2/13/2023 EnchantaVaughn Approved 1. Behavior: Client was present and very relaxed when QMHP arrived, as evidenced by him lying on the couch and watching a movie with his siblings. Mom appeared to be in an energetic mood and preparing dinner for later. Mom explained that she was okay with having session today and wanted client to get the most out of in-home services since so many community resources are limited. Although both mother and client are getting along the two continue to have issues after sessions are being conducted. 2. Behavior: Client and QMHP discussed his role in the home. Client shared that he is learning to develop the skills needed to achieve his goals on a daily basis and is proud at how far he has come. Client admitted that him and his mom are getting along better and he’s beginning to see the value in family time and spending quality time with his loved ones. Client followed all directions given by mom and counselor. Client displayed a calm demeanor without getting angry or frustrated. 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. Client continued to state to QMHPC as well as mother that he is not going to change in one day and that he really does "believe in himself". 1. Intervention: QMHP conducted session on helping mother and family reduce the stressors in the home and community settings. QMHP informed mom that client can benefit from other contactless services, thus probing them to utilize resources in the community that will help client reduce his aggressive behaviors. QMHP reviewed with mother the ability to limit the stress in the home and to utilize the reward system appropriately. QMHP utilized active listening skills while probing mother on the affect ways that she attempts to reduce client's negative behaviors. QMHP praised mother for her efforts to better herself and her living situation by making sure she provides client with everything he needs (e.g. clothes, food, shelter) to move forward and keep client away from negative influences in his life. QMHP will provide client with support and encouragement. QMHP will monitor, observe, and redirect client behaviors as needed. QMHP will continue to build a rapport. QMHP actively listened and provided support as mother explained that client exhibited difficulty in home, school, and community environments. QMHP inquired if client was prescribed any medications for his diagnosis. QMHP inquired if moving was the reason behind client’s inappropriate behaviors as a way to gain more attention from mom. QMHP encouraged mom to talk to client about the new changes in a less therapeutic setting to prepare him for transition and dealing with his thoughts and feelings. 2. Intervention: QMHP went through program overview with family to reiterate key points and program objectives that would pertain to their specific situation and helping to build a new therapeutic relationship with the family and client without making them feel overwhelmed. QMHP encouraged client to continue displaying positive behaviors. QMHP supported client involvement in selected activities. QMHP processed with client about what he learned from activity after the review. QMHP praised client for his cooperation. QMHP praised and recognized client for his hard work, efforts, participation, and working towards improvement by changing daily habits and implementing a positive and consistent routine. QMHP employed positive reinforcement when the client was able to achieve all of his objectives and encouraged him to maintain his positive behavior by providing him with a review of his objectives. QMHP reinforced appropriate coping skills in the home. QMHP processed client positive responses and challenged client to maintain appropriate behaviors throughout the entire week. QMHP assisted Client in monitoring his own behaviors in efforts to promote exercising self-control in focused areas such as respecting boundaries with others. QMHP inquired about after school activities. QMHP will meet with client 4x a week to discuss progress and expectations that are working and not working in the home. 1. Response: Client appeared to be receptive to QMHP’s interventions and services that were provided to him during the session. Client reported that him and mom have a close relationship but have difficulty with communicating with anyone when he is upset. It was communicated by parent that client needs to realize that he has a lot going for himself, but he allows others to get him off track. Client reported that he is looking forward to receiving help and wants to learn how to deal with his anger and depression. Client understands that his treatment plan is a behavior contract that will reflect his improvements in the home. Client stated that he is open to new ideas. Client was acceptive of prompts given by mom and counselor. Client agreed to listen to the adult and follow all rules no matter if he sees someone else breaking them. Client is reminded to tell an adult if someone is interrupting his learning no matter where he is. Client informed QMHP that he has been learning a lot in each session. Client thanked QMHP for helping his family communicate with each other in a more positive and productive way. Client stated that talking and sharing things in his life helped him to evaluate his poor choices and correct his mistakes. Client went on to report that he will practice therapeutic techniques with his family when he feels that it is the right time and place. Client has attempted to utilize what he acquired from today’s session to reduce symptoms of ADHD. Client responds well to praise and support. 2. Response: Client appeared to be receptive to receiving positive reinforcement from his mother as demonstrated by his happy and inviting body language. The frequency and intensity of the client's defiant affect decreased. Client shared some of the things he does at home to help him relax. Client stated he loves to listen to music, play video games, and be on the phone, tablet, or computer. Client is observed problem solving on his own and handling his emotions appropriately. Client responds well to feedback. Client responds well to the positive reinforcement provided by QMHP and is seen increasing self-esteem and confidence. Client participated in reviewing key concepts on his mental illness and how to manage the symptoms. Client showed good understanding of what it means to be respectful, encouraging, mindful, and fair to others. Client understands that problem solving starts with thinking before acting. Client demonstrates problem solving by staying calm and using his senses. Client acknowledges expectations and reviews goals and objectives with counselor and parent. Client said he was going to practice coping strategies and relaxation techniques in all aspects of his daily living routine in hopes that he will be a better person, student, sibling, and friend. Client implemented the positive reinforcement provided by his counselor and was able to stay motivated and enjoy his day.