1/26/2023 EnchantaVaughn Approved 1. Behavior: Client appeared to be in a joyful mood, as evidenced by client smiling during conversation with mother. Client was excited, indicating he was going to have a good session. Client displayed affection toward mom when she left the room. Client utilized the positive reinforcers provided by mental health professional by avoiding conflict and communicating positive thoughts. Client displayed good social behaviors, as evidenced by increased interaction and being a good example to his siblings. Client displays age appropriate skills during one on one; avoiding conflict, staying on task and focusing on achieving his goals. The client was supported as he focused on the part of himself that wants to get better. As the client was provided with a calm environment and reassurance that he would be cared for, his level of agitation has decreased. Client shows he is capable of being responsible and was supported for his contribution and cooperation in the home. Client reflected on his day, the good and the bad. Client communicated that he spends a lot of time playing video games and playing outside. Client was excited to start the psycho educational activity. Client sat quietly and waited for instruction. Client demonstrated good conduct, adhering to home rules and making a good first impression. As the client builds rapport with QMHP he was seen listening and giving positive feedback. Client was happy to be in a good space today and thanked QMHP for the support and caring about him even when he messes up or say mean things. 2. Behavior: Client volunteered to read the instructions of the next activity. Client stated he enjoys being a leader and wants to continue taking turns reading and reviewing the lesson. Client was happy he could show his intellectual side, despite being all over the place yesterday. Client displayed pleasant social behaviors during activity. Client was polite and attentive at this time. Client displayed interest in session by debriefing and answering appropriate questions. Client demonstrates a positive attitude and is seen participating in discussion and getting to know QMHP. Client was a little hyperactive at first but as time went by he became more open and relaxed. Client shared his experiences and hobbies. Client explained his needs and things he has difficulty with at home and asked if his counselor would help him. Client was happy to have a counselor at home, as well as, having day treatment counselors who assist him at the summer program. Client expressed love and joy with supporting others and helping mom as much as he could with the circumstances and limited outside time. Client needed minimum redirection or instruction and was able to maintain appropriate conduct and express positive thoughts about the session. Client remained in a happy mood for the remainder of the session. Client did not need any further support with managing his symptoms, due to displaying excellent manners and high self-esteem throughout the day. Client was suggested to take a small break before going back to the home setting in order to cool off and present relaxation and calming skills. Client presents pleasant behaviors while transitioning back to his normal routine. Client told mom he had fun and enjoyed his day with QMHP. Client was happy his counselor spent time with him today and couldn’t wait till the next visit. 1. Intervention: QMHP demonstrated and provided positive acceptance, as she attempted to reestablish a mutual and trusting relationship with the client. QMHP processed with client to gain a better understanding and identify stimulus that triggered his angry emotions. QMHP reviewed with client conflict resolution skills through instruction, modeling, role-playing, and behavioral rehearsal. QMHP will continue to assist client with managing anger and frustration by reviewing and role-playing effective coping skills. QMHP assisted client in creating a journal where he could record his thoughts and feelings whenever he didn’t want to talk about them in person. QMHP reminded client that each session is focused on helping him move forward with his goals. QMHP reviewed examples of alternative appropriate behaviors he could engage in. QMHP discussed with mom about client’s involvement during their session and how much improvement is noticed when client is calmer and relaxed. QMHP modeled how to show client more support. QMHP discussed ways to increase more positive coping mechanisms and how to display more positive behaviors. QMHP had one on one with client. QMHP explored positive behavior options he was exhibiting with client to support his willingness to continue to make good decisions and display appropriate behaviors in the home. QMHP processed client’s thoughts and feelings. QMHP inquired about evening routine and previous activities. QMHP encouraged client to utilize positive self-talk as a means of decreasing anxiety and managing frustration when encountering difficult or challenging circumstances. QMHP talked to client about his confidence levels and how they can affect his day and self-esteem. QMHP praised mother for showing more consistency and efforts with assisting her son in understanding how to follow rules in order to increase his interpersonal and coping skills in the home. 2. Intervention: QMHP inquired about client’s morning routine and what he does to get ready every day and to prepare for his session. QMHP offered active listening skills. QMHP monitored client individualized behavior modification through collaboration with mother. QMHP educated and practiced with the client on using breathing techniques and other anger management skills to assist him with maintaining a calm spirit. QMHP assisted client in monitoring his own behaviors in efforts to promote exercising self-control in focused areas such as respecting boundaries with others. QMHP modeled proper positive behavioral expectations for the client. QMHP reiterated with mom the importance of maintaining a healthy relationship with his peers by allowing client to make new friends and be his own person, without feeling he has to fit in with the others who are not displaying good behaviors or being nice. QMHP praised client for his commitment in trying to meet his objectives. QMHP practiced more approaches that mother could use in order to make sure that client remains positive and happy in the home. QMHP encouraged client to refrain from displaying negative behaviors towards his mother, to talk calmly, and express himself without an attitude. QMHP modeled proper positive behavioral expectations for the client to encourage additional layers of support and understanding of rules and expectations. QMHP provided mom with at home strategies to practice with client in case the behaviors that persists become uncontrollable or overwhelming. 1. Response: Client demonstrated positive acceptance back to QMHP. Client have been showing more respect to the adult staff and showing his appreciation for therapy. Client expressed non-aggressive emotions and showed respect to his counselor when asked questions about trust. Client verbalized good thoughts and understanding. Client developed better communication skills by expressing himself in a calm manner. Client displayed management of individualized behaviors. The client has not overreacted with anger to minor frustrations or irritants. Client responded in a pleasant manner acknowledging the positive reinforcement that the QMHP provided. Client was able to reevaluate himself and display a more positive attitude toward peers and authority. Client has become more involved in age appropriate social activities and was given positive reinforcement for these choices. Client demonstrated expectations and responded well to feedback. Client reported a decreased stress level due to his modulation of social contact, and the success of this was reviewed. Client responded well to QMHP and appeared thankful for the help and support. Client shared some of his favorite things to do and places to go that could accommodate his specific needs. Client hyperactive and impulsive behaviors were reduced, and symptoms of ADHD are stabilized. Client indicated that he was going to try his best to work with QMHP and be open to new things and promised to let mom or QMHP know when he felt overwhelmed in session. Client verbalized that he’s able to focus better when it is quieter and more peaceful. Client expressed excitement, demonstrating mindfulness and seemed to be motivated to observe closely in social environments. Client implemented good communication skills by listening attentively and closely. 2. Response: Client communicated that he wakes up early, washes his face and hands, and plays with his brother and sister. Client also mentioned that he reviews his objectives and the previous homework with mom so that he can receive an incentive for his commitment and hard work. Client was receptive to the education and training. Client gained knowledge about following directions the first time and being a good listener. Client demonstrated good social skills and ability to get along with others. Client expressed positive self-talk, modeled positive behavior, and good communication skills during role play activity. Client responded well to feedback, interacting well with everyone. Client agreed to behave at home more often. Client communicated a positive attitude when reviewing problem solving and self-control strategies. Client promised he would try his best to correct himself when faced with conflict. Client learned to avoid negative and defiant behavior and comply to rules. The interventions were noted successful and making a difference, as the client displayed new habits and routines. Client communicated positive thoughts about himself and others. Client was excited. Client was cooperative and compliant. Client displayed appropriate social skills. Client was sociable and friendly in regard to the QMHP support. Client have adapted and is observed modeling appropriate behavior. Client wished he had more friends at home and in the program. Client plans to start building more relationships with his peers. Client was happy and in a good spirit throughout the entire session. Client displayed positive expressions and maintained good tone when communicating with QMHP. Client was respectful and polite, utilizing acquired skills provided by QMHP to share his ideas when answering questions during one on one. Client was seen following directions. Client and his mother reported that they understood the importance of working towards his goals and objectives daily at home.