9/5/2023 EnchantaVaughn Approved Behavior:Upon arrival to the home setting, client appeared guarded and offensive due to encountering other challenges in the home. Client became frustrated when she could not express her thoughts and started having episode, turning her back toward her counselor and saying slick stuff under her breathe. Client was not acceptive of feedback from mental health professional or authority. Client was reprimanded and lectured on her noncompliant behaviors, however she did not show any concern at this time. Client was reported to have struggled to maintain expectations and mom dismissed her to her room to recoup, stating she would address her shortly. Client was reprimanded and pulled to the side by QMHP to correct her behaviors. Client was able to make minor changes as the day progressed. Behavior: Client began completing her therapy assignment without any distractions. Client was reminded to think positive and continue to utilize coping strategies and relaxation techniques to maintain a positive spirit when she gets down and out. Client shook her head in agreement. Client continued to express positive feelings and demonstrate positive behavior. Client expresses gratitude and compassion toward her counselor for helping her and being there for her. Client exhibits high self-esteem and is observed encouraging herself to make good choices. Client is educated that showing gratitude reduces negativity and keeps the body calm. Client appears to be calm and relaxed after today’s intervention. Client shared that she is learning to develop the skills needed to achieve her goals on a daily basis and is proud at how far she has come. Intervention: QMHP probed client to find the cause of her mom requesting today’s individual counseling session for her daughter. QMHP used active listening as she processed with client about her current mood and answered all questions asked by client that was geared toward her therapy. QMHP explored client’s inability to think positive despite things going on around her. QMHP modeled to client how to use the “Think Tactic” to allow herself time to improve her poor impulse control. QMHP reinforced the importance of decreasing hyperactive and aggressive behaviors, controlling anger, following instructions and respecting authority figures at home, school and community. Probing and unconditional positive regard were used in conjunction with warm acceptance to gather client’s perspective during today’s session. Intervention: QMHP used role-reversal with client to allow her a chance to openly express herself as well as see how she is viewed in the eyes of others when she is verbally and physically aggressive towards them. QMHP used active listening as client discussed the importance of respecting authority figures and controlling her thought process at times. QMHP then modeled to client appropriate ways to follow instructions without getting an attitude. QMHP engaged client in discussion regarding her disrespectful behaviors within the home. QMHP processed with client the importance of controlling her actions and thinking before speaking. QMHP then processed the previous therapeutic assignment in which she encouraged client to practice using low voice tones when conversing with authority and document her response to the activity in her daily journal. Response: Client acknowledges she needs to work on her temper and controlling her anger. Client is supported making the right choices and staying out of trouble. Client responded well to feedback and discussed some things she can do better when it comes to new challenges. Client agrees to follow directions the first time they are given even if that means she has to stop doing something she likes. Client was acceptive of prompts given by QMHP. Client agreed to listen to the adult and follow all rules no matter if she sees someone else breaking them. Client is reminded to tell her mom if she is having trouble at school so that she doesn’t go into the community in a bad mood or come home frustrated. Client said she was aware of her expectations and what she is expected to do each day to be successful. Response: Although client has difficulty staying focused in the session sometimes, she understands a lot of the information taught in the session helps her with her anxiety and has implemented the skills in the home this week. Client did a good job maintaining appropriate behavior in the session, utilizing the correct voice volume and displaying positive body language the entire time. Client practiced some of the examples of alternate behaviors (e.g. closing her eyes and thinking about happy memories, repeat positive “I-statements”, and ask questions that will help her understand things better) at home when she felt stressed out or upset. Client communicated that she wants to work independently instead of as a family some days so that she could gain clarity of her personal feelings without taking it out on anyone.