3/29/2023 EnchantaVaughn Approved Behavior: When QMHP-C arrived at the residence, Client was observed in her room cleaning up. Mom commented that Client has been listening and not giving her a hard time about her chores. Client was thankful to hear her mom tell her counselor good things about her. Client displayed age appropriate behaviors and was able to stay on track with goals and objectives. Client continues to be inattentive in the home setting last occurring noon today. Behavior: During second portion of the session, client displayed inattentive behaviors with QMHP-C when discussing her behaviors in the home as it relates to client not completing her chores and becoming angry with her mother when she takes her telephone from her. Intervention: During conversation at the home, QMHP-C communicated with Client and mother about Client’s progression and possibilities of goals and objectives during continuation of services. QMHP-C also encouraged mother to point out possible stressors and/or irritations that Client may trigger by behaving negatively. QMHP-C consulted with mother about increasing structure in the home to aid Client in acknowledging the importance of operating and cooperating in the home setting. QMHP-C urged mother and Client to participate in role reversal activity to aid mother and Client to realize how to respond to and interact with each other. QMHP-C continued to monitor and receive an update on Client’s relationship with mother and compliance to duties and expectations for Client in the home and in the community. QMHP-C encouraged Client to use her strategies and skills with peers, family, and other mental health professionals to support her with managing symptoms associated with ADHD. Intervention: QMHP-C probed Client about talking with her mother about her feelings. QMHP-C commended Client on utilizing coping strategies to increase her understanding of feelings and emotions. QMHP-C intervened to prevent the negative behaviors from escalating. QMHP-C physically redirected Client to an alternative activity. QMHP-C provided guidance on alternative behaviors and clear instruction on the alternative behavior. Intervention: QMHP-C provided positive feedback when Client engaged in the more appropriate behavior. QMHP-C related the session to being able to express feelings appropriately and continued to provide positive reinforcement for Client appropriate behaviors and acknowledged her efforts with building rapport and sharing her experiences without shutting down or displaying meltdowns. Response: Client and mother displayed good active listening skills. Client agreed that she has been doing a lot better in the home. Mom was aware that Client has not met her goals to be discharged from the program and is acceptive of the continuation of services. Mother expressed Client’s behaviors have improved but she still has to remind Client about remaining consistent with reacting positively when being reprimanded or redirected. Mother states to QMHP-C that she has considered implementing a minor schedule for Client to assist her with her completion of chores. Mother mentions that schedule assists her as well and allows her to remain focused on completing individual tasks without negative reactions. Client smiled as she was affirmed for her mature and pleasant behaviors. Response: Client informed QMHP-C that she was coping and utilizing deep breathing techniques to stay calm and not overreact. Client began to display positive thoughts throughout the session. It was noted that the interventions were successful. Client was able to relax and regain and regulate her overactive behaviors throughout the session. Client was receptive and open, extending a healthy rapport back to QMHP-C. Client was non-responsive to her antisocial behaviors. Client was fully engaged in the card games in a productive and constructive manner. Client did not display any difficulties or complications in response to playing games. Client is seen laughing and interacting well with her counselor. Client displayed appropriate conversation. Client responded to feedback and shared some of her own experiences with dealing with adversity in all areas of her life. Client have been practicing optimism throughout the week and taking charge of her disorder. Client stated she had a clear comprehension of the purpose of each session and what her expectations are in each session as she smiled at QMHP-C for praising and rewarding her for her efforts.