4/14/2023 EnchantaVaughn Approved 1. Behavior: Upon arrival to the home setting, QMHP-C allotted Ashiyah and Ms. Hodge to provide QMHP-C with update on Ashiyah’s behaviors since the last session. Ms. Hodge discussed with QMHP-C Ashiyah continues to struggle within the school setting with her level of disrespect and when she is questioned about her behavior, she will indicate, “The teachers don’t like me”. 2. Behavior: Ashiyah appeared to be in a content mood evident by her facial expressions such as a smile on the face. Ashiyah participated in the session; however, she needed redirection from QMHP several times throughout the session due to her off task behaviors. 1. Intervention: QMHP-C informed Ashiyah that the session would focus improving her attention span as well as reducing impulsive behaviors due to Ashiyah exhibiting impulsive behavior patterns and receiving negative consequences that have resulted from it. QMHP-C had a therapeutic conversation with Ashiyah regarding her day and how it had gone. QMHP-C modeled active listening and asked open-ended questions in order to have Ashiyah speak in greater detail. Through the use of modeling, role-playing, and behavior rehearsal QMHP-C showed the Ashiyah how to stop, think, and plan before acting. QMHP-C had Ashiyah to make up her own role-playing scenarios of impulsive behaviors to reenact. QMHP-C encouraged Ashiyah to review the use of “stop, look, listen, think, and plan” in day to day living and identify positive consequences. 2. Intervention: QMHP-C assisted Ashiyah in making a list of consequences of impulsive behaviors. Due to Ashiyah’s interaction QMHP-C modeled and taught Ashiyah social skills (i.e. calm tones, considering the impact of her comments, etc.) that control impulsivity. QMHP-C introduced a therapeutic game to Ashiyah that was designed to improve her ability to stay focused on tasks until they are completed, to teach her how to do a better job handling frustration, to teach her how to anticipate distractions and create strategies to overcome them, to teach her the benefits and rewards of focusing, and to teach her how to tune out distractions while staying focused. 1. Response: During this session, Ashiyah admitted that she tends to just act without thinking about what might happen when she makes inappropriate decisions. In the beginning of the role-playing, Ashiyah didn’t take it too seriously. Ashiyah was laughing, making jokes, leaving in and out of the session, etc. However; after she was given the opportunity to make up her own role-playing scenarios, she tended to take them more seriously. Ashiyah was able to list several consequences of impulsive behaviors. Some of these included: not getting her hair done, being suspended from school, having in school suspension, not being allowed to go over her friend’s house. 2. Response: During the ending of the session, Ashiyah didn’t believe that she displays inappropriate behavior in school when it comes to being unacceptably too loud. She stated that everyone in her class is loud and it always seems as if she gets singled out by her teachers and other staff. Ashiyah did participate in the therapeutic game without any issues and was able to process different ways to handle frustrations.