1/2/2023 EnchantaVaughn Approved Behavior: Client was present and very relaxed when QMHP arrived, as evidenced by him lying on the couch watching tv with his brother and sister. Client was happy to see his counselor and thanked her for coming over. Client displays good behaviors while his counselor reviewed his treatment plan with his mom. Client stated he was having a good day. Client exhibited excellent participation with therapy assignment and displayed a cooperative attitude toward his counselor, communicating his feelings appropriately. Client was acceptive of feedback and said, “thank you for being patient with me”. Client asked for permission to go outside when he was finished with his session. His mom said okay as long as he put his best foot forward and display the correct behaviors in his session. Behavior: Client was in a happy mood and expressing healthy emotions toward the activity provided by QMHP. Client was observed interacting on an age appropriate level and making it easy to conduct the session without having to redirect him or take small breaks. It is evident, client wanted to go outside so he made sure to stay on task and pay attention to his counselor. Client was observed displaying appropriate manners during the session. Client was attentive and focused and displayed a high level of confidence when reflecting on his feelings. Client shows positivity to authority by giving them the same respect they give him, while utilizing proper voice volume in the home. Client was careful not to get off task, as seen listening to instructions carefully. As session came to an end, client was polite and respectful as he prepared to go outside. Intervention: QMHP facilitated a family discussion to talk about common mistakes children with ADHD make and how he can make better choices. QMHP had one on one with client to reflect on his evening. QMHP provided client with a release of energy by stretching to help him relax and decrease his energetic behaviors at the time of arrival. QMHP prompted client to prepare for evening by staying seated. QMHP facilitated a discussion to explore client feelings and things he liked and disliked about services, so that he can get the most out of it. QMHP offered active listening skills and showed client respect while he was sharing his ideas and thoughts about services. QMHP instructed client to follow directions and listen to his mother. QMHP processed client feelings and offered choices of what to do when faced with conflict in the home. Intervention: QMHP collaborated with mom in regard to home rules and regulations, stress management, effective teaching practices, following verbal and non-verbal instruction, role playing exercises, and an appropriate incentive system. QMHP assisted client with managing anger and frustration by reviewing and role-playing effective coping skills. QMHP reviewed methods and tactics to help client positively advocate for himself by the use of assertive communication and conflict resolution skills, as well as, to assist in reducing physical aggressive behaviors toward himself and others. QMHP praised client for his cooperation and managing his behaviors appropriately following one on one. QMHP reminded client that tomorrow is a new day. QMHP asked client what he will do differently. Response: Client displayed an understanding of ADHD and its symptoms and causes. Client reflected on his choices. Client said thank you. Client displayed healthy self-esteem in home setting. Client was observed eliminating personal conflicts at home. Client utilized conflict management skills to avoid getting into altercation with authority. Client exhibited techniques for appropriate self-expression and active listening. Client demonstrated appropriate interpersonal skills, assertiveness, confidence in self and ability to problem-solve on his own. Client communicated positive self-talk and affirmations. Client demonstrated how to verbalize his feelings without yelling and being aggressive. Client was able to speak calmly and demonstrate his improved verbalization skills while conversing with mom and QMHP. Response: Client was an active participant in role-reversal with client to allow him a chance to openly express himself as well as see how he is viewed in the eyes of others when he is verbal and physically aggressive towards them. Client then processed the previous assignment in which he was encouraged to practice using low voice tones when conversing with adult authority and document his response to activity in daily journal. Client responded well to self-talk tactics and verbalized the will to use his verbal skills the next time he’s angered while interacting with others. Client participated in brainstorming exercise and was able to identify possible conditions or triggers that precede a conflict in the home. Client did not display any outbursts during the role play exercise. Client appeared to be learning from his mistakes and correcting them throughout the day.