4/2/2023 EnchantaVaughn Approved Behavior: Upon arrival to the home setting, QMHP-C engaged mother in a discussion to determine behaviors since the last session. Mother reports, Client verbalizes alarming statements when she engages in reflective thinking, stating that she becomes really aggressive when she’s upset. Client was reminded to utilize relaxation techniques and deep breathing skills before she makes a mistake she can’t take back. Client verbalizes different complaints but utilizes her coping skills properly. Member continues to show defiance in the home. Behavior: During the second portion of the session, Client expressed needing more support and agreed to be less emotional and more logical with handling stressful situations at home. Client displays an increased ability regarding problem solving and making wise decisions. The client was supported for demonstrating a decrease in level of paranoia. Client continues to show defiance in the home. Intervention: QMHP-C engaged client in a conversation regarding her recent behaviors, progressions and setbacks. QMHP-C explored client’s responses and responded accordingly. QMHP-C talked with client about the importance of adhering to rules and expectations in school, at home and in the community. QMHP-C separated client from inappropriate interaction, in efforts to reduce tension and stress-provoking situations. QMHP-C encouraged client to resist negative behaviors in efforts to refrain from requiring to be redirected by her mom over and over. QMHP-C reviewed examples of alternative appropriate behaviors she could engage in. QMHP-C isolated client from distractions to decrease disruptive behaviors and to reduce excessive talking in session. QMHP-C communicated with client on displaying appropriate control. QMHP-C utilized empathetic listening skills as client expressed her understanding of stressful situations. Intervention: QMHP-C held consultation with client and mother about effective intervention strategies that build on the client's strengths. QMHP-C provided positive gestures to encourage client on her positive behaviors both socially and academically. QMHP-C processed client thoughts and feelings. QMHP-C explored client’s responses and provided appropriate feedback. QMHP-C supported client with working on herself and trying her best to understand the purpose of each session. QMHP-C encouraged client to be mindful of other peers/family personal space. QMHP-C encouraged client to refrain from displaying negative behaviors towards her mom, to talk calmly and express herself without an attitude. QMHP-C explored the positive behavior options she was exhibiting with client to support her willingness to continue to make improvements with her mental, emotional, and physical health. Response: Client retained a lot of the information she was taught which motivates her to pay more attention and make better choices at home so that she can reduce conflict and avoid drama in the home. Client is observed problem solving on her own and handling her emotions appropriately. The client stated that she can be good and listen to her mom. Client was able to cooperate and comply to rules and regulations due to positive influence from her mom. Client implemented pro social skills successfully. Client maintains good etiquette by sitting in her seat during the session, raising her hand and asking appropriate questions, being respectful toward mental health professional, remaining quiet during quiet time and active during social time, listening to her mom, and modeling appropriate behavior. Response: Client told QMHP-C that she will do her best to follow directions and stay attentive to the activity. Client has difficulty staying focused when distracted and has to be reminded to get back on track and focus on herself. Client responds well to praise and support. Client is acceptive of redirection. Client understands that her actions have consequences. Client acknowledges she needs to work on her temper and controlling her anger when she doesn’t get her way. Client understands that her treatment plan is a behavior contract that will reflect her improvements and setbacks in program or in the home. Client wants to make her counselor and parents proud by doing a good job every day. Client said she was going to practice coping strategies and relaxation techniques in all aspects of her daily living routine in hopes that she will be a better person.