2/6/2024 EnchantaVaughn Approved QMHPA greeted Ms. Cosby upon arrival to the home setting. Upon arrival to the home setting, Ms. Cosby appeared to be in a relaxed mood evident by her facial expressions such as a smile on the face and engaging in appropriate conversation with QMHPA. QMHPA inquired about her day. Ms. Cosby did not present any symptoms of S/I or H/I at the time of the session. QMHPA utilized modeled behaviors of behavioral rehearsal to assisting Ms. Cosby in understanding and recognizing the cognitive, physiological, and behavioral mechanisms that anxiety and depression had. QMHPA explained on a level that Ms. Cosby was able to understand how treatment helped modify anxiety and depression. QMHPA utilized behavioral rehearsal to demonstrate and practice with Ms. Cosby routinely use relaxation, cognitive readjusting, exposure, and conflict-resolution exposures as needed to confront emergent apprehensions. QMHPA assisted Ms. Cosby in identifying and rehearsing how to manage and respond to future situations in which lapses and relapses occurred. QMHPA engaged Ms. Cosby in a skills building activity. QMHPA explained to Ms. Cosby that the purpose of this activity was for counselor to model behaviors to assist her in creating a directive of at least two spheres of worry for use in exposure that connect to worry/anxiety about harm from others, financial problems, and lack of social relationships. Ms. Cosby shared that because there is so much that is taking place in her life and she is juggling a lot; she has been unable to actively apply the calming exercises. Ms. Cosby stated to QMHPA that she tries to recognize those angry triggers that make her upset, it doesn’t come to her in time. She stated to QMHPA that she tries to control her angry issues when it comes to conflict resolution and other problems; however, she continues to be a work in progress.