response to positive cognitions. Client accepted responsibility for her angry outbursts and aggressive behaviors. Client stated she will display anger control and not threaten or intimidate others. Mom was satisfied with the interventions that was provided to Client and agreed to the next session with QMHP-C.