9/4/2023 EnchantaVaughn Approved Behavior: Upon arrival, client was observed in the living area displaying a calm attitude and waiting for her counselor to come inside the house. Client appeared to be in an exquisite mood, as evidenced by her genuine smile and energetic spirit. Client commented that she felt good and was ready for her therapy. Client has demonstrated good behaviors throughout the day by not allowing anything to distract her or to get the best of her and acknowledging the small wins Behavior: While counselor reviewed her objectives, client displayed normal affect towards her mom and little brother who were also rooting for her with their full support. Client was able to talk about her likes and dislikes and figure out how she can be more productive at home. Client displays an increased ability regarding problem solving and making decisions while interacting well within the home and displaying a respectful attitude toward mental health professional. No redirection was needed at this time and session came to an end. Intervention: QMHP administered therapy session by exploring and engaging in conversation with client about her day. QMHP listened to client verbalize her feelings towards making good decisions at home and avoiding conflicts with mom and other adult family members. QMHP applauded client for listening to her mother. QMHP supported client with displaying leadership skills and being the example for her peers. QMHP provided praise when the client continued to display positive behaviors, remaining on task and was very respectful. Intervention: QMHP administered psycho educational activity with client and assisted when needed. QMHP monitored individualized behaviors for acquisition of objectives. Examples of assertive, effective communication were provided (e.g. I have to leave now”; “I can’t afford to get into any more trouble”). Positive feedback was provided to the client as she displayed a clear understanding to how to use effective communication and assertiveness skills. QMHP encouraged client to have a good rest of her day. Response: Client has not overreacted with anger to minor frustrations or irritants recently in the home. Client responded in a pleasant manner acknowledging the positive reinforcement that the QMHP provided. Client is making progress with expressing her feelings and showing others respect and courtesy by talking with appropriate tone, initiating conversation with peers, and waiting for her turn to talk before blurting out loud. Client demonstrated expectations and responded well to redirection from mother and VACCD staff. Response: Client displayed correct management of individualized behaviors, such as keeping her hands to herself and staying active in therapeutic activity. Client did not display any outbursts during the role play exercise. Client made constant direct eye contact with authority figures. Client was able to speak calmly and demonstrate her improved communication skills while engaging in self-reflection. Client was pleased to be praised for her behaviors. Client said she was feeling good and plans to have a good rest of her day.