10/1/2023 EnchantaVaughn Approved Behavior: Josiah shared that today was a rough day because he kept getting into trouble and arguing with his father about him being distant and not showing any interest in the family activities. Josiah communicated that no one listens to him about what he wants to do, and it really bothers him. Behavior: Josiah took over 10 minutes to display fully deescalated behaviors. Josiah became more impulsive and started to cause more disruptions. Josiah was eventually separated from therapy session and endured his consequences of solitude and exudence from the individualized treatment and mental health skill building for 15 minutes. Josiah accepted suggestions from QMHP-C as evidenced by Josiah adjusting his responses and behaviors. Josiah complied and went over ISP objectives with QMHP-C with no resistance. Intervention: QMHP-C coached Josiah to acknowledge and list his strengths, resilience and the positive outcomes that often occur when he makes informed decisions opposed to impulsive ones. QMHP-C verbally identified Josiah's impulsiveness to Josiah and encouraged Josiah to use self-control strategies (i.e. decrease hyperactive behaviors. QMHP-C reviewed several strategies for conflict resolution and positive social behaviors with Josiah in efforts to increase Josiah’s awareness. Josiah was encouraged to use good judgement, and respect authority figures. QMHP-C provided Josiah with a release of energy by walking to get a drink of water to help him relax and open up more. Intervention: QMHP-C facilitated activity to allow Josiah insight into several conflict resolution and problem-solving skills to utilize at home. QMHP-C discussed with the family one goal they believe they need to work on individually and as a family. QMHP-C had each member write down goals and discussed through brainstorming and creating a goals chart on how to achieve each one. QMHP-C prompted Josiah to express how he believes his family should treat each other. QMHP-C encouraged Josiah to think twice before reacting negatively or aggressively in situations that may not need that level of reaction to be solved. QMHP-C used the basic listening sequence to clearly draw out the point of view that Josiah was feeling and get beyond his aggressive language and behaviors. QMHP-C encouraged Josiah to utilize positive self-talk as a means of decreasing anxiety and managing frustration when encountering difficult or challenging circumstances. Response: Josiah was receptive as QMHP-C demonstrated and defined the meaning of empathy. Josiah actively participated with QMHP-C as they discussed and processed empathy. Josiah demonstrated that he was able to process productive expressions of anger. Josiah displayed active behaviors in family setting. Josiah need progress with expressing himself in the session. Josiah displayed partial participation during psycho-educational activity as evidenced by his frequent need to be refocused and minimal interaction during the processing conversational portion of the activity. Response: Josiah was able to identify the role he plays in each situation and continues to comply with authority rules and regulations. Josiah also applied himself by utilizing his strengths to focus on his goals. Josiah responded well to feedback and discussed some things he can do better when it comes to new challenges. Josiah stated he would try better self-management, as the day pursues. Josiah displayed hyperactive behaviors such as yelling out responses out of turn and talking over his mom when confronted about his attitude and poor conduct at home today. Josiah required to be re-focused 3-4 times by QMHP-C as others spoke. Josiah was observed chastising dad about the responses that was shared with his counselor.