10/28/2023 EnchantaVaughn Approved Behavior: During the in-home visit, Laylah displayed poor actions and was observed disobeying her mom’s commands. Laylah continued showing negative manners, despite being told to stop and correct her behaviors. Ms. Boone reports, Laylah remained upset and would not respond to QMHP-C or mom. Laylah was not listening or trying to resolve any conflict. Behavior: Laylah continued to display a negative attitude. Mother stated that she does not understand why Laylah gets as worked up as she does or what exactly makes her so upset. Mother shared that she allowed Laylah to do more than she should be allowed to do, especially at her age. Laylah was not happy with the way her mom expressed her recent behaviors and became very silent in the session. Laylah observation was viewed as unmotivated, as she displayed playful and immature reactions toward authority figures. Intervention: QMHP-C redirected Laylah a few times in the session to refocus and pay more attention. QMHP-C prompted Laylah to refrain from impulsive, hyperactive, defiant, and aggressive behaviors especially running, refusing authority instruction, and interrupting another’s person day. QMHP-C educated Laylah on ways to prevent distractions from affecting her attention span. QMHP-C discussed and spoke with mom and Laylah about upcoming psychological appointment with Laylah’s doctors to evaluate her for medication and behavioral support. QMHP-C reviewed and discussed objectives and goals that will allow and teach Laylah how to channel her reported behaviors within the home, school, and community environments. Intervention: QMHP-C explained the importance of removing distractions when trying to complete an assignment or task. QMHP-C modeled pro-social behaviors for Laylah to strengthen her understanding of what to do in school, at home, and in the community. QMHP-C will teach Laylah necessary coping skills to decrease impulses. QMHP-C reviewed strategies targeted at helping Laylah to work through her difficulties expressing her anger. QMHP-C utilized age appropriate mood regulation skills and techniques, as a way to help Laylah’s destructive and critical demeanor, as well as to assist her with regaining and regulating her uncontrollable conduct. Response: Laylah blames her mental illness for her attitude, mood, and behaviors. Laylah was reluctant and hesitant to participate in session. Laylah had difficulty relaxing and following QMHP-C prompts. Laylah did not offer any forms of social or friendly rapport back to QMHP-C, remaining unemotional displaying an unresponsive and nonchalant attitude throughout the session. Laylah took over 30 minutes to recognize her behaviors as unacceptable. Laylah communicated her understanding of following directions and being respectful to authority figures daily but exhibited opposite commitment. Response” Laylah became more impulsive and started to cause more disruptions in the home. Laylah demonstrates a lot of impulsive behaviors when she has to be involved in her therapy for 2 hours. Laylah continued aggressive behaviors. Laylah required redirecting from QMHP-C to reduce her aggression. Laylah stated that she doesn’t intend on being negative and agrees she need to work on controlling and channeling her anger better. Laylah’s self-esteem and confidence remained low regardless of interventions. Laylah continued to display hyperactive behaviors. Laylah required to be re-focused by QMHP-C as she waited for her mom to speak on her behalf.