9/20/2023 EnchantaVaughn Approved Behavior: When QMHP-C arrived at the residence, Client appeared to be exhibiting restless, overactive, agitated and uncontrollable manners, as it was complicated and difficult for Client to remain in her chair. QMHP-C informed her this session was going to continue to focus on managing her anger. Behavior: During second portion of the session, Client appeared to be frustrated as she was blowing when QMHP-C was discussing with her ways to replace positive behaviors with negative behavior. Intervention: QMHP-C communicated with Client and mother about Client’s progression and possibilities of goals and objectives during continuation of services. QMHP-C also encouraged mother to point out possible stressors and/or irritations that Client may trigger by behaving negatively. QMHP-C consulted with mother about increasing structure in the home to aid Client in acknowledging the importance of operating and cooperating in the home setting. Intervention: QMHP-C probed Client about talking with her mother about her feelings. QMHP-C commended Client on utilizing coping strategies to increase her understanding of feelings and emotions. QMHP-C intervened to prevent the negative behaviors from escalating. QMHP-C physically redirected Client to an alternative activity. QMHP-C provided guidance on alternative behaviors and clear instruction on the alternative behavior. Response: Mother and Client displayed active listening while QMHP-C verbalized thoughts regarding progression and possibilities in order to continue services. Mother states to QMHP-C that she has considered implementing a minor schedule for Client to assist her with her completion of chores. Mother mentions that schedule assists her as well and allows her to remain focused on completing individual tasks without negative reactions. Response: Client was able to select topics that were directly related to reduction of stress and emotional negativity, which made her less agitated and more relaxed. Client wanted to be fair but continued verbalized negative comments and expressing an angry tone throughout the first hour of session. Client was eventually separated from therapy session and endured her consequences of solitude and exudence from the individualized treatment and mental health skill building for 30 minutes.