1/9/2023 EnchantaVaughn Approved 1. Behavior: Upon arrival, the client was noticed distant, unfocused, and unstable as she displayed unconcern and disinterest toward making improvements with her behaviors in the home. During the conversation with QMHP, it was difficult for client to express herself and be honest about the role she plays in her added stress. Client displayed inappropriate conduct as she continued to show a lack of attention and consideration towards the information that was being processed with her, despite methods and techniques used to help her. 2. Behavior: Client became frustrated when she could not express her thoughts during family discussion and started having episode, turning her back toward her mother and counselor and covering her face with her shirt. Client was not acceptive of feedback and began to pout when she didn’t receive the attention that she desired. Client was sent to reflect and cool off in her room. Client was reprimanded and lectured on her behaviors until she was able to switch her attitude and participate in her therapy without any complaints. 1. Intervention: QMHP will educate client on behavior modification to help client identify what behavior she needs to decrease and avoid daily. QMHP worked with client on methods and techniques to help her reduce, lesson, or eliminate her impulsive conduct, as well as, to be more aware of her unpleasant behaviors within her day to day routine. QMHP reiterated to client the benefits of following the rules and of the privileges she can receive when she does so. 2. Intervention: QMHP assisted client with identifying privileges that she would like but does not receive due to her negative behaviors; in efforts to stimulate her thinking about cause and effect of her behavior choices. QMHP gave client the opportunity to express and explore her perceptions of how her symptoms of ADHD can affect her relationships with peers and adult staff. QMHP instructed client to reiterate her ISP objections in efforts to trigger a desire to achieve them by improving her current negative attitude. 1. Response: Client was not in a good mood at this time. Client had difficulty relaxing and following QMHP prompts. Client continued aggressive behaviors. Client did not extend a sociable rapport back to the QMHP. Client required redirecting from QMHP to reduce her voice volume 3-4 times. Client self-esteem and confidence remained under satisfactory. Client continued to display hyperactive behaviors for 30 minutes prior to decreasing them. 2. During the session at the home, mother expressed client’s behaviors have improved but she still has to remind client about remaining consistent with reacting positively when being reprimanded or redirected. Mother and client displayed good communication. Although mom is more stressed with the end of her pregnancy, she has cut back on work to spend more time with her daughter. Client responds well to praise and encouragemeResponse: Client required to be re-focused by QMHP as she waited for her mom to speak on her behalf. Client communicated understanding by nodding her head. Client is aware that she can be a hand full. Client admitted that she struggles with making good choices on her own. Client reported that she is looking forward to receiving help and wants to learn how to deal with her anger and depression better. Client understands that her treatment plan is a behavior contract that will reflect her improvements in the home.