8/8/2023 EnchantaVaughn Approved Behavior: JaCarei is learning to maintain behavioral management at home without being redirected or corrected by QMHP-C or parent. JaCarei communicated with QMHP-C that he does not feel as if he need psychotherapy to cope with his symptoms or conditions. JaCarei continues to display inappropriate social skills in therapeutic setting. JaCarei communicated that he understands how he has anger issues at times and loses his temper when things don’t go his way. JaCarei is willing to keep working on more positive coping techniques so that he can deal with his feelings around his family. Behavior: JaCarei 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. JaCarei appeared to be obtaining the information and showing more positive feelings, at this time. JaCarei appears to be functioning well in his crisis situations due to the increased support and supervision that he has received. JaCarei 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, JaCarei requires additional resources provided within intensive in-home services. Intervention: QMHP-C inquired of JaCareis’ current mood. QMHP-C utilized active listening skills as JaCarei spoke of his current mood. QMHP-C assisted JaCarei in exploring other coping strategies that he had previously used to solve other problems. QMHP-C had one on one with JaCarei to talk about today’s events. QMHP-C provided support and encouragement to ensure goals and objectives are met. QMHP-C initiated a rapport building conversation with JaCarei in efforts to learn more of his likes and dislikes as well as triggers to negative behaviors listed on his ISP. Intervention: QMHP-C will review key concepts of being a responsible child in the home. QMHP-C will educate JaCarei about being respectful, encouraging, mindful, and fair to peers and authority while making good decisions in the home. QMHP-C will teach JaCarei necessary coping skills to decrease impulses. QMHP-C will brainstorm strategies with JaCarei and encourage self-monitoring. QMHP-C listened to JaCarei explain why he reacts in the manners that he does and why he feels as if his behavior is appropriate. Response: JaCarei displays normal behavior in therapeutic setting. JaCarei exhibited a positive attitude toward mom and counselor. JaCarei verbalizes positive feelings about himself but recognizes areas he needs to work on. JaCarei smiled and continued to give QMHP-C his undivided attention. JaCarei was observed in his seat and raising his hand when he wanted to ask a question. JaCarei interacted well in the session and demonstrates good team building skills. JaCarei displays good attitude by saying “thank you”. JaCarei did an excellent job by showing interest in the session by asking appropriate questions. Response: JaCarei utilized conflict management skills. JaCarei exhibited techniques for appropriate self-expression and active listening. JaCarei communicated positive self-talk and affirmations. JaCarei was able to recognize personal strengths and abilities to perform better at home. JaCarei stated some days it’s boring so he is having challenges with certain activities and needs help staying focused. JaCarei said he was being nice until he got in trouble for talking and being disruptive while people were sleeping in the house. JaCarei knows what is expected of him and is trying to make better choices moving forward.