1/6/2023 EnchantaVaughn Approved 1. Behavior: During home visit, client mental state was observed as, intolerant and defensive, as it was reported by the mother that client was not having a good day. Client displayed angry outbursts and lashed out at QMHP when inquired about why she was having a bad day. Mom explained that client have stayed in her room all day and refused to eat or talk to anyone. Client looked lost in her own thoughts and feelings, as she demonstrated a persistent failure to comply to the rules and expectations and respect for QMHP within the session. 2. Behavior: Client ignored the instructions and directives of QMHP while showing a lack of empathy and compassion towards authority figures within therapeutic surroundings. Her mom explained client has been showing off recently and engaging in difficult acts and mistreating others in the home. Mom expressed that she talked to client several times to straighten her up, but the behaviors continue throughout the day. Client have been having episodes while mom was communicating with the QMHP about her negative choices. 1. Intervention: QMHP modeled effective ways to communicate by exploring more ways to discuss problematic behaviors. QMHP assisted client with recognizing and exploring triggers of her impatience. QMHP encouraged client to continue documenting people and situations that evoke anger or aggressive behaviors. QMHP utilized active listening skills while probing client about situations that provokes her anger. After processing with client, she was redirected to continue exploring feelings and ways to conduct herself appropriately in the home. 2. Intervention: QMHP encouraged client to listen to her mother. QMHP established alternative responses that are more appropriate than ignoring an adult. QMHP explored non-verbal activities that can still benefit client without causing her to shut down and give up on her therapy. QMHP will review actions and consequences, as it pertains to home rules. QMHP intervened to prevent the negative behaviors from happening and encouraged client to keep following her treatment. 1. Response: Client was assisted in practicing general communications skills around her family. Although, client did not respond as information was shared on anxiety and stress. Client understood that when she becomes agitated she needs to refrain from taking it out on people and to communicate how she is feeling. Client reported to QMHP that she doesn’t like the way the world is right now with her being separated from her friends and wish things could go back to normal. Client blames her mental illness for her attitude, mood, and behaviors. 2. Response: Client stated that she doesn’t intend on being negative and agrees she need to work on controlling and channeling her anger, as well as, listening and communicating her feelings better. Client understood how communicating effectively and assertively could help her resist the urge to have negative episodes. Client also understood the examples that were provided by her counselor. Client’s mom verbalized that she will increase the level of communication with client to figure out what is causing her to act out so often.