2/14/2024 EnchantaVaughn Approved Behavior: Client is learning to maintain behavioral management at home without being redirected or corrected by QMHP or parent. Client communicated with QMHP that he does not feel as if he need psychotherapy to cope with his symptoms or conditions. Client continues to display inappropriate social skills in therapeutic setting. Client communicated that he understands how he has anger issues at times and loses his temper when things don’t go his way. Client is willing to keep working on more positive coping techniques so that he can deal with his feelings around his family. Behavior: Client expressed that he wanted to look into more activities outside the home that could benefit him and help him deal with his stress at home. Client appeared to be obtaining the information and showing more positive feelings, at this time. The client appears to be functioning well in his crisis situations due to the increased support and supervision that he has received. Client learned to cope with stressors and eliminate defiance, which contributes to his success in day treatment. Due to patient’s inability to decrease ADHD symptoms and impulsive behaviors, client requires additional resources provided within intensive in-home services. Intervention: QMHP inquired of clients’ current mood. QMHP utilized active listening skills as client spoke of his current mood. QMHP assisted client in exploring other coping strategies that he had previously used to solve other problems. QMHP had one on one with client to talk about today’s events. QMHP provided support and encouragement to ensure goals and objectives are met. QMHP initiated a rapport building conversation with client in efforts to learn more of his likes and dislikes as well as triggers to negative behaviors listed on his ISP. Intervention: QMHP will review key concepts of being a responsible child in the home. QMHP will educate client about being respectful, encouraging, mindful, and fair to peers and authority while making good decisions in the home. QMHP will teach client necessary coping skills to decrease impulses. QMHP will brainstorm strategies with client and encourage self-monitoring. QMHP listened to client explain why he reacts in the manners that he does and why he feels as if his behavior is appropriate. Response: Client displays normal behavior in therapeutic setting. Client exhibited a positive attitude toward mom and counselor. Client verbalizes positive feelings about himself but recognizes areas he needs to work on. Client smiled and continued to give QMHP his undivided attention. Client was observed in his seat and raising his hand when he wanted to ask a question. Client interacted well in the session and demonstrates good team building skills. Client displays good attitude by saying “thank you”. Client did an excellent job by showing interest in the session by asking appropriate questions. Response: Client utilized conflict management skills. Client exhibited techniques for appropriate self-expression and active listening. Client communicated positive self-talk and affirmations. Client was able to recognize personal strengths and abilities to perform better at home. Client stated some days it’s boring so he is having challenges with certain activities and needs help staying focused. Client said he was being nice until he got in trouble for talking and being disruptive while people were sleeping in the house. Client knows what is expected of him and is trying to make better choices moving forward.