10/30/2023 EnchantaVaughn Approved Client greeted QMHP welcoming counselor into her home. Client appeared to be in a cheerful mood, as evidenced by client smiling during conversation with mother. Client was excited, indicating she was going to have a good session. QMHP engaged Ms. Boone in a disucssion as it relates to her anger since the last session. Mother reported client continues to isolate herself as well as self-report from client at least 2 times within the day. Client reports when she isolates herself from others she is able to gather her thoughts so she will not be so upset. Client demonstrated withdrawn behaviors at times within the second portion of the session as client was starring at her phone and not listening to the conversation with her mother (Ms. Boone) about her behaviors. QMHP demonstrated and provided positive acceptance, as she attempted to reestablish a mutual and trusting relationship with the client. QMHP processed with client to gain a better understanding and identify stimulus that triggered her angry emotions. QMHP reviewed with client conflict resolution skills through instruction, modeling, role-playing, and behavioral rehearsal. QMHP will continue to assist client with managing anger and frustration by reviewing and role-playing effective coping skills. QMHP assisted client in creating a journal where she could record her thoughts and feelings whenever she didn’t want to talk about them in person. QMHP reminded client that each session is focused on helping her move forward with her goals at which QMHP will assist client with these goals at least 3 times weekly during sessions. QMHP discussed with mom about client’s involvement during their session and how much improvement is noticed so far since the first initial session. QMHP modeled how to show client more support. QMHP discussed ways to increase more positive coping mechanisms and how to display more positive behaviors. QMHP had one on one with client. QMHP explored positive behavior options she was exhibiting with client to support her willingness to continue to make good decisions and display appropriate behaviors in the home. QMHP processed client’s thoughts and feelings. QMHP inquired about evening routine and previous activities. QMHP encouraged client to utilize positive self-talk when encountering difficult or challenging tasks. Client expressed non-aggressive emotions and showed respect to her counselor when asked questions about trust. Client verbalized good thoughts and understanding. Client developed better communication skills by expressing herself in a calm manner. Client displayed management of individualized behaviors. The client has not overreacted with anger to minor frustrations or irritants. Client responded in a pleasant manner acknowledging the positive reinforcement that the QMHP provided. Client was able to reevaluate herself and display a more positive attitude toward peers and authority. Client has become more involved in age appropriate social activities and was given positive reinforcement for these choices. Client demonstrated expectations and responded well to feedback. Client reported a decreased stress level due to her modulation of social contact, and the success of this was reviewed. Client responded well to QMHP and appeared thankful for the help and support. Client shared some of her favorite things to do and places to go that could accommodate her specific needs. Client hyperactive and impulsive behaviors were reduced, and symptoms of ADHD are stabilized.