3/7/2024 EnchantaVaughn Approved Behavior: When the therapy was set to begin, client showed disinterest toward QMHP’s prompts and activities. Client struggled to commit to the instructions provided and this caused a lot of conflict in the session. Mother was completely sensitive toward client due to her mental illness but did not excuse her behavior at which behaviors last up to 3-4 minutes in duration. Behavior: Although, client chose to distance herself when reflecting on her experiences. Client needed to let go of her doubt and insecurity and was supported with reducing symptoms of ADHD. Client expressed that she tries to communicate with her mother in the same way that she communicates with her counselor but it’s hard at which mother reports behaviors last up to 5 minutes in duration. Intervention: QMHP spoke with mom in reference to her daughter’s treatment plan and advised them of any changes or concerns that may be present at this time. QMHP provided parent with additional resources on client’s diagnosis and information that maybe useful for her at home. QMHP engaged in conversation with client about her triggers. QMHP informed client on our culture, genes, upbringing, education, gender, beliefs, and life experiences make us who we are. QMHP encouraged client to be kind to herself, her peers, and her elders. QMHP utilized empathetic listening skills as client expressed her understanding of stressful situation. QMHP provided age appropriate understanding of the mother’s perspective of the situation and why she is there to help resolve any issues she has. Intervention: QMHP explored non-verbal activities that can still benefit client without causing her to shut down. QMHP redirected client to an alternative activity that was more fitting to her needs. QMHP provided guidance on alternative behaviors and clear instruction on the alternative behavior. QMHP assisted client with learning new ways to express herself without feeling embarrassed or scared. QMHP engaged client to teach positive and appropriate anger management techniques. QMHP reminded client to utilize her calming techniques when she feels like she is getting ready to explode. QMHP processed with client how the calming techniques can make a difference on the way she perceives the world around her. Response: There were a few changes that were needed to complete her treatment plan. After being introduced to other resources outside of the home, client seemed a little less irrational. The struggles that are apparent in the home are mainly because client sometimes has to adjust to the schedule that mother has implemented for their safety. Client understands that her mother is trying to aid her with prioritizing skills and create structure in the home. Client expressed that when she is involved in a conflict she has a hard time communicating with her family and often shuts herself down from everyone. Client have unresolved issues, which triggers her to revisit those unwanted emotions when she experiences trauma. Response: Client displayed quiet and guarded expressions during the activities, displaying low participation and low confidence around her mom and sister. Client speaks about herself in a negative tone communicating that she feels ashamed and unhappy about her efforts and abilities. Mom have tried to deal with the behaviors without VACCD support but realized that she cannot do it by herself. Client demonstrated that she was able to process productive expressions of anger once she calmed down. Client informed counselor how she was working on doing better and helping her mom with taking care of responsibilities and lift some stress off her plate.