3/8/2024 EnchantaVaughn Approved Behavior: QMHP met with client for in-home services and to check on how she was doing since the last visit. Client was present in the home during session. Client was mildly talkative during session. Client has issues with understanding the effects of her behaviors attitude and continues to behave in a hyperactive mood. Client was unable to focus today. Client expressed that she tries to communicate with her mother in the same way that she communicates with her counselor but it’s hard. Client wants to figure out how to open up to her mom more at which mother reports her behaviors can last up to 2 minutes in duration. Behavior: Client verbalized to QMHP on how she struggles with not being able to implement her coping skills when she is upset. She admits when these behaviors present themselves she will shut down for about 20 minutes. Intervention: QMHP went to the home to meet with client to support her with her anxiety. QMHP initiated a rapport building conversation with client in efforts to learn more of her likes and dislikes as well as triggers to negative behaviors listed on her ISP. QMHP engaged in conversation with client about her day. QMHP actively listened to client verbalize that she was agitated today and the reasons to her agitation. Instruction, modeling and role-playing techniques were used to help client’s general communication skills. QMHP taught client effective problem-solving skills (i.e. identifying the problem, brainstorm alternate solutions, select an option, implement a course of action, and evaluate). Intervention: QMHP engaged the client in a role reversal exercise and required the client to think about her goals for the future. QMHP will review key concepts of being a responsible student with her family. QMHP will educate client about being respectful, encouraging, mindful, and fair to peers and authority while making good decisions in school. QMHP will brainstorm strategies with client and encourage self-monitoring. QMHP will provide mediation and relaxation techniques, as well as, simple praises and encouragement to continue the positive behaviors she was exhibiting. QMHP will teach client necessary coping skills to decrease impulses. QMHP commended client on utilizing coping strategies to increase her understanding of feelings and emotions. Response: Client blames her mental illness for her attitude, mood, and behaviors. Client stated that she doesn’t intend on being negative and agrees she need to work on controlling and channeling her anger, as well as, listening and communicating her feelings better. Client displayed management of individualized behaviors. Client responded in a pleasant manner acknowledging the positive reinforcement that the QMHP provided. Client discussed mental illness and its causes as a family. Client understood that when she becomes agitated she needs to refrain from taking it out on people and to communicate how she is feeling to others. Client communicated positive affirmations and self-talk once she was able to let go of negative, agitated feelings. Response: Client was able to reevaluate herself and display a more positive attitude toward peers and authority. Client demonstrated expectations and responded well to feedback. Client has become more involved in age appropriate social activities and was given positive reinforcement for these choices. Client appeared to grasp a clear understanding of the “unexpected behaviors” she often displays in the home especially the behaviors that have affected her the most. Client was assisted in practicing general communications skills. Client understood effective problem-solving skills to help solve or overcome a problem or stressor the she is currently facing. Client displayed interest in learning about ADHD.