9/25/2023 EnchantaVaughn Approved Behavior: Upon arrival to the home setting, mother and Josiah was in a happy mood upon arrival. Josiah was seen in appropriate clothing and displayed excellent hygiene. Josiah presented with a sunny affect. Josiah was speaking calmly and listening when QMHP-C spoke to him. Josiah volunteered to help set up the session area today and respectfully asked if there were anything that was needed from him. The family showed positive interactions during today’s session. Behavior: Josiah displayed off-task behaviors evident by him starring off into the wall and or being distracted by others surrounding him such as people entering in and out of the home. Intervention: QMHP-C will implement a routine that will encourage Josiah to be responsible and promote self confidence in academic and social settings. QMHP-C reflected with Josiah on his day, reviewing both good and bad experiences. QMHP-C processed with Josiah, "what would you do different tomorrow”. QMHP-C encouraged Josiah to have a good evening. QMHP-C supported Josiah with displaying positive social interactions with peers and authority. QMHP-C reinforced appropriate coping skills in the home. QMHP-C processed Josiah positive responses and challenged Josiah to maintain appropriate behaviors throughout the entire week. QMHP-C assisted Josiah in monitoring his own behaviors in efforts to promote exercising self-control in focused areas such as respecting boundaries with others. QMHP-C modeled proper positive behavioral expectations for Josiah. QMHP-C introduced concept of nonverbal communication cues in efforts to review the expected behaviors or results to the nonverbal cue. Intervention: QMHP-C continued to establish a positive supportive relationship with Josiah. QMHP-C offered simple suggestions to Josiah for behaving appropriately in the home and community and encouraged Josiah to practice the positive behaviors at other family houses too. QMHP-C provided guidance on alternative behaviors and clear instruction on the alternative behavior. QMHP-C provided positive feedback when Josiah engaged in the more appropriate behavior. QMHP-C explored positive behavior options with Josiah to support his willingness to make good decisions and have positive behaviors at home and in the community. QMHP-C commended Josiah on his positive behaviors. QMHP-C explained and emphasized to Josiah the importance of having a level grip on utilizing his coping skills to avoid mood swings and to promote positive thinking and self-motivation. QMHP-C assisted Josiah with managing his anger and frustration by reviewing and role-playing effective coping skills with Josiah, encouraging mom to participate. Response: Josiah communicated constructive affirmations and self-talk during initial discussion with QMHP-C. Josiah smiled as he saw QMHP-C's positive actions. Josiah was able to process making good choices with QMHP-C and his mother. Josiah listed 2-3 behaviors that he was going to utilize in efforts to remain positive behaviors. Josiah appeared to be receptive to receiving positive reinforcement from his mother, as demonstrated by him smiling and his inviting body language. The frequency and intensity of Josiah's defiant affect decreased. Josiah shared some of the things he does at home to help him relax. Josiah stated he loves playing sports and games outside with his friends, especially to get away from home when his sister and brother bothers him all the time. Josiah participated in reviewing key concepts on his mental illness and how to manage the symptoms. Josiah showed good understanding of what it means to be respectful, encouraging, mindful, and fair to others. Josiah is observed correcting his mistakes and making good choices. Response: Josiah was able to utilize coping skills to eliminate stressors and unwanted feelings. Josiah displayed self determination to stay focused and pay attention while QMHP-C went over each prompt. Josiah was pleasant and cooperative and demonstrated a willingness to discuss the factors contributing to his stress and anxiety. Josiah was responsive to the interventions and attempted to implement skills right away. Josiah said he felt great and wanted to color or draw something cool to give to his mom to show his appreciation for everything she does for him. Josiah utilized deep breathing techniques to relax and stay calm during stressful environment, especially when it’s a lot going on around him. Josiah was happy to go to a quieter space to finish the educational assignment, verbalizing appropriate understanding by asking and answering appropriate questions.