1/16/2023 EnchantaVaughn Approved 1. Behavior: Client expressed little interest in coming to her session today. Client shared that she was not in a good mood. Client frowned up her face and looked away from her counselor. Client expressed sadness and disappointment. It is evident that part of clientâs mood stems from lack of support and affection from her social network. Client reframed from engaging in conversation and tried to cover her face and ears, so she wouldnât have to listen. Client refused to pay attention, as observed. Client fails to exhibit age appropriate behaviors in the home. Client continues to avoid mental health counselor prompts and directives and is encouraged to be respectful and understanding that everything will not be resolved overnight and to be a little more patient with services while everyone is adjusting their schedules due to the pandemic. 2. Behavior: Client continued to give Mom and QMHP a hard time after being asked to participate in the assigned activity. Client was standoffish and distant, ignoring debriefing and refusing to communicate her feelings when inquired about why she wasnât participating. Client often displays frequent outbursts when things donât go her way. Client becomes easily annoyed. Client reacts by shutting down and displaying attention-seeking behaviors, such as making inappropriate noises and talking loudly. Client avoids wanting to listen to information being shared, as she began to pout and roll her eyes at the QMHP. Client discussed things she would like to do over what the QMHP instructed her to do. After about 15 minutes of reflective thinking, client was given a break and directed to deep breathe, stretch, and regroup so that she can finish the activity. 1. Intervention: QMHP greeted client and assessed her behaviors and mood. QMHP inquired about clientâs day and provided affirmations. QMHP probed about any angry feelings or the inclination of safe and unsafe behaviors. QMHP probed client about certain behaviors and how she sometimes feels like the only way to respond is in a negative manner. QMHP redirected client negative behaviors. QMHP intervened aggressive behavior and motivated client to act in a civilized way. QMHP educated client about using good manners at home and offering alternative methods and suggestions to model appropriate language that client should use to ask for things or to get someoneâs attention. QMHP processed client feelings and offered choices of what to do when faced with conflict or challenged in the home setting. 2. Intervention: QMHP facilitated a family discussion to talk about common mistakes children with ADHD make and how she can make better choices. QMHP utilized a reflective thinking exercise to help the client better understand and identify her triggers and stressors. QMHP revisited with client about respecting others and discussed applying polite words when asking for help. QMHP discussed anxiety and explained it is a normal part of life. QMHP gave client the opportunity to open up and share her feelings. QMHP communicated active listening skills. QMHP educated client about sharpening her senses and utilizing problem solving techniques daily. QMHP worked with client to reduce or eliminate harmful and hostile manner, within her daily functioning life. QMHP will provide client with support and encouragement as needed. 1. Response: Client initially presented with talkative behaviors as she probed the QMHP and asked different questions. Client exhibits a non-responsive attitude when reflecting on her day. Client reduced impulsive behaviors after 2-3 prompts from her mother and QMHP. Client began to show greater control of her anger. Client appeared to decrease the intensity of her anger and frustration. Client was pleasant and cooperative and demonstrated a willingness to discuss the factors contributing to her undesirable mood from earlier. Client acknowledged that she tends to feel overwhelmed when asked to complete extra responsibilities and chores around the house. Client practiced some of the examples of alternate behaviors within the home immediately following her reevaluation and understanding of her needs as an ADHD recipient. 2. Response: Client demonstrated minimal progress during this session. Client failed to identify her triggers and stressors. Client reframed from answering QMHP questions. Client was filled with mixed emotions. Client is working on walking away and telling an adult before responding to anger provoking situations. Client understands that problem solving starts with thinking before acting. Client was anxious to transition into the psycho social activity. Client did not demonstrate any unsafe actions by trying to hit or attack others. Client is observed correcting her mistakes and making good choice. Mom shared client has made some major improvements but wants her to put some effort into building more virtual friendships, finding a hobby, and being more independent in the home.