2/15/2023 EnchantaVaughn Approved 1. Behavior: Upon arrival, the client was sitting down on his tablet working on school work. Client appeared to be in a good mood, as evidenced by him smiling and running up to QMHP to give a hug. Client explained that he had been in the house for the past couple days. The client and sibling continue to have sibling rivalry that impacts the sibling relationships and causes verbal and or physical aggression. 2. Behavior: Client displayed good listening skills while beginning the next activity. Client was very attentive to the instructions and guidelines of the activity. Client demonstrated well-mannered behaviors when giving feedback. Client exhibited appropriate conversation with QMHP. At times during the session, client needed to be redirected for utilizing profanity when going back into the home. Client reminded himself of the positive statement he utilized the previous session. 1. Intervention: Prior to starting the session, the QMHP complemented client on his well-mannered and mature attitude that he had displayed. QMHP utilized a combination of mood regulation techniques, to help client delay the need for his immediate gratification and inhibit his impulses. QMHP provided active listening skills. QMHP identified the positive consequences client has experienced in response to delaying empathy and treating others respectfully. QMHP examined and evaluated client’s demeanor in order to manage his compliance with following rules. QMHP will brainstorm strategies with client and encourage self-monitoring. QMHP provided mediation and relaxation techniques, as well as, simple praises and encouragement to continue the positive behaviors client was exhibiting. QMHP engaged the client in a role reversal exercise and required the client to think about his goals. QMHP commended client on utilizing coping strategies to increase his understanding of feelings and emotions. QMHP processed client positive behaviors. QMHP assisted client with finding and utilizing necessary resources. QMHP verbalized the awareness that all people are unique, learn differently, and have various strengths and weaknesses. 2. Intervention: QMHP continued to work with client to help him increase respect for him family. QMHP asked client to identify, roleplay, and model appropriate social skills during session. QMHP provided positive words of praise and reassurance to encourage and promote confidence and respect for himself. QMHP asked client open ended questions to get him to interact and increase participation. QMHP modeled pro-social behaviors for client to strengthen his understanding of them. QMHP reminded and practiced breathing and relaxation techniques to teach client the importance of the “stop, think before act” method. QMHP held consultations with client and mother about effective intervention strategies that build on the client's strengths and compensate for his negative behaviors. QMHP encouraged client’s mother to provide frequent positive reinforcement to maintain client's interest and motivation in maintaining positive behaviors and completing his chores around the house, including all therapeutic assignments given by QMHP. QMHP complimented client for utilizing acquired skills, paying attention, and focusing on the importance of the assignment. QMHP supported client displaying positive social interaction. QMHP continued to support client and meet his needs. 1. Response: Client and his family was able to verbalize how they were feeling and how their day was. Each family member understood the expectations and rules for family session. Client and dad verbalized that they are doing well with communicating with each other. Client understood his expectations and what ways he could utilize the session to best fit his learning style. Client was receptive and open to the information that was provided by QMHP, as he listened attentively to all that was presented to him regarding his behaviors. Client’s mom was approachable and open-minded to the feedback given by QMHP. Client was able to express his feelings and moods in a positive way without getting upset. Client stayed on task and returned a sociable and friendly rapport back to mental health counselor without any negativity. Client followed the instructions and remained focus and active during the therapeutic activity. Client was cooperative. Client participated and cooperated well with the social skills activities. Client was able to answer the thinking questions with assistance from counselor. Client asked questions to counselor concerning the social skills activities. Client also verbalized that he displayed positive behaviors in school, as well as, in the community. 2. Response: Client fully participated in role-reversal techniques during the session. Client was attentive and cooperative, as shown by his pro-active skills and following directions the first time. Client was able to demonstrate positive interaction and excellent manners without having an episode. Client said thank you. Client displayed high self-esteem and confidence. Client appropriately answered QMHP open-ended questions. Client was observed practicing breathing and relaxation strategies and mastering the “stop, think, act” method. Client was acceptive of QMHP support. Client followed all directions, as he demonstrated ability to adhere to the rules and expectations of individual session. Client was able to develop a list of resourceful people who he could turn to for support, assistance or instruction. Client understood to seek support at least once from one of these individuals during the week. Father agreed to record three to five responsible behaviors by the client during the week that pertain to his behavior. Father agreed to start focusing and acknowledging client’s positive behaviors instead of his negative behaviors. Client was supported for using positive techniques for obtaining attention and confirmation of caring.