5/11/2023 EnchantaVaughn Approved (AM) Upon arrival, client was witnessed walking in class in a productive and positive mood. Client started off his morning on a great note. Client maintained productive and collaborative behaviors going into social activities. Client on-task behaviors were reduced, as seen not being polite or respectful to his peers. Client got into an altercation with another student during class. Teacher communicated that he may have been provoked and he does not back down to anyone. Client was reminded to utilize his relaxation strategies, such as staying calm and walking away. Client agreed that he could have responded differently but expressed the boy was bothering him first and he was doing his work. Client was educated that people are going to test him and try to distract him when he’s doing good and he has to be wise enough to ignore it. Client understands his expectations and promises to work on staying calm so that he won’t be involved with any other incidents. Client tend to get off track when trying to be involved with situations outside of his own. Client had trouble working with peers during team building activity, as reported by teacher. Client continues to get frustrated when people pick on him in class and have a hard time ignoring distractions. Client has attempted to maintain expectations within the classroom when unsupervised. Client models great listening skills once he focuses his attention back on his work. Client went to lunch without hyperactive behaviors and appeared more calm and relaxed during this time. (PM) Client transitions smoothly and safely to session area, displaying appropriate behaviors. Client greets his group members and waits for instruction. Client expresses good statements about turning his day around, using his manners, and processing his thoughts and feelings. Client is more confident in group setting, as evidenced by his high level of participation. Client have been doing a better job controlling impulsive and hyperactive behaviors, due to the positive reinforcement provided by QMHP. Client reduces sadness and finds more excitement in learning and being a leader around his peers. Client seem less aggrivated and more content with reflecting on his day, due to earning points for good behavior and wanting to be recognized for his growth and development and huge turn around in school this year. (EOD) Client returned to academic setting in a confident manner and went to his seat to finish his work. Client was seen interacting well with his peers and being respectful in class. Client is allowed to sit on the carpet as an alternate calming area and this have been increasing good behavior, as well as, pushing him to concentrate and focus on his work. Client communicates happy thoughts and feelings about his day in school and continues to display appropriate social skills. Client have been displaying excellent commitment with achieving objectives 2 and 3, but did not obtain objective 1. (AM) QMHP observed client while in the classroom in efforts to determine the need for intervention. QMHP was informed of the clients behaviors. QMHP reviewed the reported behaviors with client in efforts to allow him to express his point of view. QMHP encouraged client to list alternative behaviors he could have participated in. QMHP provided a positive hand gesture such as a thumbs up in efforts to show approval of clients current actions. QMHP did not have to redirect client. QMHP will continue to assist client with managing anger and frustration by reviewing and modeling effective coping skills. QMHP processed and explained the process and importance of coping skills. QMHP prompted client to identify one coping strategy he uses when he becomes upset or frustrated. QMHP processed and explained the effects of positive coping mechanisms with client. (PM) QMHP observed client as he walked through the hallways with his classroom being led by his teachers. QMHP stated simple praises to client as he walked past. QMHP will continue to offer postive reinforcement when observing client adhering to his ISP objectives. QMHP observed client in his classroom in efforts to assist with any negative behaviors towards his classmates or his teachers. QMHP did not have to intervene with clients behaviors as he demonstrated adherance to classroom rules and expectations. QMHP encouraged the client to respect his teacher. QMHP reviewed school rules and expectations with client before walking him into his seat, ensuring that he was safe and comfortable. (EOD) QMHP informed client that he has been showing a lot of improvement in efforts to support his accomplishment. QMHP provided strategies such as positive reframing. QMHP assisted client with practicing reframing negative thoughts with more positive thoughts in efforts to reduce impulsive reactions throughout the day. QMHP implemented positive mantras with client, reminding him to process his ISP objectives. QMHP thoroughly explained negative consequences for negative behaviors. QMHP reviewed expectations while transitioning with client to evening specials. QMHP prompted the client to be mindful of his behaviors and how they affect others. QMHP supported client with packing and putting away his supplies. QMHP was informed that client dismissed without incident by his teachers. (AM) Client transitions smoothly and safely to session area, displaying appropriate behaviors. Client smiled as he saw QMHP's positive gestures. Client greets his group members and waits for instruction. Client expresses good statements about his day saying he was doing his work, using his manners, and being fair to others. Client is more confident at school, as evidenced by assertive and proud tone. Client have been doing a better job controlling impulsive and hyperactive behaviors, due to keeping his hands to himself and staying in designated area. Client reduces sadness and finds more excitement in learning about the events associated with bringing awareness to the less unfortunate and at-risk children. (PM) Client displayed appropriate transition in the hallways. Client displayed excellent rapport in therapy session, as evidenced by his positive attitude and willingness to contribute to discussion. Client accepted responsibility for his angry outbursts and aggressive behaviors. Client stated he will display anger control and not threaten or intimidate others. Client reduced impulsive behaviors after 3-4 prompts from his teachers and QMHP. Client began to show greater control of his anger. Client appeared to decrease the intensity of his anger and frustration. Client was able to reduce negative behaviors and focus on the lesson. (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 client said thank you. The frequency and intensity of the client's defiant affect decreased. Client utilized positive body language as he interacted with his group, taking turns demonstrating each prompt and reflecting on his experience and choices. Client was reported to have dismissed without incident.