3/22/2023 EnchantaVaughn Approved (AM) Upon arrival, client was observed grabbing breakfast and walking quietly to his class. Client was in a great mood, as evidenced by his smile and positive energy. Client was observed in his seat and listening to announcements. Client was seen turning in his work and joining peers in a team building exercise. Client gave full participation by following along with instructions and contributing to group discussion. Client was praised by teacher and counselor for displaying age appropriate behaviors and making good choices. Client was encouraged to keep up the good work. (PM) Client transitioned to lunch without interruptions, displaying polite and respectful manners to peers and staff. Client avoided pushing and shoving in line. Client was able to sit with his class without exhibiting hyper activeness or getting out of his seat. Client was observed playing well with his peers and engaging in positive conversation. Client transitioned to session to participate in a group intervention. Client was in a good mood. Client was observed practicing positive behaviors. Client reduced disruption by utilizing proper voice volume and staying on task. (EOD) Client walked back to class. No incident were reported. Client expressed positive thoughts about himself and others. Client was coping well with stressors and was very productive in class. Client was monitored and supported for displaying appropriate manners towards peers and authority. Client prepared for dismissal. Client ended the day on a good note, achieving all objectives. (AM) QMHP observed client in the classroom in efforts to determine whether he required assistance. QMHP enhanced knowledge of a consistent daily routine. QMHP provided positive gestures to encourage client to verbalize positivity with peers and authority. QMHP inquired about medication regimen to ensure appropriate self functioning. QMHP enhanced food management skills by encouraging client to bring healthy snacks from home as an alternative for lunch. QMHP expressed understanding of self care and personal hygiene. QMHP offered praise and positive reinforcement to enhance self esteem and sense of achievement. QMHP probed sense of empowerment by communicating positive self talk. (PM) QMHP taught basic problem-solving skills. QMHP increased discipline for inappropriate behaviors. QMHP engaged client in conversation regarding his recent choices, progressions, and setbacks. QMHP utilized empathetic listening skills as client expressed his feelings. QMHP processed client’s responses and gave appropriate feedback. QMHP helped client discover positive outlets of expression and using creativity to avoid negativity. (EOD) QMHP reminded client of his goals and objectives. QMHP explored positive behavior options he was exhibiting with client to support his willingness to continue to make good decisions and have positive behaviors in school. QMHP encouraged client to reframe from displaying defiance of authority toward teachers, to talk calmly and express himself without anger and frustration. QMHP talked with client about the importance of adhering to rules and expectations in school, at home, and in his community. (AM) Client smiled as he saw QMHP's positive gestures. Client continued to work on the classroom activity. Client continued to interact in a positive manner with his teachers and classmates. Client nodded in agreement. Client demonstrated understanding. Client discussed the reasoning behind his negative behaviors towards others with QMHP. Client agreed that he would refrain from displaying negative behaviors towards his teacher. Client calmed down and went into his classroom. (PM) Client required additional redirection from QMHP to get him to focus on the classroom assignment. Client was able to settle down and return to classroom activity. Client was responsive to teachers lesson. Client acknowledged that he tends to engage in disruptive behavior when he begins to become frustrated with schoolwork. Client accepted responsibility for his angry outbursts and aggressive behaviors. Client stated he will display anger control and not threaten or intimidate others. (EOD) Client was observed and reported to have been pleasant and cooperative during classroom activities and demonstrated a willingness to adhere to school and classroom rules and expectations. Client listed 3-4 classroom behaviors that he was going to utilize in efforts to remain positive behaviors. Client appeared to be receptive to recieving positive reinforcement from his teacher as demonstrated by his smiling and inviting body language. The frequency and intensity of the client's defiant affect decreased. Client dismissed without incident.