11/13/2023 EnchantaVaughn Approved Behavior: During the beginning of the session, client was noticed distant, distracted, and impulsive as she displayed unconcern and disinterest for the therapy that was taken place. During the conversation with QMHP, it was difficult for client to stay seated. Client displayed inappropriate conduct as she continued to show a lack of attention and consideration towards the information that was being processed with her, despite methods and techniques used to help her control her overactive and impulsive behaviors. Client displayed angry emotions and had a hard time listening and following directions. Client became frustrated when she could not express her thoughts during family discussion. Behavior: Client was not acceptive of feedback from mental health professional or authority and displayed a lot of temper tantrums when she didn’t receive the attention that she desired. Client was reprimanded and lectured on her noncompliant behaviors. Client began to exhibit negative and disrespectful behaviors towards the QMHP. Client was reprimanded and pulled to the side to correct her behaviors. Client was observed telling her counselor “No” and refusing to do her psycho educational work. Client presented defiance toward parent when confronted about her poor attitude. Client was sent to reflect and cool off on the couch until the end of session. Intervention: QMHP modeled for her how to approach her family/friends about her feelings, good or bad. QMHP engaged with client on conflict resolution and forgiveness. QMHP presented client with different techniques for conflict resolution (i.e. walking away, taking a time out and avoiding the situation/person, using positive language, or simply telling an adult). QMHP retrained client on relaxation skills, which included pace breathing, muscle relaxation, and calming imageries as a way for client to regain and control hyperactive conduct. The QMHP demonstrated and provided positive talk therapy as she processed with client about her defiant feelings. Intervention: QMHP brainstormed with client a list of conflicts that typically occur in her life in efforts to identify possible conditions or triggers that preceded the actual conflict. QMHP utilized role playing to demonstrate the calming effects of predicting the thoughts, feelings and actions of self and others prior to the outbreak of a conflict. QMHP role played with the client to assist her in bettering her social-emotional-mental skills. QMHP prompted client to share anticipated thoughts and feelings and to indicate how this process reduces angry reactions. QMHP will continue to assist client with working towards targeted goals and objectives. Response: Client expressed that no one cared about her in the way that her counselor did, and she said “thank you” to QMHP. Client appeared to be learning from her mistakes and correcting them throughout the day. Client responded well to praise. Client was receptive as QMHP demonstrated and defined the meaning of empathy. Client actively participated with QMHP as they discussed and processed empathy. Client demonstrated that she was able to process productive expressions of anger. Client displayed active behaviors in family setting. Client is making progress with expressing herself. Response: Client was open and receptive to the intervention presented by the counselor. Client was able to verbalize the concept of the intervention and provided verbal feedback throughout the session. Client actively engaged in the role-playing activity effectively exhibiting the learned calming strategy. Client maintained positive disposition throughout the session and did not need to be redirected or prompted to get back on task. Client expressed that when she is involved in a conflict she will take a self-time out. Client was attentive to the role play activity, even implementing strategies he just learned to reduce her negative responses.