4/11/2023 EnchantaVaughn Approved (AM) Upon arrival, client was observed entering the classroom displaying hyperactive behaviors due to excessive noise and running around his seat. Teacher described that client was a little off and needed a morning break. Client was taken out of his environment to engage in a 20 minute break with his counselor. Client was offered to create a coloring book and to utilize his calming techniques by counting to ten and reflect. Client was given a rubber bracelet to use a stress reliever aid and to convert to it when he feels himself getting on track again. QMHP insisted that the bracelet be a motivator and not a distraction. Client was reminded to have a good day. (PM) Client joined class in lunch room with more cooperative manners by being polite to peers and staff and following directions. Client went back into academic setting refusing to listen to his teacher. Client was prompted several times to go to his correct station. Client refused to join his group and decided to do an activity of his choice. Client was redirected to participate with the class. Client was given an opportunity to refocus and make better choices. Client did not want to reflect with his counselor and stated he wasn’t coming. Client began banging on the door and interrupting teacher while she was giving instruction. Client would not stop making noise and continued to disrupt the class while they were trying to learn and complete their work. Client started throwing pencils and paper across the room. Client was observed hitting other students in class who were trying to get him to be quiet. Client was aggressive and defiant and counselor contacted administrative and parent. Client was called for early release and given a referral for possible suspension. (EOD) Client dismissed from school in a more content and calm way, displaying appropriate attitude. Client did not meet any objectives today, as evidenced by negative behaviors and poor conduct. (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.