3/31/2023 EnchantaVaughn Approved Behavior: Client appeared to be in downward mood when QMHP arrived. Mom said he needed client to stop acting like somebody did something wrong to him when he’s the one acting selfish. Client would not share or play with his brother or sister even when they asked nicely. He continues yo be disrespectful. Behavior: Client had difficulty concentrating on his activity. Client did not demonstrate a cooperative attitude during the family activity. Client demonstrates overactivity in the home that makes it hard for him to fully participate in the session without being aggressive. Client exhibits poor listening skills while talking over authority. It is evidenced that client has not utilized appropriate skills, techniques, or strategies taught in the home which the purpose of today's session. Behavior: Client and QMHP discussed his role in the home. Client shared that he is learning to develop the skills needed to achieve his goals on a daily basis and is proud at how far he has come. Client admitted that him and his mom are getting along better and he’s beginning to see the value in family time and spending quality time with his loved ones. Client followed all directions given by mom and counselor. Client displayed a calm demeanor without getting angry or frustrated. Client was observed interacting on an age appropriate level and making it easy to conduct the session without having to redirect him or take small breaks. Client continued to state to QMHPC as well as mother that he is not going to change in one day and that he really does "believe in himself". Intervention: QMHP collaborated with mom regarding behaviors and performance in the home, such as daily functioning and life skills to determine if he made any improvements. QMHP assisted client with recognizing and exploring triggers of his impatience. QMHP encouraged client to continue documenting people and situations that evoke anger or aggressive behaviors so that he can learn to deal with his anxiety safely and appropriately. Intervention: QMHP utilized role playing to demonstrate the calming effects of predicting the thoughts, feelings and actions of self. QMHP utilized active listening skills while probing client about situations that provokes his anger. QMHP informed client of replacement behaviors in efforts to decrease attention seeking behaviors the client often is involved in. Intervention: QMHP conducted session on helping mother and family reduce the stressors in the home and community settings. QMHP informed mom that client can benefit from other contactless services, thus probing them to utilize resources in the community that will help client reduce his aggressive behaviors. QMHP reviewed with mother the ability to limit the stress in the home and to utilize the reward system appropriately. QMHP utilized active listening skills while probing mother on the affect ways that she attempts to reduce client's negative behaviors. QMHP praised mother for her efforts to better herself and her living situation by making sure she provides client with everything he needs (e.g. clothes, food, shelter) to move forward and keep client away from negative influences in his life. QMHP will provide client with support and encouragement. Response: Client engaged in reflective thinking. Client was open and receptive to the interventions presented by the counselor. Client was able to verbalize the concept of the interventions and provide verbal feedback. Client understands that his mother is trying to help him prioritize skills and create structure in the home. Client expressed that when he is involved in a conflict or argument he will take a self-time out. Response: Client was attentive to the role play activity, even implementing strategies he just learned to reduce his negative responses and perceptions. Client demonstrated his knowledge through his provided examples. Client understood effective problem-solving skills to help solve or overcome a problem or stressor the he is currently facing. Response: Client appeared to be receptive to QMHP’s interventions and services that were provided to him during the session. Client reported that him and mom have a close relationship but have difficulty with communicating with anyone when he is upset. It was communicated by parent that client needs to realize that he has a lot going for himself, but he allows others to get him off track. Client reported that he is looking forward to receiving help and wants to learn how to deal with his anger and depression. Client understands that his treatment plan is a behavior contract that will reflect his improvements in the home. Client stated that he is open to new ideas. Client was acceptive of prompts given by mom and counselor.