7/3/2023 EnchantaVaughn Approved Behavior: Client was able to cooperate and communicate well during the session. Client was in a pleasant mood and presented good behaviors, as evidence of her smiling and getting excited for the session. Client was excited to express her feelings and share her favorite thing she loves about having counseling as a way to help her get through challenging situations and work on her attitude. Client exhibited a good attitude toward mom and QMHP. Client was seen interacting and engaging appropriately throughout the session requiring little to no redirection. Behavior: Client was seen being sociable and respectful. Client has implemented interventions and strategies taught by QMHP in her daily activities. Client shows understanding of simple direction by following through effectively. Client displays a great attitude and high level of participation at this time, which is supported and encouraged by VACCD staff. Client appears to be calm and relaxed after today’s intervention. Client exhibited a positive attitude, and this was monitored during non-stressful and stressful moments in all settings. Client displayed calm and peaceful expressions. Client responds by saying “thank you for teaching me the importance of self-control and helping me become a better me.” Intervention: QMHP inquired about client’s overall day. QMHP attentively listened to client’s issues. QMHP reeducated client on the dangers of involving herself with activities that are both negative and harmful. QMHP worked with client on methods and techniques to help her reduce, lesson, or eliminate her impulsive conduct and as well as to be more aware of her unpleasant behaviors within her daily functioning life. QMHP reiterated to client the benefits of following the rules and of the privileges she can receive when she does so. 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. Intervention: 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 figures. QMHP instructed client to reiterate her ISP objections in efforts to trigger a desire to achieve them by improving her current negative attitude. QMHP reviewed methods and tactics to help client positively advocate for herself by the use of assertive communication and conflict resolution skills daily and as well as to assist in reducing physical aggressive behaviors toward herself and others. QMHP verbally identified the client’s impulsiveness to the client and encouraged the client to use self-control and decrease hyperactive behaviors. Response: Client followed all directions during the session. Client acknowledges expectations and reviews goals and objectives with counselor and parent daily. Client was acceptive of prompts given by mom and counselor. Client agreed to listen to the adult and follow all rules no matter if she sees someone else breaking them. Client is reminded to tell an adult if someone is interrupting her learning and mental health in anyway. Client was doing a good job ignoring distractions and maintaining appropriate behavior in the session. Client incorporated numerous strategies that she learned from her previous sessions that she felt worked best for her with meeting her objectives. Response: Client presents verbalizations of anger, as well as, tense facial expressions when confronted about her attitude and negative actions in the home and in each therapeutic session. The client displayed a pattern of overreaction to stress, due to her history of hyperactive/impulsive behaviors which causes her to be aggressive and defiant on a weekly basis. The client displays difficulty establishing trust with adults, due to feeling let down by her mother. Client communicates negative thoughts about her daily functions, expressing sadness and guilt more than love and happiness.