10/16/2023 EnchantaVaughn Approved 1.Behavior: Upon arrival, Client behaviors were viewed as inattentive and chatty. Client appeared to be frantic and restless. Client was lectured about her hyperactive conduct in the house and what she needs to do in order to meet her objectives. Mother appeared to be in a tired mood and was frustrated Client was refusing to listen or do the right thing, especially once her counselor arrived. 2. Behavior: Client displays impulsive and hyperactive behaviors 3-4x per, lacking self-control while engaging in family and individual therapeutic activities. Client is observed displaying inappropriate behavior by sucking her teeth and rolling her eyes repeatedly. Client struggles with handling her emotions, displaying multiple outbursts when given redirection and has a hard time accepting the consequences of her actions. Client struggles with listening and following directions even with mother present. 1.Intervention: QMHP-C observed Client’s progression and responded accordingly. QMHP-C reiterated the directives twice to ensure Client understands the exercise. QMHP-C encouraged Client to try to release her emotions so that she doesn’t bottle them up and explode all at once. QMHP-C reminded Client that talking about her feelings is healthy. QMHP-C reviewed Client’s goals and objectives with parent. QMHP-C prompted Client to think about how her negative actions can affect others. QMHP-C communicated with mom that Client need to learn how to calm down on her own. QMHP-C will continue to assist Client with managing anger and frustration by reviewing and role-playing effective coping skills. QMHP-C helped Client problem solve when she began displaying negativity towards herself and others. QMHP-C utilized worksheet exercises to have Client make appropriate decisions when faced with verbal confrontations in the home and community settings. 2. Intervention: QMHP-C developed a plan to help Client with the challenging areas. QMHP-C will work with Client to identify parts of her body that hold tension and anger. QMHP-C established alternative responses that are more appropriate than ignoring an adult. QMHP-C explored non-verbal activities that can still benefit Client without causing her to shut down. QMHP-C will review actions and consequences, as it pertains to home rules. QMHP-C intervened to prevent the negative behaviors from escalating. QMHP-C physically redirected Client to an alternative activity. QMHP-C provided guidance on alternative behaviors and clear instruction on the alternative behavior. QMHP-C provided positive feedback when Client engaged in the more appropriate behavior. QMHP-C will collaborate with mom regarding behaviors and performance in the home on a weekly basis. 1. Response: Client participation level was low when practicing calming techniques, as evidenced by Client flat mood and demeanor. Client looked confused, indicating that she didn’t know the reason for her negative behaviors. Client displayed a disinterest in the therapeutic activities, due to avoiding discussion and prompts. Client was unable to relax when being instructed by the use of the calming and relaxing techniques. Client was resistant and reluctant in regard to QMHP-C positive empathetic acceptance. Client was inattentive and unfocused throughout the session. Client informed QMHP-C of her behaviors after QMHP-C confronted her again about her behaviors. Client understood the rules to the home but could not give QMHP-C an answer as to how come she could not follow the house rules every day. Mother verbalized that she would come up with defined rules for the home and agreed that the rules are probably what are needed in the home. 2. Response: Client speaks about herself in a negative tone communicating that she feels ashamed and unhappy about her efforts and abilities. Client later displayed quiet behaviors as she shrugged her shoulders and did not want to answer QMHP-C questions. Client did not respond as information was shared on anxiety and stress. Client continued to make poor choices in session as it pertains to verbal skills and communication. Client displays challenges in a few areas, including but not limited to her goals and objectives.