2/15/2023 EnchantaVaughn Approved 1. Behavior: Upon QMHPâs arrival, Client was reported misbehaving in the home today. Mom communicated that client hit her little brother in the face when she got mad she couldnât play with a toy that wasnât hers. Client remained upset, despite hurting someone else. Client got in trouble and was put in time out for 30 minutes. Client is dealing with her insecurity and anger issues, which have been confronted in the session. Mom communicated that she went to a talk to client to figure out why she was so aggressive and to teach her to keep her hands to herself. Mom explains that she does not know what to do with her daughter during this time of need and is seeking programs to assist with her misbehavior. Mom has been taking on full responsibilities of clientâs actions but is extremely overwhelmed. Client has shown disrespect in the home and require assistance and support daily. 2. Behavior: Client has a hard time communicating her feelings when sheâs put on the spot. Client communicated poor sportsmanship and failed to take responsibilities for her actions. When inquired about what happened, client insisted she had no parts and that everything was her brotherâs fault. Client was reminded that she has to be willing to except help in order to get better and avoid punishment for her negative actions. Client exhibits difficulty with her behaviors and needs one on one assistance. Client displays low self-esteem and inability to grasp understanding of age appropriate activities. Client continued to get up out of her seat and avoid directives. Client was prompted to get back on task and follow directions. The client listed many activities in which she wishes to engage as her mental illness symptoms lessen. 1. Intervention: QMHP increased discipline for inappropriate behaviors. QMHP will help client develop healthy self-esteem by reducing level of anxiety and emotional reactions related to home or session and other independent functioning. QMHP will teach client necessary coping skills to decrease impulses. QMHP will brainstorm strategies with client and encourage self-monitoring. QMHP will provide mediation and relaxation techniques. 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 informed client of more acceptable and expected responses to situations that would normally lead client to be triggered and display inappropriate, negative behaviors while in the home. 2. Intervention: QMHP inquired about evening activities. QMHP will collaborate with mother regarding behaviors and performance throughout the week. QMHP modeled appropriate ways for client to get positive attention from her family without needing to be violent or disrespectful. QMHP modeled language for client to use while in session, home and in the community that will promote pro-social behaviors and effective communication. QMHP reiterated to client the benefits of following the rules. QMHP trained client in taking steps to prevent problems including displaying negative home behaviors. QMHP refocused client as she was observed becoming fidgety and restless. QMHP will monitor, observe, and redirect client behaviors as needed. QMHP will review and give feedback regarding ADHD and its causes and affect toward client well-being and functioning. 1. Response: Client was able to be redirected successfully. Client stated she would try better self-management as the day pursues. Client expressed that she tries to think highly of herself. Client communicated that she feels that she will be better behaved, due to consistent support in the home and seeing QMHP 4x a week. Client showed interest in building interpersonal relationships with peers and authority to increase support system in the community while sheâs away from home. Client understands that the way she treats her little brother is a direct reflection of the way she will treat her friends. Client understands why it is important to keep her hands to herself. Client admitted she was wrong and wanted to make things right moving forward. . Client learned to avoid negative and defiant behavior and comply to rules. 2. Response: Client participated in the next activity to utilize and learn new interventions and strategies that she can implement in all areas of her life. Client was observed strategizing a plan to better herself by writing down her thoughts and feelings and exploring her creative side with arts and crafts. Client expressed appreciation to QMHP by smiling and giving good eye contact. Client was able to contain impulsive actions. Client was able to maintain her composure when she was confronted with the potential for conflict. Client was observed engaging in several conflict resolution skills by walking away and telling an adult first. Client verbalized that sheâs able to focus better when it is quieter and more peaceful in the home. Client demonstrated more acceptable responses, avoiding anger provoking situations in the home and community.