9/18/2023 EnchantaVaughn Approved 1.Behavior: Upon arrival to Ms. Cosby home, Ms. Cosby appeared to be in a positive mood evident by her facial expressions such as a smile on the face. Ms. Cosby appeared to be groomed and dressed weather appropriate. Ms. Cosby did not present any symptoms of S/I or H/I at the time of the session. 2.Behavior: Ms. Cosby displayed depressive behaviors at times when discussing how she plans to overcome some of the challenges she is experiencing. She was able to relax once being reassured by QMHPA. 3.Behavior: Ms. Cosby presented off-task behaviors as she was withdrawn from the session evident by her watching something on her phone and trying to make appointments for her son. 1.Intervention: QMHPA assessed Ms. Cosby for symptoms of S/I. QMHPA introduced herself to Ms. Cosby informing Ms. Cosby the purpose of Mental Health Skill Building Services. QMHPA reviewed with Ms. Cosby her orientation information upon her receiving services and how it is important for her to comply with services in an effort for her to get the best practices while receiving treatment. QMHPA provided Ms. Cosby with important numbers such as her local ER of her choice, Crisis Hotline information in the event Ms. Cosby was in a crisis situation as well as QMHPA contact information. QMHPA reviewed with Ms. Cosby her safety plan and encouraged her to place her safety plan on her refrigerator or a safe place where she can always have access to. QMHPA reviewed with Ms. Cosby her current medications and discussed with her the importance of her adhering to her medication management and attending her appointments on a consistent basis in an effort to stabilize her mental health illness. QMHPA engaged Ms. Cosby in an activity assisting Ms. Cosby with identifying appropriate ways to cope with depression and other life stressors. 2.Intervention: QMHPA assisted Ms. Cosby with breathing techniques, exercising and guided imagery. QMHPA explained to Ms. Cosby using appropriate coping skills daily will increase positive emotions. QMHPA reviewed with Ms. Cosby techniques of handling anxiety when there is external stimulation. QMHPA guided Ms. Cosby through a walking exercise where she is to identify relaxing situations to decrease depression. QMHPA explained to Ms. Cosby about being able to display positive emotions to avoid depression by interacting with those throughout the community. QMHPA questioned Ms. Cosby about interacting with family members and how she feels about being able to interact with family. QMHPA discussed with Ms. Cosby reducing isolative behaviors. QMHPA explained to Ms. Cosby isolation can cause depression to increase to do the lack of expressing feelings and bottled-up emotions. 3.Intervention: QMHPA engaged Ms. Cosby in a discussion surrounding her ADL’s/IDAL’s. QMHPA provided Ms. Cosby with information on personal hygiene. QMHPA engaged Ms. Cosby in role play activity to help Ms. Cosby improve on her social skills with her peers. QMHPA provided Ms. Cosby with insight on how improving her communication skills would help in her interaction with members of her family as well as others in the community. QMHPA and Ms. Cosby role played different scenarios to assist her with being able to establish healthy relationships. QMHPA educated Ms. Cosby on how these coping skills that were demonstrated throughout the session will assist her with decreasing some of the angry and depression that she encounters on a daily basis. QMHPA scheduled the next upcoming session with Ms. Cosby while encouraging her to review coping techniques discussed with her in today’s session. 1.Response: Ms. Cosby appeared to be receptive to QMHPA interventions provided to her in the session. Ms. Cosby verbalized to QMHPA she was really thankful to have begun receiving services as she is struggling with several issues in her life affecting her mental health. Ms. Cosby discussed with QMHPA her current depression such as being a single parent raising her children to the best of her ability as the fathers of her children are not doing nothing for them. 2.Response: Ms. Cosby discussed with QMHPA she is going to take a picture of her safety plan as well as put it on her dresser so she can see as well as review it often. Ms. Cosby discussed with QMHPA her point of contact in the event of an emergency which is calling her boyfriend or her brother who she is close with. She reports having limited support from family members as. She reports her boyfriend and her brother is considered as her support system; however, her boyfriend works most of the time leaving her to be isolated from others in the community. Ms. Cosby reports she struggles with being able to implement coping skills for her symptoms of depression, anxiety and anger. She reports struggling with being able to resolve conflict as well as implement positive decisions making skills. Ms. Cosby was able to demonstrate the ability to implement coping skills taught to her such as practicing deep breathing skills when she experiences anxiety or depression. 3.Response: Ms. Cosby was able to provide QMHPA with one example of guided imagery through the use of assistance of QMHPA such as being on her dream vacation when feeling depressed or experiencing anxiety. Ms. Cosby reports she struggles with her ADL’s/ IADL’s as she has limited finances and struggles to pay her car payment and provide hygiene products for herself. Ms. Cosby reports she wanting to apply for SSI and obtaining a new psychiatrist because she needs medication that is going to assist her with her depression. Ms. Cosby reports she is going to continue to work on areas of improvement in her life being as though she assistance and guidance with being able to stabilize her mental health illness.