1/30/2023 EnchantaVaughn Approved 1. Behavior: Client was present in the home when it was time to begin her therapy. However, the client appeared to be in a low and sullen mood. Client was inquired why she felt this way. Client did not respond. Client displayed poor communication and was given a moment to cool off. Client appeared to be in a downward mood. Mom expressed that client often acts like this when things don’t go her way. Mom reported that client has had a hard time removing distractions which causes her to be unfocused on the assignments/tasks at hand. 2. Behavior: Mom reported client gets angry, aggressive, and becomes uncooperative almost daily as a result of her ADHD behaviors. Client avoids wanting to listen to information being shared, as she began to pout and roll her eyes at the QMHP. Client have not utilized healthy coping practices and was urged to do so. Client chose not to express her feelings without exhibiting inappropriate behaviors. Mom expressed being overwhelmed with client’s increase in bad, inappropriate behaviors. 1. Intervention: QMHP engaged in conversation with client for 30 minutes to discuss her recent behaviors. QMHP actively listened to client verbalize that she was agitated today and the reasons to her agitation. 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). Instruction, modeling and role-playing techniques were used to help client’s general communication skills. 2. Intervention: QMHP aided this intervention with client on personal skills. QMHP communicated with client on displaying appropriate control. QMHP probed client about certain behaviors and how she sometimes feels like the only way to respond is in a negative manner. QMHP educated client about using good manners at home and offering alternative methods and suggestions to model appropriate communication that client should use to ask for things or to get someone’s attention. 1. Response: Client showed low level of participation, walking away and avoiding QMHP; not wanting to be bothered. Client is easily frustrated when confronted about not listening to authority figures and begins to increase her anger from 3x to 5x. Client is working on walking away and telling an adult before responding to anger provoking situations. Client understands that problem solving starts with thinking before acting. Client displayed an unresponsive and nonchalant attitude toward QMHP when reviewing strategies from previous session. 2. Response: Client displayed a disinterest in the interventions that were applied to her. Therapy activity was viewed as ineffective and unproductive. The storytelling techniques were also ineffective to modeling appropriate ways to manage stress. Client struggled with expressing or identifying stimulus that triggers her angry emotions, as she is learning to reflect on her current situation in the home. Client admitted to counselor that she does sometimes find difficulty in adapting to the virtual lifestyle.