11/2/2023 EnchantaVaughn Approved Behavior: QMHP arrived to Client's home today for today's scheduled session. Client's home was observed being up kept, and very disorganized with dirty clothes, trash, toys, and school items scattered all over the floor. Client's asked several times for him to help clean up but he gave her a hard time, smacked his lips, and rolled his eyes. Client claimed he had nothing to do with the house being disorganized and blamed his brother and sister for everything at least 2-4 times lasting up to 20 minutes before he is able to calm himself. Behavior: During the second portion of the session, client reported that his brother and sister have been getting on his nerves and that he has tried to be patient with them, but they fail to listen to him which causes him to engage in aggressive behaviors toward them by pushing and yelling at them, but they continue to bother him. Client went on to report that he feels that they do it on purpose and they do not care if he gets mad or hits them on a daily basis and lasting the reminder of the day. everything at least 2-4 times lasting up to 20 minutes before he is able to calm himself. Intervention: QMHP provided client with support and he was challenged to assume responsibility for his household by cleaning regularly. QMHP challenged client to create a schedule of days that he completes certain cleaning tasks in the home. QMHP used active listening skills and challenged Client to use positive communication skills toward others, and discussed managing his anger properly using relaxation techniques. QMHP challenged Client to be patient with his brother and sister in order to avoid aggressive behaviors. Intervention: QMHP engaged client in a discussion regarding the importance of using assertiveness skills to avoid having temper tantrums and lashing out at his brother and sister. QMHP discussed with Client the triggers that cause him to have frequent angry outbursts with his brother and sister. QMHP encouraged Client to think before reacting and to not allow his anger to get the best of him or let his brother and sister see him becoming disrespectful to prevent drama in the household. Response: Client stated that he will try to assume responsibility for his actions and that he will clean the home in a timely manner, and expressed that he has been very tired and that is why he hasn't cleaned up yet. Client verbalized that it is very overwhelming when he allows his room to become so junky because he doesn’t know where to start when cleaning it and he hates not being able to play or relax throughout the day since the only other space available is the kitchen and living area where there is too much going on for him. Response: Client agreed that he feels that he is in a power struggle with his diagnosis and he will work toward improving his assertiveness skills because he did not want to get involved in a physical altercation and risk being put on punishment. Client stated that he is working toward improving his angry outbursts in the home, school, and community.