6/21/2023 EnchantaVaughn Approved (AM) Upon arrival, client exited the camp van with peers in a good manner. Client is seen coming into camp politely and quietly. Client said good morning to staff. Client is observed going to his morning activity. Client is observed interacting well with others. Client behaviors are supported by QMHP. Client is encouraged to keep up the good work. Client smiled and continued playing. Client displays good social skills at this time. Client transition into the next activity smoothly and safely. Instructor reported client was well behaved during the group activity. Client was given a thumbs up by QMHP. Client presents a positive attitude. Client utilized coping strategies to deal with conflict and stress. Client exhibits high self esteem in the social setting. Client demonstrates excellent conduct. No redirection was given until client began to get off task causing disruption for his group who were being good. (PM) Client was observed listening to camp staff during swimming lessons. Client was compliant and respectful. Client demonstrated self control by keeping his hands to himself and managing his anger and frustration effectively. Client was full of energy in the game room. Client was competitive and challenged others to table tennis and a round of pool. Client enjoys playing games. Client displayed the correct behavior in the lunch room, as reported by camp staff. Client particpated in all activities of his age group and was observed building new friendships and being a team player. (EOD) The client energy level has increased due to engaging with campers and working as a team. Client was praised for being able to put aside his pride and implement new social skills (i.e. positive self talk and empathizing with others). Client transitioned smoothly in between sessions, communicating positive expressions, showing cooperative attitude with his counselors and staff. Client stayed on task and dismissed quietly with his peers, ending the day achieving his objectives. (AM) QMHP welcomed client to camp and assessed his behaviors and mood. QMHP inquired about client’s day and provided affirmations. QMHP probed about any angry feelings or the inclination of safe and unsafe behaviors. QMHP utilized active listening as information was conveyed. QMHP communicated with client on displaying appropriate control. QMHP probed client about certain behaviors and how he sometimes feels like the only way to respond is in a negative manner. QMHP continued to engage with client and provided positive reinforcement as he participated in the psycho educational activity and group session. (PM) QMHP utilized behavior modification by verbally instructing client to use his inside voice and play fair. QMHP verbally identified the client's impulsiveness to the client and encouraged the client to use self control and decrease hyperactive behaviors. QMHP utilized age appropriate mood regulation skills and techniques, as a way to help control client’s destructive and critical demeanor, as well as to assist him with regaining and regulating his uncontrollable conduct. (EOD) QMHP informed client of more acceptable and expected responses to negative situations that would normally lead client to be triggered and display inappropriate behaviors while in the social environment. QMHP helped client to get back on track when he was pulled out for misbehavior. QMHP processed with client about his behaviors and offered alternative ways to conduct himself in social setting without getting in trouble or being aggressive.(AM) Client acknowledged QMHP's redirection after 2-3 prompts. Client stated “okay" and then began to calm down his actions. Client proceeded to lower his voice while calming down. Client took over 15 minutes to reduce hyperactive behaviors. Client became more impulsive and started to cause more disruptions. Client was eventually seperated from his peers and endured his concequences of solitude and excludence from the community outing. (PM) Client appeared to be frustrated by the incident, as evidenced by his reluctance to participate in the alternative activity provided by QMHP. Client displayed body language associated with anger, demonstrated by clenching his fists and face. Client continued impulsive behaviors and started running and jumping in circles, as he was prompted to remain seated over 3 times by QMHP and staff. Client left from assigned area without permission and was escorted back by a mental health professional. Client continued aggressive behaviors throughout the day. Client was witnessed by several staff hitting peers and horseplaying while transitioning from one setting to the next. Client failed to utilize mood regulating skills and presented destructive manners, feedback was given in this area. (EOD) Client expressed defensive behaviors as he claimed that he and the other campers are usually playing around when they are displaying inappropriate social skills. Client required to be re-focused by QMHP as he waited for others to explain what they were doing. Client stated he would try better self management skills and promised to be good for the rest of the day. The client was able to select topics that were directly related to reduction of stress and emotional negativity.