3/3/2024 EnchantaVaughn Approved Behavior: When QMHP-C arrived, Ashiyah was upset but was able to recollect and focus on her therapy. Ashiyah agreed to practice listening skills at home and be more open with her emotions instead of shutting down and avoiding her family. Ashiyah continues to struggle with working independently, relying heavily on support from QMHP-C and mom. Ashiyah presented outbursts and attempted to shut down, refusing to process or debrief in the session at which behaviors can last up to 10 minutes in duration. Behavior: Ashiyah withdrew during the session as she became quiet and began to display restless behaviors. Ashiyah continued to demonstrate quiet behaviors during the session. Ashiyah stated that sometimes she has a hard time accepting constructive criticism and takes her frustration out on others at which behaviors can last up to 10 minutes in duration. Intervention: QMHP-C monitored, observed, and redirected Ashiyah behaviors as needed. QMHP-C reflected with Ashiyah on her choices, reviewing both good and bad experiences in the home. QMHP-C intervened to prevent the negative behaviors from escalating and to promote good energy. QMHP-C physically redirected Ashiyah to an alternative activity to keep her mind in a productive state so that she wouldn’t become stagnant or complacent in her own space. QMHP-C provided guidance on alternative behaviors and clear instruction on the alternative behavior. Intervention: QMHP-C encouraged Ashiyah to resist negative behaviors in efforts to refrain from requiring to be redirected by her mom so many times. QMHP-C utilized empathetic listening skills as Ashiyah expressed her understanding of her mental illness. QMHP-C reassured Ashiyah that she is there to help resolve any issues she has, including her having difficulty completing simple tasks in the home, school, and community. QMHP-C informed Ashiyah that refusing to do her work is not acceptable. QMHP-C encouraged Ashiyah to be mindful of others personal space and knowing when to set boundaries and walk away. Response: Ashiyah complied and went over ISP objectives with QMHP-C with no resistance. Ashiyah was receptive of QMHP-C interventions, as seen implementing them right away following negative conduct. Ashiyah was observed intervening and regulating her emotions without displaying irritable, distant feelings which helped her come out of her comfort zone. Ashiyah knows what she needs to do to improve socially and academically. Ashiyah is making progress with expressing her feelings and showing others respect and courtesy by talking with appropriate tone, initiating conversation with parent, and waiting for her turn to talk. Response: In the second half of the session, Ashiyah acknowledged QMHP-C's redirection after 3-4 prompts. Ashiyah stated okay and began to perform in a more enlightened and friendly way. Ashiyah proceeded to reduce the aggression in her voice while communicating her thoughts with her counselor. Ashiyah accepted suggestions from QMHP-C as evidenced by the Ashiyah smiling and saying thank you. Ashiyah expressed to QMHP-C that she understood the importance intensive in-home and promised to contribute to each session.