4/14/2023 EnchantaVaughn Approved (AM) Upon arrival, client was observed in class listening and following directions. Client appeared to be in a focused mood, as evidenced by him paying attention in class and facing forward in his seat. Client was observed listening to his teacher. Client participated in group and individual activities, displaying age appropriate behaviors. Client expressed a positive attitude toward peers. Client was supported for his cooperation and making good choices. (PM) Client transitioned to lunch smoothly and correctly, without pushing and shoving. Client was monitored in lunch waiting his turn to pick up his food. Client communicated a respectful and polite tone saying please and thank you. Client reframed from impulsive and hyperactive behaviors and praise was given. Client was able to sit in his seat and keep his hands to himself. Client returned to class to engage in a team building exercise and was seen interacting well with others and being a team player. (EOD) Client was applauded for being responsible and for conducting himself appropriately. Teacher reported client was doing well and did not require redirection. Client seems to be calm and content while in class by working quietly and staying on task. Client has shown improvement and progress in school while benefiting from TDT services due to improving his anger management and complying with rules and expectations. Client dismissed safely from school, meeting 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.