3/19/2023 EnchantaVaughn Approved 1. Behavior: Upon arrival, client presented himself with a passionate tone when welcoming QMHP into the home. Client expressed he felt excited and ready for today’s session because he had so much to talk about. Client expressed positive thoughts about his day. Client mother discussed with QMHP on how client continues to struggle with being able to communciate effectively with her about his feelings and he will shut down or lash out. 2. Behavior: Client was well dressed in wrinkle free clothing, fresh edge up, and appeared to be in an outgoing mood, as evidenced by his positive tone and energetic demeanor. Client was observed in the session on task and displaying excellent pro social behaviors (e.g. helping counselor during group activity, sharing his thoughts when needed, and volunteering to pass documents for review). Client was focused and on task however, client displayed negative attention-seeking behaviors toward his mother's boyfriend throughout the session evident by him cursing at him and needing redirection. 1. Intervention: QMHP observed client in the living room in efforts to determine whether he required assistance. QMHP determined client was on task and did not require assistance. QMHP provided positive gestures to encourage client on his positive behaviors in the home. QMHP reminded client of ISP objectives and what he needs to do in order to achieve them. QMHP reviewed examples of alternative appropriate behaviors he could engage in to stay on task without causing disruption. 2. Intervention: QMHP introduced the concept of a behavior contract to client. QMHP reviewed the purpose and expectations of a behavior contract with client in efforts to get him familiar with the concept. QMHP held consultations with client and grandmother about effective intervention strategies that build on the client's strengths and compensate for his negative behaviors. QMHP reminded client not to take everything personal and to relax. QMHP encouraged client’s father to provide frequent positive reinforcement to maintain client's interest and motivation in maintaining positive behaviors and completing his school assignments and/or chores. QMHP assisted client to behave in more positive ways by addressing the conflict he was facing with his dad, siblings, and other sources in the community. 1. Response: Client smiled as he saw QMHP's gestures which encouraged him to be active but focused on what’s important. Client was able to process making good choices with QMHP and his dad. Client listed 3-4 behaviors that he was going to utilize in efforts to remain positive in the home. Client appeared to be receptive to receiving positive reinforcement from his grandmother, as demonstrated by him smile and warm inviting body language. The frequency and intensity of the client's defiant affect decreased. Client continued to work on the psycho-educational activity. Client required additional redirection from QMHP to get him to focus on the assignment. Client was able to settle down and return to the activity. Client was responsive to counselor’s lesson. 2. Response: Client verbalizes confident feelings about himself but recognizes areas he needs to work on as well. Client continued to interact in a productive manner with his father and counselor in hopes they would applaud and reward his behavior. Client was seen making the right choices and staying out of trouble. Client responded well to feedback and discussed some things he can do better when it comes to new challenges. Client acknowledges he needs to work on his temper and controlling his anger when he doesn’t get his way.