9/16/2023 EnchantaVaughn Approved Behavior: When QMHP came to visit client at her home, she was witnessed in an uneasy state. Client is still adjusting to the changes in the home and community while giving others space for self-care and to stay safe during the pandemic. Client expressed that she didnât want to talk about personal setbacks in front of her mom because she didnât want to be judged for it. Client shared negative thoughts concerning her expectations and responsibilities as the oldest and how she feels overwhelmed at times. Behavior: Client explained her frustrations and why she has been more stressed than normal lately. Client wants to be able to balance everything and still be herself. Client displayed a nonchalant attitude throughout the entire session, due to wanting special treatment from her mom and counselor. Client lacked respect for both mom and QMHP, as evidenced by client's aggressive behaviors when confronted about her attitude. Client was not in the mood to talk about her feelings, as evidenced by her shutting everyone out and disregarding the conversation. Intervention: QMHP intervened to prevent the negative behaviors from escalating. QMHP informed client that when she is frustrated to refrain from lashing out and communicate how she is feeling to others, so they know exactly how she is feeling. QMHP encouraged mother to allow client to express herself in an age appropriate manner and to redirect her when needed, but to show her support when she doesnât want to talk about it. QMHP encouraged client to present healthier habits by challenging herself to speak up and say whatâs on her mind. Intervention: QMHP transitioned client to an alternative activity to see if it would help her get back on track. QMHP provided guidance on alternative behaviors and clear instruction on the alternative behavior. QMHP will teach client necessary coping skills to decrease impulses. QMHP will brainstorm strategies with client and encourage self-monitoring skills. QMHP reviewed methods and tactics to help client positively advocate for herself by the use of assertive communication and conflict resolution skills within her daily life functioning. Response: Client 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. Client failed to communicate, problem-solve, or resolve conflicts, therefore displaying a negative attitude throughout the day. The interventions were unsuccessful, as client was unable to regain self-control when being instructed in the use of calming imageries, as she continued to display stubborn behaviors. Response: Client expressed it upsets her when her mom takes away things that mean so much to her. Client also mentioned to counselor that she tries to cooperate with rules and regulations in the household but feel they are not fair to her since she is the oldest and is responsible for her and her sister. Client agreed that she is willing to improve on her communication if her mother changes some of the rules in the house and gives her more room to be independent by trusting her to take care of herself and learn from her mistakes.