6/13/2023 EnchantaVaughn Approved Behavior: Ashiyah has a difficult time transitioning from group setting to independent setting. Ashiyah struggled with following directions and listening during session. Ashiyah withdrew during the session as she became quiet and began to display restless and out of normal behaviors. Behavior: Ashiyah showed low level of participation, putting her head down and covering her face not wanting to be bothered. Ashiyah is easily frustrated disengaging in activity presented wanting to do what she liked instead of what was being told to do. Intervention: QMHP-C will implement a routine that will encourage Ashiyah to be responsible and promote self confidence in academic and social settings. QMHP-C will educate Ashiyah on behavior modification to help Ashiyah identify what behavior she needs to decrease and avoid daily. QMHP-C assisted Ashiyah in monitoring her own behaviors in efforts to promote exercising self-control in focused areas such as respecting boundaries with others. QMHP-C modeled proper positive behavioral expectations for Ashiyah to implement in her daily activities. QMHP-C educated and practiced with Ashiyah on using breathing techniques and other anger management skills to assist her with maintaining a calm spirit. QMHP-C taught Ashiyah relaxation, calming, and guided imageries, to help her reduce and regulate her overactive and angry behaviors during the session. Intervention: QMHP-C reviewed several strategies for conflict resolution skills with Ashiyah in efforts to increase Ashiyah’s awareness. Ashiyah was encouraged to use good judgement, and respect authority figures. QMHP-C provided Ashiyah with a release of energy by walking in her space, stretching, and deep breathing exercises. QMHP-C reiterated with mom the importance of maintaining a healthy relationship with her daughter by allowing her to make new friends other than her little brother that are girls her age in order to venture out and be her own person and be involved in things appropriate for her mental health. QMHP-C discussed with the family one goal they believe they need to work on individually and as a family to help Ashiyah maintain daily goals. Prior to the end of session, QMHP-C asked Ashiyah, "what would you do different tomorrow” to motivate her to want more for herself. Response: Ashiyah displayed an unresponsive and nonchalant attitude toward QMHP-C when reviewing strategies from previous session. Ashiyah anger is moderate to intense, 3-4x per week. Ashiyah displayed an unemotional and flat facial expression on her face, as she appeared disinterested in the instructions, role playing techniques and modeling techniques that were implemented with teaching her effective communication and assertiveness skills to express her anger more appropriately. Ashiyah demonstrated a willingness to discuss the factors contributing to her stress and anxiety. Ashiyah was able to detect and acknowledge both positive and negative responses modeled by QMHP-C. Ashiyah knows what she needs to do to improve socially and academically. Ashiyah expressed to QMHP-C that she understood the importance intensive in-home and promised to do a better job in each session. Response: Ashiyah acknowledged QMHP-C and explored her options. Ashiyah proceeded to reduce the aggression in her voice while calming down. Ashiyah accepted suggestions from QMHP-C as evidenced by Ashiyah smiling and saying thank you. Ashiyah promised she would try her best to correct herself when faced with conflict. Ashiyah participated in reviewing key concepts on her mental illness and how to manage the symptoms. Ashiyah was able to speak calmly and demonstrate her improved verbalization skills while conversing with her mom. Ashiyah was able to utilize coping skills to eliminate stressors and unwanted feelings. Ashiyah enjoys therapy, as shown with her positive expressions and smile. Ashiyah interacts well with QMHP-C and seems to be warming up to therapy sessions the more she involves herself mentally and physically.