4/2/2023 EnchantaVaughn Approved Behavior: Upon arrival, client was confronted by her mom for talking back when she asked her to clean up and get ready for her session. Client was sent to have one on one with her counselor immediately following this altercation. Client tried to lie about talking back and said her mom was only mad because she was making a lot of noise in the house. Client finds herself off task and interrupting QMHP, indicating she wasn’t aware of her misbehaviors and misconduct. QMHP also begin discussing with parent and client the discharging planning process. Behavior: After reviewing ISP, client shows difficulty in following home rules often choosing to act out on purpose. Reinforcement was provided to client during psycho educational. Mom also reports that client refuses to listen to her or do what she’s asked, and it has become toxic in the home displays outbursts when confronted about negative behaviors she displays, as if she’s not responsible for these concerns. It is evident, client lacks respect for authority figures and cannot admit when she’s wrong. Intervention: QMHP observed client in session in efforts to determine whether she required assistance. QMHP engaged client in a conversation regarding her recent behaviors, progressions and setbacks. QMHP monitored progress in demonstrating individualized pro-social skills (e.g. anger management, problem-solving, conflict resolution, appropriate verbalization of feelings, and cognitive-behavioral programming). QMHP talked with client about the importance of adhering to rules and expectations at home and in the community. QMHP provided mother with a list of resources to continue to assist her in the community setting and home setting as client has made moderate progress. Intervention: QMHP held consultations with client and mom about effective intervention strategies that build on the client's strengths and compensate for her negative behaviors. QMHP explored client’s responses and responded accordingly. QMHP assisted client with problem-solving skills. QMHP encouraged client’s mom to provide frequent positive reinforcement in helping her complete her objectives daily. QMHP encouraged client to practice relaxation and coping techniques in social/virtual environment as often as possible. Response: Client engaged in self-reflection, discussing good and bad parts of her day. Client communicated that she wants to work independently. Client modeled different ways to walk away from a conflict when frustrated. Client demonstrated that she was able to process productive expressions of anger. Client exhibited how to verbalize her feelings without yelling and being aggressive, which allowed others to show empathy and support regarding her emotions. Family was in agreement with the information provided by QMHP for her upcoming discharge planning. Response: Client was observed in session utilizing and learning new interventions and strategies with her family. Client realized her mom was trying to help her by pushing her to try first and then get more help from counseling. Client appeared to be learning from her mistakes and correcting them while QMHP went over her treatment plan with her mom and discussed information that provoked behaviors from today. Client learned to avoid negative and defiant behavior and comply to rules.