3/30/2024 EnchantaVaughn Approved Upon arrival, Client was observed settling into the home after a long day. Client was greeted by mental health professional. Client displayed a negative attitude with flat facial expressions when communicating her feelings to QMHP-C about her day at which mother reports client will shut down at least 4 times weekly when she cannot have her way with behaviors lasting up to 10 minutes in duration. Behavior: Client was not in the mood to talk about her feelings, as evidenced by her dialogue with QMHP-C. Client displayed disrespectful behaviors toward her mom, as evidenced by her yelling when she attempted to interact with her to make her feel better at which mother reports these behaviors can last up to 10 minutes in duration. Intervention: QMHP-C reviewed previous day activities and reminded Client of what she has to do in order to achieve her goals and objectives again today. QMHP-C reinforced Client’s positive behaviors by modeling positive behaviors. QMHP-C modeled proper positive behavioral expectations for Client. QMHP-C offered simple praises to Client for exhibiting the appropriate behaviors during the session. QMHP-C utilized cognitive skills to give Client a chance to openly and honestly discuss her feelings about her current state. QMHP-C utilized active listening skills and was empathetic with Client as she vented about her day. QMHP-C reiterated the importance of positive thinking and exercising her coping skills. QMHP-C supported Client involvement in in-home counseling. QMHP-C provided feedback to Client in regard to questions asked. Intervention: QMHP-C explored positive behavior options with Client to support her willingness to make good decisions in the home without blowing up and having a meltdown. QMHP-C continued to establish a positive supportive relationship with Client. Intervention: QMHP-C reviewed Client’s ISP objectives with her in efforts to reinforce her commitment to achieving them on a daily basis. QMHP-C aided Client in recognizing her target behaviors in efforts to reinforce the importance of complying with social norms while at home and in the community. QMHP-C facilitated activity to allow Client insight on conflict resolution skills to utilize in social settings. QMHP-C provided strategies such as positive reframing. QMHP-C assisted Client with practicing reframing negative thoughts with more positive thoughts in efforts to reduce impulsive reactions to situations that usually trigger Client's negative expressions. Response: Client was open to session and communicated openly with counselor. Client verbalized that she’s able to focus better when it is quieter and more peaceful. Client stated being around her counselor made her feel more comfortable and accepted. Client presents an alert and friendly demeanor. Client displayed a normal affect. Client was accepting of feedback provided by QMHP-C. Client displayed excellent cooperation and had no issues with expressing her feelings and emotions when faced with a sensitive topic. Client was able to show empathy toward mom by understanding the responsibilities that come with taking care of the home and having nice things. Response: Client was appreciative of QMHP-C support and encouragement. Client talked a lot today but seemed to be gaining clarity about her situation. Client expresses her needs as it pertains to meeting her objectives and still working on other goals in her life that have nothing to do with her education or staying home during the pandemic. Client was happy that she could confide in QMHP-C and not feel judged. Client recognized positive behavior methods that would be useful in the home and community as a way to develop skills needed to stabilize symptoms associated with ADHD.