4/28/2023 EnchantaVaughn Approved 1.Behavior: Upon arrival, Bernado was disrespectful toward mental health professionals refusing to process his emotions by walking off and exhibiting increased frustration. Bernado ignored prompts. Bernado was not listening or trying to resolve conflict. Bernado continued to display a negative attitude. Bernado was encouraged to relax and focus on the positives. Bernado gets frustrated when he cannot take a break and displays undesirable outbursts (i.e. frowning his face and stomping). 2.Behavior: Bernado continued to demonstrate quiet behaviors during the session. Bernado had to be told more than once to show authority the proper respect and to look forward when someone is talking to him. Bernado frowned up his face and looked away from his counselor. Bernado expressed sadness and disappointment. Bernado fails to exhibit age appropriate behaviors in the home, due to hyperactive and impulsive decision making. 3. Behavior: Bernado appeared to be content and in a relaxed state. Bernado displayed openness and was very communicative. Bernado did not have any signs of worrisome or anger. 1.Intervention: QMHP-C intervened aggressive behavior and motivated Bernado to act in a civilized way. QMHP-C redirected Bernado negative behaviors. QMHP-C revisited with Bernado about respecting others and discussed applying polite words when asking for help. QMHP-C gave Bernado the opportunity to open up and share his feelings. QMHP-C communicated active listening skills. QMHP-C educated Bernado about sharpening their senses and utilizing problem solving techniques daily. QMHP-C reviewed and gave feedback regarding ADHD and its causes and affect toward Bernado well-being and academic functioning. 2. Intervention: QMHP-C will explore positive self-talk, use instruction modeling, and increase social communication skills with positive reinforcement role play activities. QMHP-C will educate Bernado on behavior modification to help Bernado identify what behavior he needs to decrease and avoid daily. QMHP-C taught Bernado relaxation, calming, and guided imageries, to help him reduce and regulate his overactive and angry behaviors during the session. QMHP-C provided a summary of the session, to reassure Bernado had clear knowledge of the purpose of session. QMHP-C directed Bernado to verbally express positive affirmations. QMHP-C worked with Bernado to reduce or eliminate harmful and hostile manner, within his daily functioning life. 3. Intervention: QMHP-C engaged Bernado in therapeutic activity via cellular device to work toward gaining skills for anger management. QMHP-C explored Bernado’s triggers and fuses that causes him to have difficulty with expressing his feelings and frustrations of anger. 1.Response: Bernado anger is moderate to intense, 2-3x per week. Bernado is working on walking away and telling an adult before responding to anger provoking situations. Bernado understands that problem solving starts with thinking before acting. Bernado displayed an unresponsive and nonchalant attitude toward QMHP-C when reviewing strategies from previous session. Bernado displayed an unemotional and flat facial expression on his face, as he appeared disinterested in the instructions, role playing techniques and modeling techniques that were implemented with teaching him effective communication and assertiveness skills to express his anger more appropriately. 2.Response: Bernado promised he would try his best to correct himself when faced with conflict. Bernado reduced impulsive behaviors after 2-3 prompts from his teachers and QMHP-C. Bernado began to show greater control of his anger. Bernado appeared to decrease the intensity of his anger and frustration. Bernado was pleasant and cooperative and demonstrated a willingness to discuss the factors contributing to his undesirable mood. Bernado acknowledged that he tends to engage in disruptive behavior when he begins to become frustrated with his responsibilities. Bernado exhibits a non-responsive attitude when reflecting on his day. Bernado failed to identify his triggers and stressors. Bernado reframed from answering QMHP-C questions. Bernado was not in a good mood. Bernado is easily distracted by external stimuli. Response: Bernado stated that no changes needed to be made towards his safety plan. Bernado struggles with controlling his anger and frustrations when upset but has learned how to deal and cope with how he reacts when upset. Through the therapeutic activity, Bernado as able to recognize his own faults as it pertains to his anger. Bernado expresses that he struggles with feelings and thoughts that makes him angry.