10/24/2023 EnchantaVaughn Approved (AM) Upon arrival, client was observed joining his peers in the breakfast line and displaying appropriate manners while entering the school building. Client social behaviors were monitored and supported. Client waited for teacher directives while sitting quietly at his desk. Client was noticed having difficulty with learning new information in his class. Client has exhibited oppositional defiant behaviors due to new class changes. Client was upset about the changes because he feels that he does not have the knowledge or experience that his peers obtain in their classes and work. Client has refused to listen giving all authority involved a hard time, displaying a negative attitude and not complying to simple instructions. (PM) Client presented himself with low confidence and expressed insecurity and discouragement throughout day, stating he didn't want to switch his routine. Client was educated that this was a privelege not a choice and motivated to atleast give it chance. Client was witnessed transitioning into new studies without being disruptive. (EOD) Client was able to reevaluate the situation and look at the positives. Client began working on his assignments and raised his hand when he needed one on one help. Client was cooperative and verbalized positive feelings about the new activities. Client seemed to adapt to new changes. The client energy level has increased due to engaging with classmates and working as a team. Client was praised for being able to put aside his pride and implement new social skills (i.e. positive self talk and empathizing with others), achieving objectives 1 and 2, but need to work on objective 3 when faced with new challenges. (AM) QMHP welcomed client to school. QMHP inquired about evening and morning. QMHP asked how client was feeling. QMHP asked if client needed help with anything. QMHP prompted client to have a better attitude. QMHP redirected client to get back on task. QMHP explained to the client that he's smart and have a lot of potential. QMHP reminded client of his personal strengths and encouraged client to have an open mind. (PM) QMHP monitored individualized behaviors for acquisition of objectives. QMHP encouraged client to be the example for others who are also struggling with new changes. QMHP encouraged client not to follow others he see that are doing wrong and to make positive choices. QMHP reminded client of goals and objectives. QMHP intervened to assist in explaining behaviors to client and what he needs to work on if he wants to meet his academic expectations. QMHP explained to client how proud she was of him trying. QMHP expressed compassion and gratitude. (EOD) QMHP supported client with being on task and displaying appropriate manners. QMHP reflected with client on his day, reviewing both good and bad experiences. QMHP processed with client, "what would you do different tomorrow”. QMHP encouraged client to take advantage of new learning opportunities while expressing the importance of third grade education. QMHP encouraged client that tomorrow is a new day. QMHP processed client positive feelings and reinforced positive behaviors. (AM) Client greeted QMHP by saying good morning. Client stated he spent time with family yesterday and ate a healthy meal for dinner. Client stated he was feeling fine. Client expressed concerns with increasing his workload. Client was not on track with goals and objectives, due to being off task. Client did not feel the same way and admitting that he would rather go home. Client was not acceptive of constructive criticism. (PM) The client was provided with support and feedback as he displayed a realistic understanding of his recurrent pattern of mental illness symptoms. Client demonstrated self control. Client followed the right behaviors. Client has a clear understanding of goals and objectives and agrees to focus on meeting academic expectations. Client was able to recognize his role and conducted himself accordingly. (EOD) Client communicated that he's comfortable with being in his IEP class because the environment made him feel like a leader. Client shared his feelings and concerns. Client acknowledges both good and bad experiences. Client said he was going to try his best to take his third grade year more serious because he wants to do well in school. Client acknowledged the positive reinforcement given by QMHP while reflecting a positive mood.