1/18/2023 EnchantaVaughn Approved (AM) Upon arrival, client was seen preparing for morning routine. Client was observed in class working on an assignment along with his peers. Client appeared to be in studious mood, as evidenced by his focus and concentration in class. Client displayed a positive attitude while waiting for teacher to start the next activity. Client was acknowledged for his patience. Client was observed in his tutoring class listening and following directions. Client was praised for being a responsible student and for initiating his assistance. Client earned “student of the day” for going above and beyond. Client was seen transitioning into lunch with excellent manners, holding the door for others and using proper voice control. Client was observed exhibiting good table manners, cleaning up his trash and holding meaningful conversations with his peers. Client was praised for making age appropriate choices, such as walking in a single file line, listening to authority, and helping others. (PM) Client is supported and monitored in the lunch room displaying appropriate behaviors and standing in line without pushing and shoving peers. Client displays appropriate manners toward cafeteria monitors by saying please and thank you. Client is seen interacting well with his age group and respecting peers personal space. Client demonstrates a good attitude while transitioning to therapy session. Behaviors were maintained and managed at this time. Client displays the correct manners at the lunch table. Client is seen conversing with peers and contributing to feedback. Client was observed following rules and being compliant of the reinforcement provided by administrative and TDT staff. (EOD) Client was observed in class listening and following directions without disruptive behaviors. Client appears to be in a good mood. Client remained on task and attentive to his work. Client avoided conflict and sadness. Client utilized his time out of class to build relationships with other students apart of the ADHD population. Client understands that the difference between him and the others kids are his choices. Client is observed laughing and smiling with peers and working as a team. Client returns to class to complete the rest of his assignments. Client was monitored in academic setting displaying age appropriate skills and reframing from outbursts. Client achieved his objectives. (AM) QMHP will teach client necessary coping skills to decrease impulses. QMHP will brainstorm strategies with client and encourage self-monitoring. QMHP will provide mediation and relaxation techniques. QMHP inquired about after school activities. QMHP will collaborate with teacher regarding behaviors and performance. QMHP applauded client for being the bigger person. QMHP modeled language for client to use while in school, home and in the community that will promote pro-social behaviors and effective communication. QMHP reiterated to client the benefits of following the rules and of the privileges he can receive when he does so. QMHP assisted client with identifying privileges that he would like but does not receive due to his negative behaviors; in efforts to stimulate his thinking about cause and effect of his behavior choices. (PM) QMHP provided simple non-verbal praises as client was observed displaying positive classroom behaviors. QMHP trained client in taking steps to prevent problems including displaying positive classroom behaviors. QMHP refocused client as he was observed becoming fidgety and restless. QMHP will review and give feedback regarding ADHD and its causes and affect toward client well-being and academic functioning. QMHP will provide client with support and encouragement. QMHP will monitor, observe, and redirect client behaviors as needed. QMHP will build rapport. QMHP will explore positive self-talk, use instruction modeling, and increase social communication skills with positive reinforcement role play activities. (EOD) QMHP used positive regard as he told the client that he appeared to have positive classroom management in class earlier in the day. QMHP informed client of more acceptable and expected responses to classroom and hallway situations that would normally lead client to be triggered and display inappropriate, negative behaviors while in the classroom or hallway. QMHP will educate client on behavior modification to help client identify what behavior he needs to decrease and avoid daily. QMHP will utilize behavior modification system to aid the client with following directions given by authority figures. QMHP will meet with client daily to discuss progress and expectations that are working and not working in school daily. (AM) Client utilized coping skills and impulses started decreasing. Client was observed strategizing a plan to better himself by writing down his thoughts and feelings and exploring his creative side with arts and crafts. Client was taught to deep breathe until he is ready to process his feelings. Client was reported displaying age appropriate behaviors and was productive and studious throughout the day. Client thanked QMHP for the support and assistance and helping him stay on track with his goals and objectives. Client was able to be redirected successfully. Client stated he would try better self-management as the day pursues. Client was able to contain impulsive actions. Client was observed having positive interactions with peers and mental health professionals. (PM) Client demonstrated responsibility and leadership. Client was acceptive of redirection. Client was able to complete his classwork with less than 3 prompts to redirect his focus to the classwork. Client showed an improvement from previous days experiences in the classroom with client. Client showed interest in building interpersonal relationships with peers and authority to increase support system. Client expressed positive self talk, modeled positive behavior, and good communication skills during role play activity. (EOD) Client learned to avoid negative and defiant behavior and comply to rules. Client was seen following directions. Client joined session to utilize and learn new interventions and strategies. Client expressed appreciation to QMHP by smiling and giving good eye contact. Client expressed that he should receive an incentive for his display of desirable behaviors throughout the day. Client did not engage in any disruptive activities or behaviors. Client was able to maintain his composure when he was confronted with the potential for conflict. Client was observed engaging in several conflict resolution skills with peers by walking away and telling an adult first. Client demonstrated more acceptable responses, avoiding anger provoking situations in the classrooms and hallways.