2/13/2024 EnchantaVaughn Approved Behavior: During the in-home visit, client was observed having appropriate conversation with his family and preparing for his evening session. Client was observed grabbing chairs and clearing off space at the kitchen table, so that his mom could support him during this time with behaviors lasting up to 3 minutes in duration. Behavior: Client was seen displaying appropriate social interactions in the home toward his brother and sister, as he had been sharing and taking turns with playing. Client maintains an excellent attitude, demonstrating a good rapport with QMHP. Client continued to express positive feelings and demonstrate positive behavior as QMHP modeled positive reinforcement in the home. Mother reports when he cannot have his way behaviors last up to 20 minutes in duration. Intervention: QMHP welcomed client to the session. QMHP brainstormed strategies with client to encourage self-monitoring. QMHP verbally identified the client's impulsiveness to the client and encouraged the client to use self-control strategies to decrease hyperactive behaviors in the home. QMHP provided mediation and relaxation techniques, as well as, simple praises and encouragement to continue the positive behaviors he was exhibiting. QMHP modeled pro-social behaviors for client to strengthen his understanding of them. QMHP commended client on utilizing coping strategies to increase his understanding of feelings and emotions. Intervention: QMHP engaged the client in a role reversal exercise and required the client to think about his goals and how he plans to achieve them. QMHP provided positive feedback when client engaged in the more appropriate behavior in order to prevent him from getting in trouble. QMHP collaborated with mom regarding positive behaviors and performance in the home. QMHP provided support and encouragement to ensure client was comfortable and on track with achieving his objectives. QMHP reviewed and gave feedback regarding ADHD and its causes and affect toward client’s well-being and overall level of emotional functioning. Response: Client was responsive to counselor’s prompts. Client began to show greater control of his anger outbursts. Client appeared to decrease the intensity of his anger and frustration by utilizing deep breathing techniques and finding a hobby to distract him from any stress he may be experiencing. Client acknowledged that he tends to engage in disruptive behavior when he is frustrated or feels mistreated by someone. Client was pleasant and cooperative and demonstrated a willingness to discuss the factors contributing to his undesirable mood. Client accepted responsibility for his outbursts and aggressive behaviors. Client stated he will display anger control in the home as much as he can. Response: Client displayed positive self-talk, ability to follow instructions, role play appropriate ways to act, increase communication, and exhibit the positive reinforcers that were provided by QMHP. Client has implemented the correct behaviors, by avoiding disruptive and impulsive actions demonstrated when client proceeded to walk away from negative behaviors. Client acknowledged QMHP's praise by saying please and thank you. Client was observed intervening and regulating his emotions correctly. Client was able to demonstrate fairness and kindness to all family members by treating them with kindness, dignity, and respect.