10/10/2023 EnchantaVaughn Approved Behavior: When QMHP visited client’s place, the observation of client was exhibited as angry, hostile, and irritable, as it was reported by the mother that client was not having a good day. Client showed unwillingness to engage in the daily activities provided to him during the session. Client was seen as distant and lost in his own feelings and thoughts, as he distanced himself from others. Client expressed that he did not feel like talking today and wanted to leave the session. Behavior: Client is very chatty making it difficult for the client to pay attention or hear QMHP when given prompts and tasks. Client was not as attentive as he should have been, due to minor distractions outside the home. Client is disrespectful and blames his brother and sister for everything. Client often presents frustration when reflecting on his own feelings. Client continues to ignore QMHP directives and display defiance in the home setting. Intervention: QMHP introduced muscle relaxation, pace breathing, calming imageries, and self-control techniques, to help reduce client’s aggressive behaviors. QMHP processed with client to gain a better understanding and identify what triggered his angry emotions to increase. QMHP reviewed with client conflict resolution skills through instruction, modeling, role-playing, and behavioral rehearsal. QMHP demonstrated and provided positive acceptance, as he demonstrated a trusting bond with client. Intervention: QMHP provided mom with at home strategies to practice with client in case his behaviors become overwhelming. QMHP redirected client and discussed with him the importance of communicating his feelings with those around him. QMHP role played with client in order for him to understand his feelings and needs. QMHP encouraged client to combine communication, problem-solving and conflicts-resolution skills relevant to his needs. QMHP reminded client that each session is focused on helping him move forward with his goals. Response: Client presents unflattering, attention-seeking, and out of control behaviors 3-4x, moderate to intense. The storytelling techniques were ineffective to modeling appropriate ways to manage stress. Client appeared unbothered by the interventions provided, as he shrugged his shoulders at QMHP indicating he didn’t care. Client continued to display a lack of concern for others suffering with ADHD. Client struggled with identifying his own behaviors, as he continued to have problems managing his anger at home. Response: The interventions were unsuccessful. Client failed to communicate, problem-solve, or resolve conflicts safely. Client refused to reflect on his poor behaviors, displaying an unemotional and tensed look as the session continued. Client failed to communicate his feelings during one on one pep talk. Client was unable to relax and regain self-control when being instructed in the use of calming imageries, as he continued to display defiant, disrespectful, and stubborn behaviors. Mom was in compliance of next upcoming session.