5/5/2023 EnchantaVaughn Approved (AM) Client was found standing outside of the office door when he was expected to be in his group. Client stated he was put out of the group for talking over people. Mental health professional reported client is often very disruptive when he is done with his work and was asked more than once to stop talking so he was sent to stand in the hallway and recollect himself. Client is observed in time out reflecting and waiting for his counselor to give him permission to come back in. Client was seen in the hallway in deep thought and looking restless once QMHP arrived. When confronted by QMHP about recent behaviors and choices, client verbalized he got in trouble for talking to a classmate. Client was educated about the best and appropriate times to talk and use his words and when it is not acceptable to talk out of turn and why it is important to listen and be quiet. Client understands that he should have waited and remained quiet especially since other students were still working. Client admits he was wrong and will do his best to be quiet when he is expected. (PM) Client waits patiently for his friends to arrive to the lunch table. Client is observed walking to the line, avoiding cutting or pushing others who were ahead of him. Client has a hard time staying in his seat for a long period of time and has to walk around to other tables. Client was asked to sit down until it’s time to switch to the next period. Client expresses little frustration and was compliant of instruction. Client attempted to sneak away from class to horseplay and chase student down the hallway. When confronted and redirected, client was able to make better choices. (EOD) Teacher reported client continues to interrupt others who are trying to learn and is not being fair or respectful to his peers who gave him the courtesy and respect in quiet area. Client was redirected by counselor and inquired to reflect on his day and how he can do a better job. Client was a little frustrated and embarrassed that he had to be escorted by his teacher but realized it was to teach him a lesson. Client was reminded that his actions have consequences. Client engaged in reflective thinking for 15 minutes until he felt more relieved and ready to join his class in pm specials(AM) QMHP monitored client individualized behavior modifications. QMHP motivated client to respond to exercise and express his feelings. QMHP offered active listening skills. QMHP provided client with encouragement to demonstrate the positive behaviors and expectations they had been talking about. QMHP encouraged client to communicate to his teacher when he needs help. QMHP praised client for staying on task. QMHP complimented client for utilizing acquired skills, paying attention, and focusing on the importance of the assignment. QMHP supported client displaying positive social interaction with peers and authority. QMHP provided redirection when needed and processed with client on what he needs to do to achieve ISP objectives. (PM) QMHP led the group through each therapeutic day treatment exercise. QMHP inquired about client’s day in class and what things are he doing to make it a good day. QMHP educated client about what he can do to make the program fun and interesting, such as reading his favorite book, drawing in a journal, or putting his head down close his eyes and practice the mindful behaviors learned in session. QMHP modeled pro-social behaviors for client to strengthen his understanding of what to do in school, at home, and in the community. QMHP prompted client to refrain from impulsive, hyperactive, defiant, and aggressive behaviors especially running, refusing authority instruction, and interrupting others who are trying to learn. QMHP utilized behavior modification strategies including removing client from the stimulant environment in efforts for him to reduce inappropriate behaviors. QMHP will monitor effects of meditation and coping practices daily and report progress to all parents, teachers, and administrative staff. QMHP will assist with reducing anger-provoking situations through self talk and role play scenarios in order to prevent escalation and dealing with anger assertively. (EOD) QMHP will continue to assist client with managing anger and frustration by reviewing and role-playing effective coping skills. QMHP helped client problem solve when he began displaying negativity towards himself and others. QMHP modeled proper positive behavioral expectations for the client to encourage additional layers of support and understanding of rules and expectations. Although client needs improvement, QMHP commended client on his efforts to maintain his ISP objectives throughout the day. QMHP observed client dismissing without incident and preparing to transition back home in a positive manner, as witnessed by all staff.(AM) Client displays normal behavior in office setting. Client exhibited a positive attitude toward mental health professionals and peers. Client said it’s boring and he is having challenges with certain activities and needs help. Client said he was being good in class but got in trouble for talking out of turn. Client knows what is expected of him and is trying to make better choices. Client verbalizes positive feelings about himself but recognizes areas he needs to work on. Client smiled and hugged QMHP. Client was observed in his seat and raising his hand. Client interacted well with peers and demonstrates good team building skills. Client displays good attitude by saying “thank you”. Client did an excellent job by showing interest in the session by asking appropriate questions. Client admits when he was wrong and apologizes. Client is learning to calm down, think first, and respond without anger and frustration. Client continues to make progress with ISP objectives. (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 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 mindful smelling. Client displays good participation in session. Client walks appropriately down the hallway. Client understands that breaks are a privilege and he has to earn it. Client displays coping skills when faced with conflict due to deep meditation exercises. Client anger is moderate to intense, 2-3x per week. (EOD) Client is working on walking away and telling an adult before responding to anger provoking situations. Client understands that problem solving starts with thinking before acting. Client demonstrates problem solving by staying calm and using his senses. Client acknowledges expectations and reviews goals and objectives with counselor and parent daily. Client displays good social behavior in the program, as observed and supported by mental health professionals. Client is reported building healthy relationships in TDT program and performing a lot better on academic exercises given on his grade level.