10/15/2023 EnchantaVaughn Approved Behavior: Upon arrival, client was reported in a disappointed mood. Client did not welcome QMHP into the home. When confronted about her attitude and negative disposition, client pretended like everything was fine. Mom stated client got in trouble and had a hard time accepting the consequences of her behaviors. Client reframed from talking to QMHP and attempted to ignore everyone until she got the attention she desired. Client displayed mean facial expressions when communicating her feelings to QMHP about why she got in trouble. Client was not in the mood to talk about her feelings, as evidenced by her shutdown dialogue with QMHP and mom. Behavior: Client displayed disrespectful behaviors toward her mom, as evidenced by her yelling when she was expected to explain herself. Client lacked respect for both mom and QMHP, as evidenced by client's aggressive behaviors when confronted about her attitude. Client shared that she was not happy about being on punishment. Intervention: QMHP conducted session on limiting outbursts of anger at home, in session, and in other parts of the community. QMHP focused on this topic because of the opening statements that client made pertaining to her in-home experiences. QMHP utilized role-play to help client understand the importance of following all directions and limiting outburst of anger in a therapeutic or non-therapeutic setting. QMHP utilized active listening skills while client discussed her feelings of being in services and talking about her problems. QMHP will continue to assist client with managing anger and frustration by reviewing and role-playing effective coping skills. Intervention: QMHP isolated client from distractions to decrease disruptive behaviors and to reduce episodes. QMHP encouraged client to take ownership for her own actions before blaming someone else. QMHP utilized behavior modification strategies including removing client from the stimulant environment in efforts for her to reduce inappropriate behaviors. QMHP assisted client with identifying privileges that she would like but does not receive due to her negative behaviors; in efforts to stimulate her thinking about cause and effect of her behavior choices. QMHP will implement a routine that will encourage client to be responsible and promote self-confidence and self-determination in all settings. Response: During majority of the session, client was off task and required one on one attention. Client was provided with redirection for displaying emotional distress to minor irritants. Mother stated that she will continue to work on her approach and delivery with client as much as she possibly can, but she is no longer dealing with her attitude and aggression. Mom admits this affects her youngest child and she has addressed this to other therapeutic outlets involving caseload and education. This has been the first occasion in which client has displayed this level of behaviors in the presence of counselor. Response: Client said she is having challenges with certain challenges and needs advice. Client recognizes areas she needs to work on. Client engaged in self-reflection, discussing good and bad parts of her day. Client acknowledged that she tends to engage in disruptive behavior when she begins to become frustrated with the way people see her.