4/19/2023 EnchantaVaughn Approved Behavior: Upon QMHP arrival, client was noticed in an upset mood. Client walked up to his counselor with aggressive movements. The client did not tell him mom he was leaving, and mom was not happy about this. Client continued to show restrained behaviors. Client communicated with QMHP that he cannot talk to his mom in the same way he can talk to his counselor about his problems, due to the fact he is used to talking to his mom who is a lot more emotional and laid back. Client is afraid mom will judge him or yell at him for his mistakes. Client admitted that some of his decisions can put him in tough situations and everything is not the way he perceives it. Client was receptive to feedback and verbalized good thoughts during the session. Client shared that he is willing to work on the way he responds to his guardian and those around him as long as he can say how he feel. Behavior: Client was afraid if he told his mom how he felt about her and his mom she would get mad at him. Client expressed resentment for not being able to be open with his mom during his difficult moments and was sad about it. Client explained that he always to be close to his mom and as he got older he realized he liked different things. Client was not afraid to be vulnerable. Client expressed feeling let down by his parents and wished they spent more time getting to know him like his friends. Client was supported for being honest and upfront. Client was given a 10-minute break to process his thoughts while mom and counselor discussed important information regarding his treatment plan. The interventions were viewed as unsuccessful with the client failing to properly display changes in his attitude today. Intervention: QMHP trained client in taking steps to prevent problems including displaying positive home behaviors following aggressive, nonchalant actions. QMHP refocused client as he was observed becoming jittery and impatient. QMHP will review and give feedback regarding ADHD and its causes and affect toward client well-being and academic functioning. QMHP will provide client with support and encouragement. QMHP will monitor, observe, and redirect client behaviors as needed. QMHP will build rapport. QMHP will explore positive self-talk, use instruction modeling, and increase social communication skills with positive reinforcement role play activity. QMHP used positive regard as he told the client that he appeared to have positive home management. QMHP informed client of more acceptable and expected responses to situations that would normally lead client to be triggered and display inappropriate, negative behaviors while in the home. Intervention: QMHP assisted client to behave in more positive ways by addressing the conflict he was facing with his mom. QMHP informed client of replacement behaviors in efforts to decrease attention seeking behaviors the client often is involved in. QMHP modeled appropriate ways for client to get positive attention from his family. QMHP inquired of client’s current mood. QMHP utilized active listening skills as client spoke of his current mood. QMHP will educate client on behavior modification to help client identify what behavior he needs to decrease and avoid daily. QMHP will utilize behavior modification system to aid the client with following directions given by authority figures. QMHP will meet with client 4x weekly to discuss progress and expectations that are working and not working in the home so that client and parental guardian have a high expectation and good example of where client is mentally now compared to when he lived somewhere else. Response: Client had a hard time controlling his behaviors. With consistent redirection, client got back on track with goals and objectives. Client was able to be redirected successfully. Client stated he would try better self-management as the day pursues. Client was able to contain impulsive actions. Client was observed having positive interactions in the home. Client communicated that he feels that he will be better behaved, due to consistent support in the home with Mom and seeing QMHP 4x a week. Client expressed positive self-talk, modeled positive behavior, and good communication skills during role play activity. Client learned to avoid negative and defiant behavior and comply to rules. Client verbalized that he’s able to focus better when it is quieter and more peaceful. Response: Client took his mind from thinking and doing to a place of concentration, which allowed him to focus on one thing at a time instead of being all over the place and getting easily distracted. Client demonstrated more acceptable responses, avoiding anger provoking situations in the home. Client utilized the resources provided and seem to be doing better with managing symptoms of ADHD. Client returned to activity ready to work and was more motivated to try and stay positive for the remainder of the day. Client displays moderate participation. After several strategies and restraint by counselor, client was able to stabilize his negative behaviors by utilizing the techniques learned during today’s session. Client was able to maintain his composure when he was confronted with the potential for conflict. Client was observed engaging in several conflict resolution skills. Client was able to complete his work with less than 3 prompts to redirect his focus and attention in the session.