4/13/2023 EnchantaVaughn Approved (AM) Upon arrival, client was seen a his desk and displaying a good attitude. Client smiled pleasantly and was respectful toward peers and authority. Client was observed fully participating in classroom activity. Client appeared to be focused and attentive to his work. Client exhibited an energetic attitude in class while receiving assistance from teacher and peers. Client demonstrated appropriate social skills. Client required 0 prompts of redirection by QMHP. (PM) Client displayed a positive attitude in lunch and session. Client was friendly and exhibited a positive demeanor. Client displayed appropriate conduct at lunch table. Client was seen complying to rules and demonstrating appropriate manners. Client continued to maintain positive behaviors and impulse control in structured setting. Client displayed an acceptable level of participation during assignment. Client is observed getting along with peers and treating others fairly. (EOD) Client is supported for having a good attitude throughout the day. Client demonstrated good teamwork and listening skills. Client was reported to be respectful toward teacher and peers. Client expressed positive comments about himself and others. Client shows ability to handle his emotions and communicate his feelings. Client was cooperative going into dismissal. Client was supported for his cooperation and achieving 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 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.