2/26/2024 EnchantaVaughn Approved Behavior: As QMHP entered the house, client appeared to be in a happy mood, as evidenced by her smile and positive facial expressions. Client was seen finishing her chores and displaying appropriate manners. Mother discussed with QMHP at times when client cannot have her way she will lash out on others with behaviors lasting for 10 minutes in duration at which this is an area mother would like for QMHP to really address with her for this session. Behavior: Client exhibited excellent participation with therapy assignment and displayed a cooperative attitude toward her counselor. Client was seen completing the social activity with her family. At times within the session, client would roll her eyes and smack her teeth at QMHP as well as her mother with behaviors lasting for 3-4 minutes in duration. Intervention: QMHP provided family counseling based on specific treatment objectives. QMHP reminded client of goals and objectives. QMHP collaborated with mom in regard to home rules and regulations, behavior management, effective teaching practices, following verbal and non-verbal instruction, role playing exercises, and an appropriate incentive system. QMHP provided client with a release of energy by walking outside to help her relax and decrease her hyperactive behavior within the home environment. QMHP monitored progress in demonstrating anger management, problem-solving, conflict resolution, and appropriate verbalization of feelings. The client was encouraged to use good judgement, and respect authority figures. Intervention: QMHP facilitated a family discussion to talk about common mistakes children with ADHD make and how she can make better choices. QMHP conducted a review of this week’s session and asked client what she learned from it. QMHP held consultations with client and mom about effective intervention strategies that build on the client's strengths and compensate for her negative behaviors. QMHP encouraged client’s mom to provide frequent positive reinforcement to maintain client's interest and motivation in maintaining positive behaviors and completing her therapy work and chores. QMHP reviewed home expectations and praised and recognized client for her hard work, efforts, participation, and working towards improvement by changing daily habits and implementing a positive and consistent routine. Response: Client was able to speak calmly and demonstrate her improved communication skills while engaging in self-reflection. Client implemented her plan for restoring relationships, and this was reviewed. Client engaged in self-reflection, discussing good and bad parts of her day. Client realized her mom was trying to help her by pushing her to try first and then get help. Client nodded in agreement and promised to give it her all and to never give up. Client has become more involved with being supportive of others. Client reported a decreased stress level after having one on one with QMHP. Response: Client engaged in self-reflection and reflected on her day, the good and the bad in front of mom and seemed happier and more open minded at this time. Client focused on things she is good at and loves to do at home in order to stay motivated in the therapeutic setting and make something out of herself. Client is observed making better choices and doing the right thing at home. Client has improved with staying seated without fidgeting behavior and utilized her breaks appropriately without displaying attention-seeking behaviors to get her way.