1/1/2023 EnchantaVaughn Approved Behavior: Once QMHP contacted client, client demonstrated no energy to come to session on her own. Client was sleep on the couch next to her brother. Her mom tried waking her up several times but struggled to do so. After about 15 minutes, client decided to get up and join her therapy. Client communicated that she didn’t feel like having session today and was more focused on what was happening in the community and how it was impacting her. Client was in a low and inaccessible mood, as evidenced by her unfriendly demeanor and tense posture. Client was not afraid to be vulnerable. Client was supported for being honest. Client demonstrated ability to multi task by working independently and helping with other house duties. Client showed she is capable of exhibiting responsible behavior at home. Behavior: Client was prompted to try her best to relax and pay close attention. Client was assured that the activity only required her to listen. Client cheered up and decided to do her best and challenge herself so that she could finish the session without complaining or getting upset. Client communicated positive attitude and engaged in activity without frustration or being distracted by external stimuli. Client gave really good feedback and was responsive to all instructions given to her. Client was given praise and reinforced for participating in the session and developing self-determination skills. Client continues to display appropriate social skills in therapeutic setting. Client demonstrated that she was aiming to meet her objectives today, as evidenced by her determination and carefree spirit. Intervention: QMHP collaborated with mom regarding daily behaviors and performance in the home. QMHP reviewed and gave feedback regarding ADHD and its causes and affect toward client’s well-being and emotional functioning. QMHP monitored, observed, and redirected client behaviors as needed. QMHP monitored client individualized behaviors in collaboration with parent, herself, her peers, sibling, and environment. QMHP encouraged client to make good choices and to avoid negative thoughts about herself. QMHP processed client positive behaviors. QMHP assisted client in developing more social skills. QMHP inquired about possible challenges client can experience with applying this skill. QMHP provided positive feedback. QMHP reflected on client goals and objectives. Intervention: QMHP explored positive self-talk, use instruction modeling, and increase social communication skills with positive reinforcement role play activities. QMHP educated client on behavior modification to help client identify what behavior she needs to decrease and avoid daily. QMHP utilized behavior modification system to aid the client with following directions given by authority figures. QMHP encouraged client to communicate to her mom when she needs help. QMHP praised client for staying on task. QMHP complimented client for utilizing acquired skills, paying attention, and focusing on the importance of the assignment. QMHP supported client displaying positive interaction with peers and authority. QMHP explored the client’s capability to cope with her stressors and to get back on track with her treatment. Response: Client discussed mental illness and its causes with mom and QMHP. Client displayed interest in learning about ADHD. Client displayed self determination to stay focused and pay attention in session. Client utilized meditation and relaxation techniques. Client reported a decrease in symptoms following the relaxation techniques. Client displayed management of individualized behaviors. Client responded in a pleasant manner acknowledging the positive reinforcement that the QMHP provided. As the client developed understanding of home expectations, she reported increased satisfaction and function. Client was able to demonstrate fairness and kindness to peers and authority. Client verbalized positive feelings about building relationships at home and in the community. Response: Client was able to utilize coping skills to eliminate stressors and unwanted feelings. Client believes she will get better if she continues to work hard. Client was acceptive of support and encouragement. Client exhibited good social behaviors. Client was able to reevaluate herself and display a more positive attitude toward peers and authority. Client has become more involved in age appropriate social activities and was given positive reinforcement for these choices. Client demonstrated expectations and responded well to feedback. Client displayed positive self-talk, ability to follow instructions, role play of appropriate way to act in the home without solely depending on therapy practice. Client reported a decreased stress level due to her modulation of social contact, and the success of this was reviewed.