3/6/2023 EnchantaVaughn Approved Behavior: Client initially presented with talkative behaviors as she probed the QMHP and asked different questions. Upon arrival to the home setting, client was observed by QMHP screaming to the top of her lungs at her mother as her mother was asking her to clean up the living room for hours prior to the session. Behavior: Client was observed by QMHP yelling at her siblings to the top of her lungs as she was asking them to leave her alone as they seemed to be agigating her. Intervention: QMHP redirected and prompted the client throughout the session and offered new ways to heighten client awareness of her ill-mannered behaviors, as well as helping her with functioning more constructively within her daily life. QMHP encouraged client to present healthier habits and routine by challenging herself to make better choices and try new things. QMHP questioned client on the statements she made about having difficulty expressing her feelings. QMHP facilitated an activity on emotions to assist client to be able to identify and positively express them. QMHP reviewed strategies targeted at helping client to work through her difficulties expressing her anger. QMHP utilized age appropriate mood regulation skills and techniques, as a way to help client’s destructive and critical demeanor, as well as to assist her with regaining and regulating her uncontrollable conduct. Intervention: QMHP encouraged client to refrain from displaying negative behaviors towards her mom, to talk calmly and express herself without aggression. QMHP demonstrated and provided positive empathetic acceptance while utilizing talk therapy and active listening skills to enhance self-esteem and confidence. QMHP reemphasized with client about the basics of treating others respectfully and focusing on treating others the way she would want to be treated. QMHP examined and evaluated client responses to feedback. QMHP focused on client’s ISP objectives and what she needs to do in order to achieve them. QMHP ended session with a small pep talk and encouraged client to have a good rest of her day. Response: Client was reluctant and hesitate, as she remained mistrustful in regard to extending a friendly or respectful rapport back to the QMHP. Client acknowledged QMHP’s redirection after 3-4 prompts. Client stated okay and then began to calm down her actions. Client proceeded to lower her voice while calming down. Client appeared disinterested in regard to the information that was being provided to her by the QMHP in response to how her negativity affects herself and others around her. Client exhibited an unemotional and flat facial expression on her face, indicating she was not in the mood to process or reflect on her day. Client was resistance to applying what she learned to real life situations. Response: Client went back to her normal episodes and was not responsive to intervention. The interventions were noted unsuccessful, as it was difficult and challenging for client to relax when being instructed by the use of calming techniques. Client displayed body language associated with anger, demonstrated by clenching her fists and face. Client had to be redirected in regard to the relaxation and calming imageries. Client did not offer verbal communication. Therapy activity was viewed as ineffective and unproductive. Client displayed a disinterest in the interventions that were applied to her. Client expressed anger and frustration when she had to communicate directly with her mom without looking at QMHP for additional support.