8/13/2023 EnchantaVaughn Approved Behavior: It was noticed once session began, Ben-Nita appeared guarded and offensive due to encountering other challenges in the home. Ben-Nita became frustrated when she could not express her thoughts and started having episode, turning her back toward her counselor and saying slick stuff under her breathe. Ben-Nita was not acceptive of feedback from mental health professional or authority. Behavior: Ben-Nita was reprimanded and lectured on her noncompliant behaviors, however she did not show any concern at this time. Ben-Nita was reported to have struggled to maintain expectations and mom dismissed her to her room to recoup, stating she would address her shortly. Behavior: Ben-Nita was reprimanded and pulled to the side by QMHP to correct her behaviors. Ben-Nita was able to make minor changes as the day progressed. Intervention: QMHP probed Ben-Nita to find the cause of her mom requesting today’s individual counseling session for her daughter. QMHP used active listening as she processed with Ben-Nita about her current mood and answered all questions asked by Ben-Nita that was geared toward her therapy. QMHP explored Ben-Nita’s inability to think positive despite things going on around her. QMHP modeled to Ben-Nita how to use the “Think Tactic” to allow herself time to improve her poor impulse control. QMHP reinforced the importance of decreasing hyperactive and aggressive behaviors, controlling anger, following instructions and respecting authority figures at home, school and community. Probing and unconditional positive regard were used in conjunction with warm acceptance to gather Ben-Nita’s perspective during today’s session. Intervention: QMHP used role-reversal with Ben-Nita to allow her a chance to openly express herself as well as see how she is viewed in the eyes of others when she is verbally and physically aggressive towards them. QMHP used active listening as Ben-Nita discussed the importance of respecting authority figures and controlling her thought process at times. QMHP then modeled to Ben-Nita appropriate ways to follow instructions without getting an attitude. Intervention: QMHP engaged Ben-Nita in discussion regarding her disrespectful behaviors within the home. QMHP processed with Ben-Nita the importance of controlling her actions and thinking before speaking. QMHP then processed the previous therapeutic assignment in which she encouraged Ben-Nita to practice using low voice tones when conversing with authority and document her response to the activity in her daily journal. Response: Ben-Nita acknowledges she needs to work on her temper and controlling her anger. Ben-Nita is supported making the right choices and staying out of trouble. Ben-Nita responded well to feedback and discussed some things she can do better when it comes to new challenges. Ben-Nita agrees to follow directions the first time they are given even if that means she has to stop doing something she likes. Ben-Nita was acceptive of prompts given by QMHP. Ben-Nita agreed to listen to the adult and follow all rules no matter if she sees someone else breaking them. Ben-Nita is reminded to tell her mom if she is having trouble at school so that she doesn’t go into the community in a bad mood or come home frustrated. Ben-Nita said she was aware of her expectations and what she is expected to do each day to be successful. Response: Although Ben-Nita has difficulty staying focused in the session sometimes, she understands a lot of the information taught in the session helps her with her anxiety and has implemented the skills in the home this week. Ben-Nita did a good job maintaining appropriate behavior in the session, utilizing the correct voice volume and displaying positive body language the entire time. Response: Ben-Nita practiced some of the examples of alternate behaviors (e.g. closing her eyes and thinking about happy memories, repeat positive “I-statements”, and ask questions that will help her understand things better) at home when she felt stressed out or upset. Ben-Nita communicated that she wants to work independently instead of as a family some days so that she could gain clarity of her personal feelings without taking it out on anyone.