6/5/2023 EnchantaVaughn Approved Behavior: Client struggled in the home today, demonstrating significantly inappropriate social behavior. He continues to inconsistently accept responsibility for his actions as evidenced by him blaming others or attempting to justify his actions, experiencing a up and down mood. Client has trouble concentrating and focusing and has been experiencing mood disturbance at least 2-3 times out of the week. Client maladaptive behaviors have steadily increased persisting in the home characterized by his consistent display of aggressive and disrespectful behaviors. Behavior: Client verbalizes alarming statements when he engages in reflective thinking, stating that he becomes really aggressive when he’s upset. Client is educated that showing gratitude reduces negativity and keeps the body calm and client was not acceptive of this feedback. Client expressed needing more support and agreed to be less emotional and more logical with handling stressful situations at home. The client was supported for demonstrating a decrease in level of paranoia. Client was able to talk about his likes and dislikes and figure out how he can be more productive at home. Intervention: QMHP introduced the concept of a behavior contract to client. QMHP inquired of client‘s current mood. QMHP utilized active listening skills as client spoke of his current mood. QMHP reminded client to relax. QMHP assisted client to behave in more positive ways by addressing the conflict he was facing with his mom, siblings, and friends in the community. QMHP modeled proper positive behavioral expectations for the client to administer additional layers of support. QMHP informed client of replacement behaviors in efforts to decrease attention seeking behaviors the client often is involved in. Intervention: QMHP administered psycho educational activity with client and assisted when needed. QMHP held consultation with client and mother about effective intervention strategies that build on the client's strengths and compensate for his negative behaviors. QMHP modeled appropriate ways for client to get positive attention from his family. 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. Response: Although client has difficulty staying focused in the session sometimes, he understands a lot of the information taught in the session and has implemented the skills in the home this week. Client demonstrates he can accept compliments and constructive criticism and act civilized. Client utilized deep breathing techniques to relax and stay calm during stressful environment, especially when there is so much going on outside of the house. Client decided to practice and incorporate mental exercises at home. Response: Client required additional redirection from QMHP to get him to focus on the assignment. Client responded well to feedback and discussed some things he can do better when it comes to new challenges. Client seem to be heavily influenced by his brother and sister. Client was encouraged to learn his stressors so that he can cope through any situation on his own. Client realized that taking things personal only causes him to feel angry and alone and agrees to think more rationally. Client was happy to go to a quieter space to finish the educational assignment, verbalizing appropriate understanding of behavioral contract.