2/24/2024 EnchantaVaughn Approved Behavior: When QMHP entered the home to meet with client for in-home services, client was observed in a frivolous state. Mom communicated client acts this way when she wants to manipulate people to give her things she hasn’t earned or deserve. Client shared that she needed help on building more confidence like those around her have. Client expressed that she was frustrated but could not completely communicate her feelings at the moment at which behaviors last for about 3-4 minutes in duration. Behavior: Client often turns her back away so that she doesn't have to make eye contact when asked to engage in reflective thinking exercises with her family. Client behaves poorly in the home setting, as observed running around the house during session and being disruptive. Client displayed inappropriate body cues by smacking her lips and rolling her eyes. Client displays attention-seeking behaviors and requires consistent redirection from QMHP and mother. Client shared that she continues to struggle with communicating with those around her at which these behavior last about 20 minutes in duration. Intervention: QMHP highlighted the faulty and unnecessary behavior that the client was engaging in. QMHP informed her that her actions were disrespectful and encouraged her to resist becoming angry and making irrational decisions. QMHP assisted the client in understanding the anger that she feels and what she believes causes her to react the way she does. QMHP encouraged the client to continue to work on understanding her feelings and making sure that she responds in an appropriate manner. Intervention: QMHP will assist with reducing anger-provoking situations through self-talk and role play scenarios in order to prevent escalation and dealing with anger assertively. QMHP isolated client from distractions to decrease disruptive behaviors and to reduce excessive talking. QMHP guided client by asking her what she experiences when she encounters different types of conflicts. QMHP engaged in conversation with client about ways to continue improving her behavior and interactions around her family and friends. Response: Client was reluctant and hesitant in extending a friendly rapport back to the QMHP. Client displayed an unemotional facial expression on her face. Client showed she had no desire to listen to her mom. Client continued to be upset and stated that she is fully capable of understanding what she must do but will do it when she feels like it. Client displayed a few disruptive behaviors in the home setting, due to stressful environment and wanting to take a break. Response: Client did not utilize any of the conflict resolution skills she has learned. Client continued to be defiant and disruptive. Client would not express what triggered her negative behaviors. Client did not display that she could have handled the situation differently. Client took a strong stance on why her actions were correct and her mother was wrong for yelling at her. Client acknowledges she needs to work on her temper and controlling her anger when she doesn’t get her way. Client engaged in self-reflection, discussing good and bad parts of her day.