3/24/2024 EnchantaVaughn Approved Behavior: Client was quiet upon arrival of counselor. Client was excited to see the counselor as evidenced by her smiling and asking QMHP about her day. Client shared that she has been sad lately but did not know why. 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 and mom reports when she is frustrated she will throw items at the walls at least 2 times out the week with behaviors lasting up to 10 minutes in duration. Behavior: Client shared that she continues to struggle with communicating with those around her. Client shared that she is becoming anxious and does not know why and when this behavior present itself she will shake at least 2 days out the week with behaviors lasting up to 30 minutes in duration. Intervention: QMHP inquired about evening and morning and how client was feeling today. QMHP offered help where the opportunity presented itself. QMHP was informed of the client’s behaviors and what has been going on following yesterday’s session. QMHP reviewed the reported behaviors with client in efforts to allow her to express her point of view. QMHP encouraged client to list alternative behaviors she could have participated in besides the negative ones that caused her to receive redirection. Intervention: QMHP observed client in the home to assist with any negative behaviors towards mom. QMHP utilized cognitive skills to give the client a chance to openly and honestly discuss her feelings about her current state. QMHP utilized active listening skills and was empathetic with the client as she vented the overwhelming events that had occurred at home. QMHP reiterated the importance of positive thinking and exercising her coping skills. QMHP prompted client to address and respond to her mom with respect and be thankful for her support. Response: Client was able to respond in a more appropriate way. Client was observed and reported to have been pleasant and cooperative during psychoeducational activity and demonstrated a willingness to adhere to rules and expectations. Counselor praised client for being on her best behavior and correcting her mistakes. Client displayed good behaviors, raising her hand when she had to ask a question, waiting for her turn to speak, using her words instead of hand signals, saying please and thank you, and giving her counselor good eye contact. Response: Client said she felt great and wanted to stand up and stretch. Client utilized deep breathing techniques to relax and stay calm during toxic environment. Client administered positive behavioral expectations, reducing ADHD. As the client developed understanding of expectations, she reported increased satisfaction and function. Client responded well to feedback, interacting well with others. 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.