9/3/2023 EnchantaVaughn Approved Behavior: When QMHP walked in clientâs residence, client greeted the QMHP with love and respect. Client was polite and positive, communicating she was in a good mood. Client displayed good eye contact. Client did not talk over QMHP and displayed good listening skills. Client exhibited an appropriate attitude toward peers and authority at this time. Client was calm and patient and sitting appropriately in her seat without impulsive behaviors, which were noticed by mom and QMHP. Client was well-behaved and stayed on task the entire time. Client was observed helping and displaying good sportsmanship. Client was praised for being a responsible person. Client seems to be interested in working on herself, as evidenced by successfully completing the intervention and modeling good self-talk and affirmations. Behavior: Client appeared to be in a good mood as evidence by her participating in family activity without conflict. Client conducted herself in a very reputable manner and followed all directions during session. Client remained on task and in cooperation with home rules. Client openly discussed her feelings about her current state and how she feels about living in a pandemic and how it has changed her mentally and emotionally. Mom was proud of client for opening up and sharing things with her counselor that she rarely shares with anyone. Client and mother interacted well with each other during the session. Client was receptive to the idea of finding more activities that were fun for her but still incorporated therapeutic skill sets. Client was not involved with any incidents today and was supported by parent and in-home staff. Intervention: QMHP focused session on explaining her treatment plan and demonstrating a calming strategy to engage in before moving forward. QMHP continued to establish a positive supportive relationship with client. QMHP offered simple suggestions to the client for behaving appropriately in the home and community and encouraged client to practice positive behaviors daily. QMHP commended client on utilizing coping strategies to increase her understanding of feelings and emotions. QMHP provided positive feedback when client engaged in the more appropriate behavior. QMHP assisted client with finding and utilizing necessary resources. QMHP verbalized the awareness that all people are unique, learn differently, and have various strengths and weaknesses. QMHP assisted client in normalizing the changes that are occurring in the community. intervention: QMHP engaged the client in a role reversal exercise and required the client to think about her goals. QMHP completed another psycho-educational activity with the client that focused on reducing her impulses and displaying more self-control at home. QMHP inquired about clientâs afternoon activities and what she does when she wakes up every day to ensure she manages her hygiene and mental health appropriately. QMHP assisted client in monitoring her own behaviors in efforts to promote exercising self-control in focused areas such as respecting boundaries with others. QMHP monitored client individualized behavior modification through collaboration with mother. QMHP modeled proper positive behavioral expectations for the client to implement in her daily life functioning. QMHP provided simple praises to client for her commitment to her progress. Response: Client communicated positive affirmations and self-talk during initial conversation with QMHP. Client smiled as she saw QMHP's positive gestures. Client was able to reduce overactivity and become more attentive and stable in the session. Client was able to process making good choices with QMHP and her mother. Client listed 3-4 behaviors that she was going to utilize in efforts to remain in a productive mood. Client appeared to be receptive to receiving positive reinforcement from her mother, as demonstrated by her smiling and inviting body language. Client shared some of the things she does at home to help her relax. Client stated she loves listening to music, coloring, and talking to her friends online. The frequency and intensity of the client's defiant behaviors decreased significantly.