2/21/2023 EnchantaVaughn Approved 1. Behavior: 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 when he felt uncomfortable sitting for a long period of time. When discussing with mother about his behaviors mother reports he has continues to have a hard time with being able to control his emotions when he is upset. 2. Behavior: Client exhibits great participation in session, following rules and expectations; however, at times within the session, client needed several prompts of redirection for not respecting those who are in authority. For example, when mother and QMHP was communicating about the session and his progress, client would speak over top of the two utilizing profanity at times. 1. Intervention: QMHP had one on one with client to reflect on his day. QMHP provided client with a release of energy by walking outside to help him relax and decrease his hyperactive behavior within the home environment. QMHP reminded client that tomorrow is a new day. QMHP asked client what he will do differently. QMHP instructed client to follow directions and listen to his grandmother and dad. 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 praised client for his cooperation and managing his behaviors appropriately following one on one. QMHP assisted client with managing anger and frustration by reviewing and role-playing effective coping skills. QMHP educated client about using good manners at home and offering alternative methods and suggestions to model appropriate language that client should use to ask for things or to get someone’s attention. QMHP processed client feelings and offered choices of what to do when faced with conflict in the home. QMHP facilitated a family discussion to talk about common mistakes children with ADHD make and how he can make better choices. QMHP reminded client of goals and objectives. QMHP collaborated with dad 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. 2. Intervention: 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 verbally identified impulsive behaviors to the client and encouraged the client to use self-control and decrease hyperactive behaviors in the home daily. QMHP retrained client on anger management techniques, as a way to help him model appropriate ways to manage his anger. QMHP used appropriate behavior modeling to decrease the client’s impulsive behavior and encourage him to use self-control. QMHP monitored progress in demonstrating individualized pro-social skills (e.g. anger management, education, problem-solving, conflict resolution, appropriate verbalization of feelings, and cognitive-behavioral programming). QMHP provided individual and family counseling based on specific treatment objectives. QMHP reviewed home expectations and how client should conduct himself around peers and authority. 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 supported client with meeting his objectives and coping with stressors without needing additional redirection or prompts. The QMHP demonstrated and provided positive and empathetic acceptance with utilizing talk therapy and active listening skills throughout session. 1. 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 dad. 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. Client responded well to praise. Client was receptive as QMHP demonstrated and defined the meaning of empathy. Client actively participated with QMHP as they discussed and processed empathy. Client demonstrated that he was able to process productive expressions of anger. Client displayed active behaviors in home setting. Client verbalized that he’s able to focus better when it is quieter and more peaceful. Client expressed excitement when it was time to demonstrate his strengths in front of authority because he was confident and prepared. Client was able to recognize personal strengths and abilities to perform better. 2. Response: Client was able to cooperate and comply to rules in the home. Client implemented pro social skills successfully. Client has presented himself in a responsible way and is making progress towards his goals and objectives. Client maintains good etiquette by sitting in his seat during instructed activity, raising his hand and asking appropriate questions, being respectful toward mental health professional, remaining quiet during quiet time and active during social time, listening to his counselor, modeling appropriate behavior. Client says please, thank you, and excuse me appropriately during the session. Client shows empathy towards dad, as evidenced by him hugging, playing, and helping him. Client avoids negative language (i.e. profanity words). Client engaged in self-reflection and reflected on his day, the good and the bad in front of dad and seemed happier and more open minded. Client is making progress with expressing himself. Client made insightful comments which contributed to discussion. Client did not leave session, even when he got a little frustrated. Client responds well to praise and support. Client is acceptive of redirection. Client understands that his actions have consequences. Client is striving for a good report from dad and teachers every day. Client wants to make his family proud by doing a good job. Client retained a lot of the information he was taught which motivates him to pay more attention and take his time. Client is observed problem solving on his own and handling his emotions appropriately. Client avoids meltdowns and lashing out when upset or frustrated. Client responds well to feedback. Client responds well to the positive reinforcement provided by QMHP and is seen increasing self-esteem and confidence.