2/18/2023 EnchantaVaughn Approved 1. Behavior: During the home visit, it was noticed client and his family were all communicating in a healthy manner. Client smiled when he saw QMHP walk in the house but remained attentive until his session began. Client communicated that he was feeling good about himself since he woke up this morning. Client was well dressed in casual pants and clean shirt. Client appeared to be an optimistic mood, as evidenced Client exhibited responsible behavior during session and exhibited mature behaviors that were supported and encouraged by the adult. Client appeared to be in a jovial mood, as evidenced by his happy spirit and positive attitude. Client was noticed to be NONCOMPLIANT towards father’s directions but continued to exhibit actions that were related to his ADHD and specified challenges. Client uses a lot of non-verbal cues to express how he feels. Client engaged in reflective thinking with mental health professional. Client displayed active listening skills. Client was acceptive to feedback. Client was observed complying to rules and regulations in the home. 2. Behavior: The interventions were considered effective for the second portion of the session. Mother reported that client has been doing well at home and continues to show improvement and managing his disorder. Client is beginning to recognize his triggers and stressors and have accomplished a lot independently. Client continued to scream at times when his mother was providing QMHP with examples of his behaivors in the home when he is asked to complete a certain task. 1. Intervention: QMHP engaged client in a conversation regarding his recent behaviors, progressions and setbacks. QMHP explored client’s responses and responded accordingly. QMHP talked with client about the importance of adhering to rules and expectations. QMHP provided age appropriate understanding of his mental illness and encouraged him to utilize his coping strategies during social and non-social environments. QMHP offered to help client with his homework and to give him one on one to understand what it is that the assignment is about. QMHP administered psycho educational activity with client and assisted when needed. QMHP provided new skills and strategies to help reduce impulsive and hyperactive decisions. QMHP informed client that misbehaving carries consequences and that making good choices results in good reward. QMHP inquired about client’s feelings and provided positive affirmations. QMHP probed about any angry feelings or the inclination of safe and unsafe behaviors. QMHP utilized active listening as information was conveyed. QMHP communicated with client on displaying appropriate control. QMHP probed client about certain behaviors. QMHP provided feedback regarding client inquiries. QMHP continued to elaborate on ways client can cope and manage stressors. QMHP commended client for his participation and honesty. QMHP processed client positive behaviors. QMHP assisted client in developing more social, coping skills. QMHP inquired about possible challenges client can experience with applying this skill. QMHP provided positive feedback. QMHP reflected on client goals and objectives. 2. Intervention: QMHP consulted with father about increasing structure in the home to aid client in acknowledging the importance of operating and cooperating in the home setting. QMHP urged father and client to participate in role reversal activity to aid father and client to realize how to respond to and interact with each other. QMHP continued to monitor and receive an update on client’s relationship with father and compliance to duties and expectations for client in the home and in the community. QMHP encouraged client to use his strategies and skills with peers, family, and teachers to support him with managing symptoms associated with ADHD. QMHP probed client about talking with his father about his feelings. QMHP commended client on utilizing coping strategies to increase his understanding of feelings and emotions. QMHP assisted client to behave in more positive ways by addressing the conflict he was facing with his dad, teachers, schoolmates, and friends in the community. QMHP informed client of replacement behaviors in efforts to decrease attention seeking behaviors the client often is involved in. QMHP modeled appropriate ways for client to get positive attention from his dad and others. QMHP assisted client in exploring other coping strategies that he had previously used to solve other problems. QMHP utilized behavior modification strategies including removing client from the stimulant environment in efforts for him to reduce impulsive behaviors. QMHP encouraged client to refrain from displaying negative behaviors towards his dad, to talk calmly, and express himself without yelling or getting upset. 1. Response: Client responded well to the support provided by QMHP. Client promised to treat others with respect the same way he wants to be treated. Client seemed to be coping with his stressors and attempting to correct his mistakes as much as possible. Client promised to respect others personal space and boundaries. Client asked appropriate questions related to his behaviors at home. Client displayed appropriate behavior in therapeutic area. Client displayed good interaction with QMHP. Client was polite and courteous, cleaning up after himself. Client demonstrates leadership skills by helping others in the home. Client displayed independence with completing his work in session. Client responded well to feedback and seemed to be adapting well. Client displayed high ambition and was very productive, despite distractions. Client stated he would avoid distractions and stay on task with no problem. Client stated he would help others when he can. Client stated he would treat others fairly even if he feels mistreated. Client stated he would respect adult figures and do what he is told. Client verbalized positive statements about in-home services. Client contributed to discussion and shared his personal expectations and thoughts about his daily experiences in each session. Client smiled and thanked QMHP for the extra support and for going above and beyond to help his family during this stressful time. Response: Client was receptive to the interventions, as evidenced by his cheerful expressions. Client shook his head in understanding. Client said okay. Client agreed to complete 3 tasks at home daily to keep himself busy and out of trouble. Father praised client for being on his best behavior and correcting his mistakes. Client displayed good behaviors, waiting for his turn to speak, using his words instead of hand signals, saying please and thank you, and giving his counselor good eye contact. Client said he felt great and wanted to step outside to get some fresh air. Client verbalizes positive feelings about himself but recognizes areas he needs to work on. Client smiled and hugged QMHP for being there for him when he needed. Client displayed positive interaction and was supported with building healthy relationships. Client implemented the positive reinforcement provided by his father and was able to stay motivated and enjoy his session. Client exhibited good manners after earning incentive for his hard work. Client transitions smoothly to the next activity, displaying appropriate behaviors. Client expresses good statements about his day saying he was doing his work, using his manners, and being fair to others. Client have been doing a better job controlling impulsive and hyperactive behaviors, due to keeping his hands to himself and complying to home rules. Client reduces sadness and finds more excitement in learning about different ways to control his reaction to certain situations and be more receptive and open in therapeutic setting.