10/11/2023 EnchantaVaughn Approved Behavior: QMHPA greeted Ms. Cosby upon arrival to the home setting. Upon arrival to the home setting, Ms. Cosby appeared to be in a positive mood evident by her facial expressions such as a smile on the face. QMHPA inquired about her morning. Ms. Cosby verbalized to QMHPA that her morning was going okay. QMHPA informed Ms. Cosby of the session today which was focusing on her anxiety and depression. Upon arrival, she did not present any symptoms of S/I. Intervention: QMHPA began the session by inquiring about Ms. Cosby’s current thoughts, feelings, and emotions. QMHPA listened to Ms. Cosby discuss any new problems and/or concerns since last session. QMHPA probed Ms. Cosby about feelings of anxiety and depression. QMHPA engaged Ms. Cosby in a skills building activity. QMHPA explained to Ms. Cosby that the purpose of this activity was to assist her with utilizing coping skills when negative feelings are triggered. QMHPA encouraged Ms. Cosby to continue using her journal as a healthy outlet to verbalizing her thoughts when she's feeling overwhelmed and/or having difficulty with communicating her thoughts. QMHPA educated Ms. Cosby on relaxation techniques to learn to calm down when feeling stressed and having thoughts of negativity. QMHPA assisted Ms. Cosby with identifying automatic negative thoughts that contributes to her negative attitude and hopeless feelings. Response: Ms. Cosby appeared to be receptive to QMHPA’s interventions and services that were provided to her during the session. Ms. Cosby verbalized to QMHPA that she does recognize her anger triggers at times that causes her to be depressed. She continued to verbalize to QMHPA that she had to be able to not all those people to push her to that limit but she has a mental health issue and she does not think the way that she needs to think at times when she is upset. Ms. Cosby expressed to QMHPA during the skills building activity that she continues to have difficulty communicating with others her feels and thoughts because she gets so angry and her words does not come out the way she wants them to come out they are negative and not she engages in a lot of profanity when she is mad.