10/21/2023 EnchantaVaughn Approved 1.Behavior: Upon arrival to the home setting, Client appeared to be in a content mood evident by her facial expressions such as a smile on the face. QMHP-C engaged mother in a discussion to determiner her behaviors since the last session . Mother verbalized to QMHP-C on how client struggles with communicating with her mother, her thoughts, feelings and emotions. 2.Behavior: Client displayed withdrawn behaviors evident by her looking out the window starring and not wanting to listen to what QMHP-C was discussing with her mother about her behaviors. 3.Behavior: Client was prompted 2-3 times for utilizing profanity when discussing her behaviors on how to resolve conflict she was upset with her mother as it relates to her father not coming to see her as he planned. 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 parents. 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. 2.Intervention: 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. 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. 3.Intervention: QMHP-C with 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 daily regarding behaviors and performance in the home.' 1.Response: Client’s progression we’re viewed as stagnant. Client needed more help with understanding the exercise without relying on mom to defend her. Client let her emotions get the best of her and would not deflect during the second half of session. 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. 2.Response: 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. 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. Mother collaborated with counselor in coming up with consequences for certain behaviors displayed in the home. Mother verbalized that she did notice that 3.Response: Client is very insecure and needed more support at home, as well as, in school and planned to help her. 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.