1/5/2024 EnchantaVaughn Approved QMHPA arrived to the home of Ms. Cosby. Upon arrival to the home, Ms. Cosby appeared to be depressed evident by her stating to QMHPA that she was prepared for the session due to her having a long night the night before. QMHPA inquired about her long night. Ms. Cosby stated to QMHPA that she needs to get her grass cut and she don’t have the money and she needs to just get some household things done and she don’t have the money and when she turns to her boyfriend or someone in her family they are always having something to say, but as soon as they ask for something from her she is willing to give it to them. Upon arrival, she did not present any symptoms of S/I. QMHPA began the session by inquiring about Ms. Cosby current thoughts, feelings and emotions. During the session QMHPA provided Ms. Cosby with support through active listening, tone and paraphrasing what she was discussing with QMHPA. QMHPA provided information on depression in an effort to educate Ms. Cosby on what depression is and methods she can utilize to reduce its effects. QMHPA provided role play exercises to demonstrate coping skills to fit different scenarios. QMHPA encouraged practicing each coping skill daily to reduce depressive symptoms and angry outbursts. QMHPA engaged Ms. Cosby in a discussion to determine if she had thoughts of harming herself or others. QMHPA provided information in the event she feels as if she will harm herself or others to call 911 and she was provided with two hotline numbers. Ms. Cosby appeared to be receptive to QMHPAs’ interventions and services that were provided to her during the session. Ms. Cosby shared that she has felt really down today because she was not prepared financially to but things. Ms. Cosby was able to identify depressive triggers nor was she was able to identify ways to reduce her depressive mood and avoid negatively connecting with others. Ms. Cosby stated, “I walked in my house and I went off on everybody. Ms. Cosby admits that she did not consider such calling a supporter. Through role-play exercises Ms. Cosby was able to begin reducing depressive moods through using relaxation skills, positive thinking and self-monitoring. Ms. Cosby shared that her depressed mood sand anger has created separation, conflicts and a great deal of anger in the home. Ms. Cosby shared that being depressed all the time is negatively affecting her life and destroying her relationship with people she loves. Ms. Cosby participated in the role-play exercises to demonstrate coping skills and how to utilize them. Ms. Cosby acknowledged that she understands what to do when she is having thoughts and feelings of depression and suicidal thoughts. Ms. Cosby admitted she has no thoughts of harming herself or others at this time. Ms. Cosby was provided with 911 information and hot line numbers in the event she had thoughts of hurting herself or hurting others. Ms. Cosby processed information from QMHPA. Ms. Cosby admits that she has been trying to replace her negative thinking with positive thinking. Ms. Cosby was supported. Ms. Cosby shares that she does not feel like harming herself or others.