7/22/2023 EnchantaVaughn Approved Behavior: Upon arrival to the home setting, it was difficult for Ashiyah to stay calm during family discussion and she started having episode, turning her back away from her counselor and refusing to communicate in the appropriate way. Ashiyah increased aggressive and unpleasant behaviors after being redirected by QMHP-C. Ashiyah began pouting and complaining saying that everything always fall on her regardless if it’s fault or not. Ashiyah dislikes therapy, disregarding set rules in the session to do what she wanted without feeling obligated to be responsible or entitled to process and explain her emotions. Behavior: Ashiyah presented defiance toward authority when confronted about her poor attitude. Ashiyah was reminded to deep breathe whenever she felt she was about to explode or have an outburst. Ashiyah was given another opportunity to participate and display cooperation. Intervention: During conversation at the home, QMHP-C utilized active listening as information was conveyed. QMHP-C communicated with Ashiyah on displaying appropriate control. QMHP-C modeled language for Ashiyah to use that will promote pro-social behaviors and effective communication. QMHP-C reiterated to Ashiyah the benefits of following the rules and of the privileges she can receive when she does so. QMHP-C provided simple non-verbal praises as Ashiyah was observed displaying positive social behaviors. QMHP-C educated Ashiyah about using good manners. QMHP-C encouraged Ashiyah to continue displaying age-appropriate behavior no matter what. Intervention: QMHP-C monitored progress in demonstrating individualized pro-social skills (e.g. anger management, education, problem-solving, conflict resolution, appropriate verbalization of feelings, and cognitive-behavioral programming). QMHP-C processed with Ashiyah about her feelings regarding her mental health. QMHP-C reminded Ashiyah of goals and objectives. QMHP-C collaborated with mother in regard to home rules and regulations, home management, effective teaching practices, instruction and role-play exercises. QMHP-C assisted Ashiyah with problem-solving on her own and provided Ashiyah with appropriate feedback. Response: Ashiyah exhibited techniques for appropriate self-expression and active listening. Ashiyah understands that in order to do her best, she has to feel her best. Ashiyah demonstrated appropriate interpersonal skills, assertiveness, confidence in self and ability to problem-solve on her own. Ashiyah demonstrated how to verbalize her feelings without yelling and being aggressive. Ashiyah appeared to be calm after the intervention. Ashiyah demonstrated more acceptable responses, avoiding anger provoking situations. Ashiyah showed her gratitude for being able to release unwanted tension within the home environment. Response: Ashiyah participated in brainstorming exercise and was able to identify possible triggers that can arise in the home with limited/inappropriate social interactions. Ashiyah appeared very relaxed and upbeat during exercise and needed no redirection to transition to the next activity. Ashiyah displayed appropriate understanding of exercise. Ashiyah communicated positive self-talk and affirmations to stay motivated. Ashiyah was able to recognize personal strengths and abilities to perform better. Ashiyah was observed complying to authority requests and demands the first time they are given. Ashiyah was open to the mutual and trusting relationship that was reestablished by the QMHP-C.