1/30/2024 EnchantaVaughn Approved Behavior: Upon arrival to the home setting, Josiah was attentive and well behaved but mother reports at times when he cannot have his way, he will shut down with behaviors lasting about 2-4 minutes in duration. Behavior: Josiah was observed displaying off-task behaviors when discussing his behaviors with his mother and getting upset with his siblings as they were laughing at him and when this behavior presented themselves behaviors last up to 2 minutes in duration. Intervention: QMHP-C redirected Josiah and reminded him that the behavior that he was showing was disrespectful. QMHP-C demonstrated Josiah's reactions and discussed with him the proper way to behave when being spoken to by someone who is an authority figure. QMHP-C reminded Josiah the importance of respecting adult figures, especially his father. QMHP-C role played with Josiah and gave him insight on how to better respond to a situation when he is frustrated. QMHP-C encouraged Josiah to utilize positive self-talk as a means of decreasing anxiety and managing frustration when encountering difficult or challenging circumstances. QMHP-C listened to father after several attempts to get his attention. Intervention: QMHP-C encouraged Josiah’s dad to provide frequent positive reinforcement to maintain Josiah's interest and motivation in maintaining positive behaviors in all settings. QMHP-C informed Josiah of replacement behaviors in efforts to decrease attention seeking behaviors Josiah often is involved in. QMHP-C modeled appropriate ways for Josiah to get positive attention from his dad. QMHP-C reminded Josiah of his strengths and abilities. QMHP-C assisted Josiah in developing more positive anti-social skills. QMHP-C inquired about possible challenges Josiah can experience with applying this skill. QMHP-C provided positive feedback. QMHP-C utilized role playing to demonstrate the calming effects of predicting the thoughts, feelings and actions of self and others prior to the outbreak of a conflict. QMHP-C prompted Josiah to share anticipated thoughts and feelings and to indicate how this process reduces angry reactions. QMHP-C dismissed Josiah from session when it was clear to do so. Response: Josiah was able to select topics that were directly related to reduction of stress and emotional negativity, which made him less agitated and more relaxed. Josiah expressed that he hates being in the house all day but understands why he must remain inside. Josiah displayed little concern about his health and assured that he was taking the precautions to stay clean and proactive. Josiah began separating himself from toxic environment in order to decrease tension in the household. Josiah is observed correcting his mistakes and making good choices. Josiah was able to utilize coping skills to eliminate stressors and unwanted feelings. Josiah displayed self determination to stay focused and pay attention in session. Josiah utilized meditation and relaxation techniques. Josiah was seen decreasing anger and frustration. Josiah reported a decrease in symptoms following the relaxation techniques. Response: Josiah was observed avoiding disruptive and impulsive actions demonstrated when Josiah proceeded to walk away and utilize deep breathing. Josiah was observed intervening and regulating his emotions. Josiah knows what he needs to do to improve socially and academically. Josiah expressed to QMHP-C that he understood the importance intensive in-home and promised to do a better job in each session. Josiah proceeded to reduce the aggression in his voice while calming down. Josiah accepted suggestions from QMHP-C as evidenced by Josiah smiling and saying thank you. Josiah displayed positive self-talk, ability to follow instructions, and role play effectively. Josiah was able to demonstrate fairness and kindness to peers and authority. Josiah provided several scenarios for QMHP-C to model positive prosocial behaviors within. Josiah was able to detect and acknowledge both positive and negative responses modeled by QMHP-C.