5/1/2023 EnchantaVaughn Approved Behavior: During today’s in-home visit, JaCarei was observed sitting in the living room talking back to his mother when requested to clean up, so he can prepare for his session. JaCarei verbalized he hates doing chores. JaCarei expressed that his brother and sister doesn’t have to do anything, and he has to be responsible for everything which is not fair to him. JaCarei attempted to walk off indicating he was not in a good mood or willing to follow directions unless given the help he desired. Behavior: It was noticed by QMHP-C, JaCarei had a tired look on his face but switched moods once session started. JaCarei’s energy increased once he got comfortable in the home, initiating a conversation with QMHP-C. JaCarei communicated that he does not want to be a part of any conflict with his mom and wants to resolve any issues before it gets worst. JaCarei reported that he is angry. JaCarei was able to remove himself from distractions and focus on his therapy session. JaCarei agreed to deep breathe, count to 10, or think about positive affirmations when having disagreements at home. Behavior: JaCarei verbalized that he wanted to take a break. JaCarei was given the opportunity to spend additional time with mental health professional after his chores was finished. JaCarei was helpful to his counselor by being organized and putting away anything that did not contribute to current activity. JaCarei was educated that showing good behaviors is important. JaCarei displayed initiative to make better choices and prove that he is willing to do a better job than what’s represented in front of him. Intervention: QMHP-C monitored JaCarei individualized behaviors in collaboration with his mother and social/family environment. QMHP-C observed JaCarei in the home in efforts to determine whether he required assistance. QMHP-C engaged JaCarei in conversation regarding his recent choices, progressions, and setbacks. QMHP-C encouraged JaCarei to make good choices and to complete his chores before expecting any free time. QMHP-C processed JaCarei negative comments to try and manage his reactions to certain prompts. Intervention: QMHP-C inquired about morning experiences during initial in-home contact with JaCarei. QMHP-C asked how JaCarei was feeling and if he needed anything. QMHP-C will review problem solving and give feedback regarding ADHD and its causes and effect to well-being and mental performance. QMHP-C encouraged JaCarei to be receptive to all feedback and to take in what is being said rather than how it’s being said. QMHP-C will teach JaCarei meditation skills to decrease any mental or emotional tension. QMHP-C assisted JaCarei in developing more communication skills. Intervention: QMHP-C processed and reiterated with JaCarei about the rules in the home. QMHP-C went over social skills activity with JaCarei to help him understand the importance of following rules. QMHP-C processed with JaCarei the thinking questions to each social skill activity. QMHP-C activity helped JaCarei state, demonstrate, or identify how to communicate his feelings to his family. QMHP-C taught basic problem-solving skills. QMHP-C isolated JaCarei from distractions to decrease disruptive behaviors and to reduce explosive episodes. Response: JaCarei transitions smoothly and safely to session area, displaying appropriate behaviors. JaCarei was seen waiting for instruction. JaCarei understands that problem solving starts with thinking before acting. JaCarei demonstrates problem solving by staying calm and using his senses. JaCarei acknowledges his improvements and vows to stay consistent with his therapy. JaCarei have been doing a better job controlling impulsive and hyperactive behaviors. Response: The JaCarei has overreacted with anger to minor irritants, such as being asked to clean up behind himself. JaCarei responded in an unpleasant manner without acknowledging the support that was given by the mental health professional. JaCarei reported an increase stress level due to his modulation of social contact, and this was reviewed with his mother. JaCarei discussed the reasoning behind his negative behaviors towards others with QMHP-C. Response: JaCarei required additional redirection from QMHP-C to get him to focus on the next psycho social assignment, as presented. JaCarei was able to settle down and return to therapeutic activity in a calm and positive manner. JaCarei was responsive to mother’s frustration and realized he expected him to be responsible so that he is a good example to his brother and sister who both look up to him. JaCarei acknowledged that he often engages in disruptive behavior when he feels he is being targeted or mistreated.