10/14/2023 EnchantaVaughn Approved Behavior: QMPHA greeted Ms. Cosby upon arrival to the home setting. Upon arrival to the home setting, Ms. Cosby appeared to be in a good mood evident by her facial expressions such as a smile on the face. QMPHA inquired about her day. Ms. Cosby discussed with QMPHA that she was in a good mood today. No visible signs of SI/HI during the session. Intervention: QMPHA began the session by engaging Ms. Cosby in a discussion to determine her current thoughts, feelings and emotions. QMPHA began by asking if Ms. Cosby if she needed to seek medical attention. Today’s session focused on implementing appropriate skills for ADL’s. QMPHA encouraged Ms. Cosby to accept responsibility for her negative actions, her poor choices and poor decisions. QMPHA used personal experiences to help Ms. Cosby process the consequences of her actions. QMPHA informed Ms. Cosby that by her implementing this skill it would increase some self-monitoring. QMPHA reinforced identifying several coping tools she can use to decrease her angry expressions and outburst as well as verbal threats when faced with choices and day to day living. QMPHA reiterated active listening skills and responding skills needed to communicate effectively and appropriately. QMPHA educated Ms. Cosby on how this skill will assist her with developing some positive tools when communicating in a social setting. QMPHA continued to discuss with Ms. Cosby on her discharge planning. Response: Ms. Cosby appeared to be receptive to QMPHAs suggestions. Ms. Cosby admitted that in recent weeks she has been on a path of doing exactly what she wants to do no matter the consequences. Ms. Cosby stated, “I don’t feel nobody care about me so why should I care so I just did and do whatever”. Ms. Cosby was not able to process that her poor decision making cause her difficulties. Ms. Cosby shared that she has been thinking a lot lately on how she would like for her life to be but feels she does not have what it takes to live a good life. Ms. Cosby stated, “I feel like I am always doing something dumb every day. It is like trouble be looking for me. I just want to be happy and not always depressed or mad at something or somebody. Ms. Cosby was not able as of this writing to identify how she can use self monitoring to help her decrease her depressive symptoms and her angry outbursts. Ms. Cosby through active listening was able to identify the benefits of care listening, problem solving and eye contact and skills to help her develop some self monitoring skills. Ms. Cosby shared during the session that she wanted to contact her friend and apologize for her actions the last time they spoke on the phone. Ms. Cosby was commended and supported for her positive attitude and her determination to make things right. Ms. Cosby was able to work on her interpersonal skills as well as identify triggers to her angry and identify ways she can manage her anger and anger outburst so that she can connect with others socially