6/18/2023 EnchantaVaughn Approved Behavior: When QMHP-C arrived at the residence, Ben-Nita appeared to be exhibiting restless, overactive, agitated and uncontrollable manners, as it was complicated and difficult for Ben-Nita to remain in her chair. QMHP-C informed her this session was going to continue to focus on managing her anger. Behavior: During second portion of the session, Ben-Nita appeared to be frustrated as she was blowing when QMHP-C was discussing with her ways to replace positive behaviors with negative behavior. Intervention: QMHP-C communicated with Ben-Nita and mother about Ben-Nitaâs progression and possibilities of goals and objectives during continuation of services. QMHP-C also encouraged mother to point out possible stressors and/or irritations that Ben-Nita may trigger by behaving negatively. QMHP-C consulted with mother about increasing structure in the home to aid Ben-Nita in acknowledging the importance of operating and cooperating in the home setting. QMHP-C urged mother and Ben-Nita to participate in role reversal activity to aid mother and Ben-Nita to realize how to respond to and interact with each other. QMHP-C continued to monitor and receive an update on Ben-Nitaâs relationship with mother and compliance to duties and expectations for Ben-Nita in the home and in the community. QMHP-C encouraged Ben-Nita to use her strategies and skills with peers and family in order to support her with managing symptoms associated with ADHD. Intervention: QMHP-C probed Ben-Nita about talking with her mother about her feelings. QMHP-C commended Ben-Nita on utilizing coping strategies to increase her understanding of feelings and emotions. QMHP-C intervened to prevent the negative behaviors from escalating. QMHP-C physically redirected Ben-Nita to an alternative activity. QMHP-C provided guidance on alternative behaviors and clear instruction on the alternative behavior. QMHP-C provided positive feedback when Ben-Nita engaged in the more appropriate behavior. QMHP-C related the session to being able to express feelings appropriately and continued to provide positive reinforcement for Ben-Nita appropriate behaviors and acknowledged her efforts with building rapport and sharing her experiences without shutting down or displaying episode. Response: Mother and Ben-Nita displayed active listening while QMHP-C verbalized thoughts regarding progression and possibilities in order to continue services. Mother states to QMHP-C that she has considered implementing a minor schedule for Ben-Nita to assist her with her completion of chores. Mother mentions that schedule assists her as well and allows her to remain focused on completing individual tasks without negative reactions. Ben-Nita smiled as she was affirmed for her mature and pleasant behaviors. Ben-Nita informed QMHP-C that she was coping and utilizing deep breathing techniques to stay calm and not overreact. Ben-Nita displayed hyperactive behaviors such as yelling out responses out of turn and talking over her mom when confronted about her attitude and poor conduct at home today. Ben-Nita required to be re-focused 3 times by QMHP-C as others spoke on her previous actions and mistakes. Ben-Nita was observed chastising mom about the responses that was shared with her counselor. Response: Ben-Nita was able to select topics that were directly related to reduction of stress and emotional negativity, which made her less agitated and more relaxed. Ben-Nita expressed that she hates being in the house. Ben-Nita didnât understand why she couldnât go outside. Ben-Nita acknowledged she didnât do nothing around the house today because she didnât feel like it and was upset that her mom expected her to straighten up the downstairs by herself. Ben-Nita wanted to be fair but continued verbalized negative comments and expressing an angry tone throughout the first hour of session. Ben-Nita was eventually separated from therapy session and endured her consequences of solitude and exudence from the individualized treatment and mental health skill building for 30 minutes.