4/10/2023 EnchantaVaughn Approved (AM) Upon arrival, client was observed laughing and smiling with peers as he entered the school building. Client appeared to be in a good mood, as evidenced by his upbeat and cheerful spirit. Client was sent to class to begin his work. Client got put out of class during test time for blurting out and being disrespectful to his teacher. Client expressed that he was asking for a divider for his table. Client was encouraged to follow rules and expectations in class by raising his hand and waiting to be called on. Client was acceptive and grabbed his journal to self reflect. Teacher reported he asked client to wait out in the hallway and do not appreciate client walking away without permission. Client had one on one with QMHP about classroom management and following directions. (PM) Client was observed in lunch displaying appropriate attitude. Client was observed displaying appropriate behaviors. Client was monitored and supported for conducting himself appropriately. Client entered his session with a positive attitude. Client was seen building rapport with QMHP. Client interacted well with his group members during team building exercise. Client expressed positive thoughts about the activity, making insightful comments. Client was engaged in group discussion, giving good feedback to others while they shared their work. (EOD) Client returned to class to prepare for dismissal. Client was observed in his seat and on task. Client was praised and rewarded for having a good day and achieving all objectives. (AM) QMHP will teach client necessary coping skills to decrease impulses. QMHP will brainstorm strategies with client and encourage self monitoring. QMHP will assist client with self monitoring skills to enable him to participate in fundamental learning. QMHP will provide mediation and relaxation techniques. QMHP inquired about after school activities. QMHP will collaborate with teacher regarding behaviors and performance. (PM) QMHP applauded client for being the bigger person. 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 encouragment. 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 will educate client on behavior modification to help client identify what behavior he need 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 communicated positive affirmations and self talk. Client utilized self monitoring skills in class. 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. (PM) 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 her modulation of social contact, and the success of this was reviewed. (EOD) As the client developed understanding of academic expectations, she reported increased satisfaction and function. Client responded well to feedback, interacting well with others. Client implemented her plan for restoring relationships, and this was reviewed.