4/28/2023 EnchantaVaughn Approved Behavior: During todayâs visit, Ashiyah was having a hard time coming to her session. Ashiyah blamed her family for her negative choices and appeared unapologetic for participating in disruptive actions in the home ( last occurring yesterday) as mother reports when she tells her to clean up the home she gets upset and starts to cuss and scream. Behavior: Ashiyah was silent for about 15-minutes then decided to communicate her feelings to her counselor. Ashiyah wants to be able to balance everything without feeling like sheâs responsible for other people in the home as she reports she get angry ( last occurring on yesterday) because her mother makes her clean up after her siblings and she is not the one that is messing up the living room area. Intervention: QMHP-C prompted Ashiyah to refrain from impulsive, hyperactive, defiant, and aggressive behaviors especially refusing authority instruction, and interrupting others. QMHP-C encouraged Ashiyah not to complain and be more kind. QMHP-C intervened to assist in explaining behaviors to Ashiyah and what she needs to work on if she wants to meet her goals and objectives. Instruction, modeling and role-playing techniques were used to help Ashiyahâs general communication skills. QMHP-C taught Ashiyah effective problem-solving skills (i.e. identifying the problem, brainstorm alternate solutions, select an option, implement a course of action, and evaluate). Intervention: QMHP-C informed Ashiyah that when she is agitated to refrain from taking it out on people and communicate how she is feeling to others, so they know exactly how she is feeling. QMHP-C intervened to prevent the negative behaviors from escalating. QMHP-C verbally redirected Ashiyah to an alternative activity. QMHP-C provided guidance on alternative behaviors and clear instruction on the alternative behavior. QMHP-C will assist with reducing anger-provoking situations through self-talk and role play scenarios in order to prevent escalation and dealing with anger assertively. QMHP-C processed with Ashiyah, âtomorrow is a new dayâ ; "what would you do different tomorrowâ. Response: Ashiyah was highly oppositional during the start of the session, displaying argumentative and frustrating behaviors. Ashiyah did not offer any forms of social or friendly rapport back to the QMHP-C, remaining unemotional displaying an unresponsive and nonchalant attitude throughout the session. Ashiyah had a difficult time processing her feelings and admitting she was wrong. Ashiyah was aggravated as counselor tried to deescalate the situation that was occurring. Ashiyah did not express appropriate communication after positive reinforcement was provided. Response: Ashiyah reiterated that she wished she had her own space to explore more things she like to do while being home all day. Ashiyah stated that she would try to listen more so that she is able to understand what she needed to do in order to achieve her goals and objectives on a consistent basis. Ashiyah agreed to go to bed on time each night, review, practice, and study material, wake up for school on time, and work harder. It was difficult for Ashiyah to relax and remain stable when being instructed by the calming techniques during the session. Ashiyah showed lack of concern and empathy in response to positive cognitions. Ashiyah was reluctant and hesitant to the interventions provided.