3/3/2023 EnchantaVaughn Approved Behavior: During today’s in-home visit, client was observed sitting in the living room talking back to his mother when requested to clean up, so he can prepare for his session. Client verbalized he hates doing chores. Client expressed that his brother and sister doesn’t have to do anything, and he has to be responsible for everything which is not fair to him. Client attempted to walk off indicating he was not in a good mood or willing to follow directions unless given the help he desired. Behavior: It was noticed by QMHP, client had a tired look on his face but switched moods once session started. Client’s energy increased once he got comfortable in the home, initiating a conversation with QMHP. Client communicated that he does not want to be a part of any conflict with his mom and wants to resolve any issues before it gets worst. Client reported that he is angry. Client was able to remove himself from distractions and focus on his therapy session. Client agreed to deep breathe, count to 10, or think about positive affirmations when having disagreements at home. Behavior: Client verbalized that he wanted to take a break. Client was given the opportunity to spend additional time with mental health professional after his chores was finished. Client was helpful to his counselor by being organized and putting away anything that did not contribute to current activity. Client was educated that showing good behaviors is important. Client displayed initiative to make better choices and prove that he is willing to do a better job than what’s represented in front of him. Intervention: QMHP monitored client individualized behaviors in collaboration with his mother and social/family environment. QMHP observed client in the home in efforts to determine whether he required assistance. QMHP engaged client in conversation regarding his recent choices, progressions, and setbacks. QMHP encouraged client to make good choices and to complete his chores before expecting any free time. QMHP processed client negative comments to try and manage his reactions to certain prompts. Intervention: QMHP inquired about morning experiences during initial in-home contact with client. QMHP asked how client was feeling and if he needed anything. QMHP will review problem solving and give feedback regarding ADHD and its causes and effect to well-being and mental performance. QMHP encouraged client to be receptive to all feedback and to take in what is being said rather than how it’s being said. QMHP will teach client meditation skills to decrease any mental or emotional tension. QMHP assisted client in developing more communication skills. Intervention: QMHP processed and reiterated with client about the rules in the home. QMHP went over social skills activity with client to help him understand the importance of following rules. QMHP processed with client the thinking questions to each social skill activity. QMHP activity helped client state, demonstrate, or identify how to communicate his feelings to his family. QMHP taught basic problem-solving skills. QMHP isolated client from distractions to decrease disruptive behaviors and to reduce explosive episodes. Response: Client transitions smoothly and safely to session area, displaying appropriate behaviors. Client was seen waiting for instruction. Client understands that problem solving starts with thinking before acting. Client demonstrates problem solving by staying calm and using his senses. Client acknowledges his improvements and vows to stay consistent with his therapy. Client have been doing a better job controlling impulsive and hyperactive behaviors. Response: The client has overreacted with anger to minor irritants, such as being asked to clean up behind himself. Client responded in an unpleasant manner without acknowledging the support that was given by the mental health professional. Client reported an increase stress level due to his modulation of social contact, and this was reviewed with his mother. Client discussed the reasoning behind his negative behaviors towards others with QMHP. Response: Client required additional redirection from QMHP to get him to focus on the next psycho social assignment, as presented. Client was able to settle down and return to therapeutic activity in a calm and positive manner. Client was responsive to mother’s frustration and realized he expected him to be responsible so that he is a good example to his brother and sister who both look up to him. Client acknowledged that he often engages in disruptive behavior when he feels he is being targeted or mistreated.