6/27/2023 EnchantaVaughn Approved (AM) Upon arrival, client appeared to be in a low and drowsy mood. Client did not contribute to group discussion and verbalized little communication during the morning debrief. Client expressed he was tired, due to staying up all night playing video games. Client was not interested in any of the camp interventions and continued to nodd off and distance himself from others. Client tend to become anxious or irritated when a person or situation does not conform to expectations. Client experiences high levels of anxiety in any social interaction situation. Client demonstrates low motivation in the camp setting, always wanting to sit down and do nothing. (PM) Client avoids age group activities and requests to do more leisure activities, such as reading, watching a movie, coloring, or converse with his peers. Client slept for most of the day and did not participate in the activities until it was time to eat lunch. Client transitioned to the lunch setting in a civil manner, walking in line and using proper voice volume in the hallways. Client exhibited excellent pro social behaviors by sharing and helping others. (EOD) Client displayed an optimistic attitude going into the end of the day. Client was seen sharing and taking turns without conflict. Client was rewarded for exhibiting good pro social skills and utilizing his calming down techniques to make it to dismissal without upsetting his peers or being verbally aggressive with his counselors. Client was reminded of his goals and objectives and understands what he has to do in order to achieve them. Client was acceptive to prompts and was able to go through the rest of the evening without being an interruption to his peers, executing all objectives. (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.