11/19/2023 EnchantaVaughn Approved QMHPA arrived to the home go Ms. Cosby to conduct an individual session with Ms. Cosby. Upon arrival at the home, Ms. Cosby presented with positive affect evident by her facial expression and physical demeanor. QMHPA informed Ms. Cosby that this session was going to continue to address her individualized goals. Ms. Cosby did not present any symptoms of SI or HI at the time of the session being conducted. QMHPA offered Ms. Cosby several options of rewards for appropriately verbalizing feelings of anger, expressing feelings appropriately. QMHPA commended Ms. Cosby for the improvements in her behavior and utilizing some of the techniques that has been discussed over previous sessions. QMHPA encouraged Ms. Cosby to continue to practice utilizing the breathing techniques, stop and think techniques and other related techniques on a daily basis so that when she is angry or when she no longer has control over things, she will instantly use those techniques to calm her down. QMHPA provided Ms. Cosby with support through body tone, listening and paraphrasing. QMHPA reviewed the importance of expressing feelings of anger appropriately. QMHPA asked Ms. Cosby to list healthy physical outlets that could be used to express feelings of anger to prevent maladaptive behaviors. Ms. Cosby was receptive to engage in this session. Ms. Cosby was respectful and demonstrated appropriate interactions with QMHPA, and displayed socially acceptable behaviors while on today’s outing. Ms. Cosby was able to convey her understanding of the importance of expressing feelings of anger appropriately. Ms. Cosby demonstrated effective communication skills; she sustained adequate eye contact and responded appropriately when conversing with QMHPA. Ms. Cosby had no difficulties identifying healthy physical outlets to express feelings of anger. Ms. Cosby maintained a positive attitude throughout the duration of today’s session.