6/28/2023 EnchantaVaughn Approved (AM) Upon arrival, client was viewed as overactive, crawls on the floor, avoids directions the first time, have to be prompted several times to listen to authority instructions, follows behind others who are doing wrong, does not like to share, continues to interrupt others who are trying to learn, client is observed making noises and being disruptive in the hallway while transitioning from one setting to the next. (PM) Client is extremely energetic and active while in the gym and playing areas. Client appears to be in a good mood, as evidenced by him smiling and laughing with peers at lunch time. Client is monitored with expressing positive words of affirmation and reminded to be nice to others. Client presents cheerful and excited emotions throughout the day. Client is seen listening to his counselors and behaving well inside of the camp building. Client does a great job with following camp rules and utilizing his relaxation skills when needed. Client is observed resting and pacing himself and staying in his assigned area without causing conflict. (EOD) Client is supported with adhering to his expectations and managing his anger in an appropriate manner. Client did not display frustration when faced with stressful task, instead he was positive and pro active verbalizing he was having fun. Client met objectives 1, 2, and 3 as observed avoiding self-destructive behaviors and implementing problem solving strategies taught by QMHP. (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.