2/14/2024 EnchantaVaughn Approved Behavior: Client greeted his counselor with happy expressions and positive language, indicating he was ready for his 2-hour session. Client appeared to be in a cheerful mood, as evidenced by client smiling during conversations with his family. Client was excited, confirming he was going to have a good session and a good day. Client continues to display defiance and poor impulsivity at which behaviors can last up to 20 minutes in duration. Behavior: Client was excited to begin the psycho educational activity. Client sat quietly and waited for instruction before giving his opinion on the subject at matter. Client demonstrates bad conduct, and adhering to home rules. Mother became very upset and was yelling at Client. Mom expressed that she is tired of Client behavior and will no longer tolerate it. Client exclaimed that he does not care and began to cry. Client did not wish to speak to anyone for 15 minutes and ignored anyone who tried to speak to him. Intervention: QMHP went to the home for the purpose of meeting with client individually. QMHP processed with the client the feelings he shared about his mental stress. QMHP utilized cognitive skills to give the client a chance to openly and honestly discuss his feelings about his current state. QMHP reinforced clientâs positive behaviors by modeling positive behaviors. Intervention: QMHP will explore positive self-talk, use instruction modeling, and increase social communication skills with positive reinforcement role play activities. QMHP taught client effective problem-solving skills (i.e. identifying the problem, brainstorm alternate solutions, select an option, implement a course of action, and evaluate). QMHP modeled pro-social behaviors for client to strengthen his understanding of them. Intervention: QMHP-C encouraged Clientâs mom to provide frequent positive reinforcement to maintain Client's interest and motivation in maintaining positive behaviors in all settings. QMHP-C informed Client of replacement behaviors in efforts to decrease attention seeking behaviors Client often is involved in. QMHP-C modeled appropriate ways for Client to get positive attention from his mom even while living with dad. QMHP-C inquired of Clientâs current mood. QMHP-C utilized active listening skills as Client spoke of his current mood. QMHP-C modeled proper positive behavioral expectations for Client to administer. QMHP-C assisted Client in exploring other coping strategies to utilize in the home. Response: Client appeared to be learning from his mistakes and correcting them throughout the day. Client responded well to feedback. Client was receptive as QMHP demonstrated and defined the meaning of empathy once he was able to let go of his anger. Client demonstrated that he was able to process productive expressions of anger. Response: Client expressed that he hates being in the house with his younger siblings when all of his friends are outside. Client didnât understand why he couldnât stay up late when there is no school. Client acknowledged he didnât do nothing around the house today because he didnât feel like it and was upset that his mom expected him to straighten up the downstairs while his siblings slept all day. Client wanted to be fair but continued verbalized negative comments and expressing an angry tone throughout the first hour of session. Response: Client successfully participated in the social-emotional skill activity that was being applied during the second part of the session. Client actively engaged in the role-playing activity effectively exhibiting the learned calming strategy. Client expressed that when he is involved in a conflict he will take a self-time out before resulting in negative outbursts.