11/2/2023 EnchantaVaughn Approved Behavior: Upon arrival to the home setting, client displayed challenges with following instruction and listening to authority at least 4-6 times daily. Client was inattentive and unfocused as mother discussed with QMHP on how when Laylah cannot have her way, she self reported she will isolate herself from everyone and give attitude to everyone in the home for about 20 -30 minutes. Behavior: During the second portion of the session, client appeared to be upset with her mother as well as QMHP when discussing ways to manage her behaviors in a positive manner and not acting out at least 2-4 times with moderate behaviors lasting 10-15 minutes per self-report. Intervention: QMHP observed client in the home in efforts to determine whether she required assistance. QMHP engaged client in a conversation regarding her recent behaviors, progressions and setbacks. QMHP explored client’s responses and responded accordingly. QMHP inquired about client’s overall day. QMHP attentively listened to client’s issues at least 2-3 times weekly.. QMHP reeducated client on the dangers of involving herself with activities that are both negative and harmful. QMHP worked with client on methods and techniques to help her reduce, lesson, or eliminate her impulsive conduct and as well as to be more aware of her unpleasant behaviors within her daily functioning life. Intervention: QMHP reiterated to client the benefits of following the rules and of the privileges she can receive when she does so. QMHP assisted client with identifying privileges that she would like but does not receive due to her negative behaviors; in efforts to stimulate her thinking about cause and effect of her behavior choices. QMHP gave client the opportunity to express and explore her perceptions of how her symptoms of ADHD can affect her relationships with peers and adult figures. QMHP gave positive feedback and encouragement throughout the day especially during challenging or stressful tasks. QMHP processed with client about her previous behaviors and why she needs in-home services at least 2-3 times weekly. Response: Client exhibited an unemotional and flat facial expression on her face, indicating she was not in the mood to process or reflect on her day. Client was reluctant and hesitate, as she remained mistrustful in regard to extending a friendly or respectful rapport back to the QMHP. Client acknowledged QMHP’s redirection after 2-3 prompts. Client stated she was okay and began to calm down. Client proceeded to lower her voice when communicating with her counselor to show more respect. Client promised she would implement her objectives to the best of her ability. Client agreed to follow the expectations and rules in the home. Client responded well to the support provided by QMHP. Client said thank you and promised to treat others fairly. Client ensured she would listen to her mother and stop being stubborn. Response: Client agreed to be patient and separate herself from conflict. Client seemed to be coping with her stressors and attempting to correct her mistakes as much as possible. Client have a hard time keeping her hands to herself when playing but promised to respect others personal space and boundaries. Client asked appropriate questions related to her disorder. Client appeared disinterested in regard to the information that was being provided to her by the QMHP in response to how her negativity affects herself and others. Client was resistance to applying what she learned to real life situations. Client communicated that she was going to behave and be on her best behavior moving forward. Client promised to make good choices and work harder towards her goals.