4/1/2024 EnchantaVaughn Approved Behavior: QMHPA arrived to Kaila’s residence. Upon arrival Kaila was mopping her bathroom floor and putting away her bath towels. Kaila shared that she felt nervous. QMHPA engaged her in a discussion to determine why she felt nervous. Kaila stated to QMHPA that she did not know why she felt that way. Kaila did not present any symptoms of SI or HI. Intervention: QMHPA began the session by engaging Kaila in a discussion to determine her current thoughts, feelings and emotions. QMHPA began by asking if Kaila if she needed to seek medical attention. Today’s session focused on implementing appropriate skills for ADL’s. QMHPA encouraged Kaila to accept responsibility for her negative actions, her poor choices and poor decisions. QMHPA used personal experiences to help Kaila process the consequences of her actions. QMHPA informed Kaila that by her implementing this skill it would increase some self-monitoring. QMHPA reinforced identifying several coping tools she can use to decrease her angry expressions and outburst as well as verbal threats when faced with choices and day to day living. QMHPA reiterated active listening skills and responding skills needed to communicate effectively and appropriately. QMHPA educated Kaila on how this skill will assist her with developing some positive tools when communicating in a social setting. Response: Kaila appeared to be receptive to QMHPAs suggestions. Kaila admitted that in recent weeks she has been on a path of doing exactly what she wants to do no matter the consequences. Kaila stated, “I don’t feel nobody care about me so why should I care so I just did and do whatever”. Kaila was not able to process that her poor decision making cause her difficulties. Kaila shared that she has been thinking a lot lately on how she would like for her life to be but feels she does not have what it takes to live a good life. Kaila stated, “I feel like I am always doing something dumb every day. It is like trouble be looking for me. I just want to be happy and not always depressed or mad at something or somebody. Kaila was not able as of this writing to identify how she can use self monitoring to help her decrease her depressive symptoms and her angry outbursts. Kaila through active listening was able to identify the benefits of care listening, problem solving and eye contact and skills to help her develop some self-monitoring skills. Kaila shared during the session that she wanted to contact her friend and apologize for her actions the last time they spoke on the phone. Kaila was commended and supported for her positive attitude and her determination to make things right. Kaila was able to work on her interpersonal skills as well as identify triggers to her angry and identify ways she can manage her anger and anger outburst so that she can connect with others socially.