6/20/2023 EnchantaVaughn Approved (AM) Upon arrival, client was observed walking into camp and settling into the morning activity. Client joined his group outside for a game of tag. Client seemed to be enjoying himself and getting along with others. Client transitioned into musical chairs with a positive attitude. Client displayed appropriate manners during dodge ball and did not get in trouble for misbehaving. Client was supported with achieving his objectives and participating in each assigned station. Client expressed happy thoughts about going to the gym to play Basketball with his camp friends. Client interacted well with his peers while playing different racing games. Client asked QMHP to assist him with starting a game of Simon says by gathering everyone together and keeping everyone quiet. (PM) Client was seen being polite and courteous to peers and staff while picking up his meal. Client was seen sitting at the table and engaging in conversation. Client was excited to attend his psycho social and joined his group. Client continued to treat others with respect and adhere to camp rules throughout the day. Client was seen preparing for a coloring activity and team building games. Client inquired if the group was going to the pool today. (EOD) Client is seen focused and on task. Client negative symptoms have stabilized, he has begun to cope with all stressors, as well as, decreasing his impulsive behaviors while in the class setting. Client is beginning to process information that is important to his education and this has significantly improved his relationships at school. Client implements relaxation techniques by taking deep breaths and counting to 10 when he feels overwhelmed and continues to adapt to his social environment. As the client prepares for the end of the day, he is observed encouraging others to be quiet so that the teacher will give them free time to play and relax. Client exhibits good team work skills and confidence while achieving his objectives for the day, as monitored and supported. (AM) QMHP monitored client individualized behavior modifications in collaboration with his peers and other mental health professionals. QMHP motivated client to reframe from having episodes when given directions and do what he is supposed to do. QMHP offered active listening skills. QMHP encouraged client to stay on task and avoid temper tantrums. (PM) QMHP processed with client about psychoeducational activity while assisting with each step. QMHP supported client involvement in psychoeducational activity (i.e. asking appropriate questions, giving feedback, and verbalizing his work) while expressing understanding of assignment. QMHP praised client for cooperation and following directions. (EOD) QMHP redirected client to show more effort and to try. QMHP expressed there is no right or wrong way to play but not participating is unacceptable. QMHP offered timeout as an alternative to help client make better choices. QMHP processed with client about not participating in psychoeducational activity and expressed the importance of listening to authority. QMHP educated client that he needs to a better job at handling his emotions but there is no reason to get upset or frustrated. QMHP expressed disappointment at client for continuing to act like a baby after returning back to camp. (AM) Client responded well to the support provided by QMHP. Client said thank you and joined the other campers in the morning group. Client said he was going to be good and treat others with respect. Client ensured he would listen and follow directions. Client said okay and communicated that when an adult isn’t around it’s hard for him to deal with conflict on his own. Client agreed to be patient and separate himself by walking away, deep breathing, or counting to 10. Client acknowledged QMHP's redirection after 4-5 prompts. client stated ok and then began to calm down his actions. Client proceeded to reduce the aggression in his voice while calming down. Client took over 45 minutes to display fully deescalated behaviors. (PM) Client became more impulsive and started to cause more disruptions. Client was eventually separated from his peers and endured his consequences of solitude from the community outing for 15-minutes. (EOD) Client accepted suggestions from QMHP as evidenced by the client smiling and saying thank you. Client stated he would keep his hands to himself. Client stated he would help when needed. Client stated he would treat others fairly. Client stated he would respect adult figures and do what he is told. Client verbalized positive statements about camp and the campers he has met so far. Client contributed to group discussion and shared his personal expectations and thoughts about his camp experience. Client dismissed without incident.