4/9/2024 EnchantaVaughn Approved Behavior: Upon arrival Mom explained that she was fine with having session today and wanted Ashiyah to get the most out of in-home services despite having difficulty with getting Ashiyah to listen and be more respectful at which mother reports behaviors occur on a weekly basis and last 20 minutes in duration. Behavior: Ashiyah appeared to be withdrawn at times within the session when discussing with her mother her behaviors as well as her on ways she can better communicate her thoughts. The withdrawal lasted up to 2 minutes in duration at the time of the session. Intervention: QMHP-C conducted session on helping Ashiyah and mother reduce the stressors in the home and community. QMHP-C informed mom that Ashiyah can benefit from other services, thus probing them to utilize resources in the community that will help Ashiyah reduce her aggressive behaviors. QMHP-C reviewed with mother the ability to limit the stress in the home and to utilize the reward system. QMHP-C utilized active listening skills while probing mother on the affect ways that she attempts to reduce Ashiyah's negative behaviors. Mother was praised for her efforts to better herself and her living situation by making sure she provides Ashiyah with everything she needs to move forward and keep Ashiyah away from negative influences in her past. QMHP-C will provide Ashiyah with support and encouragement. Intervention: QMHP-C will explore positive self-talk, use instruction modeling, and increase social communication skills with positive reinforcement role play activities. QMHP-C will educate Ashiyah on behavior modification to help Ashiyah identify what behavior she needs to decrease and avoid daily. QMHP-C will utilize behavior modification system to aid Ashiyah with following directions given by authority figures. QMHP-C inquired about activities Ashiyah might be interested in for future outings. QMHP-C will meet with Ashiyah 4x a week to discuss progress and expectations that are working and not working in the home. Ashiyah reported that her and her mom have a close connection but have difficulty with communicating when Ashiyah is not happy. It was communicated by parent that Ashiyah needs to realize that she has a lot going for herself, but she allows others to get her off track. Response: Ashiyah was able to deescalate once given a new discussion topic, but only minimally participated as she continued to be guarded. Ashiyah is aware that she can be a hand full. Ashiyah admitted that she can’t control her temper sometimes. Ashiyah reported that she is looking forward to receiving help and wants to learn how to deal with her anger and depression. Ashiyah understands that her treatment plan is a behavior contract that will reflect her improvements in the home. Ashiyah stated that she is open to new ideas. Ashiyah was acceptive of prompts given by mom and QMHP-C. Ashiyah agreed to listen to the adult and follow all rules no matter if she sees someone else breaking them. Ashiyah is reminded to tell an adult if someone is interrupting her learning no matter where she is. Ashiyah presents a positive attitude when given the opportunity to earn a reward. Response: Ashiyah implemented the positive reinforcement provided by her mom and was able to stay motivated and enjoy her day. Ashiyah exhibited good manners after earning incentive for her hard work. Ashiyah interacted well within her home environment. Ashiyah reported a decreased stress level due to her modulation of social contact, and the success of this was reviewed. Ashiyah implemented the positive reinforcement provided by her QMHP-C and is able to stay motivated and enjoy her day. Ashiyah exhibited good manners in the home. Ashiyah reduces sadness and finds more excitement in learning about her family history and mental health.