1/11/2023 EnchantaVaughn Approved (AM) Upon arrival, client appeared to be in a enthusiastic mood, as evidenced by his happy and joyful spirit. Client was observed participating in classroom activities. Client was observed working actively with peers. Client exhibits following rules and regulations due to being a good listener. Client was attentive and remained in his assigned area without conflict or altercation. Teacher reported he was having a good morning. Client did not require redirection at this time and was supported for pleasant and cooperative behaviors. (PM) Client was observed walking in the hallway during transitions without any negative behaviors. Client entered social environment calmly and smoothly. Client stood in line without excessive movement and keeping his hands to himself. Client displayed good interaction with his peers. Client displayed appropriate conversation. Client asked for permission to go see his counselor. Client greeted QMHP and joined group to complete psycho social activity. Client was observed listening and paying attention. Client expressed good statements. Client displayed appropriate communication and was acceptive of feedback. Client returned to class in a positive demeanor to begin afternoon classwork. (EOD) Client was observed displaying positive classroom behaviors and working as a team. Client appeared to be enjoying himself in class, as demonstrated by his positive body language and positive interactions with classmates. Client was seen preparing for the end of day and organizing his belongings. Client continues to display appropriate attitude and remained on task. Client was reported by teacher and staff to have dismissed without incident. Client was supported with meeting goals and objectives. (AM) QMHP observed client in the classroom in efforts to determine whether he required assistance. QMHP enhanced knowledge of a consistent daily routine. QMHP provided positive gestures to encourage client to verbalize positivity with peers and authority. QMHP enhanced food management skills by encouraging client to bring healthy snacks from home as an alternative for lunch. QMHP expressed understanding of self care and personal hygiene. QMHP offered praise and positive reinforcement to enhance self esteem and sense of achievement. QMHP probed sense of empowerment by communicating positive self talk. (PM) QMHP taught basic problem-solving skills. QMHP increased discipline for inappropriate behaviors. QMHP engaged client in conversation regarding his recent choices, progressions, and setbacks. QMHP utilized empathetic listening skills as client expressed his feelings. QMHP processed clientâs responses and gave appropriate feedback. QMHP helped client discover positive outlets of expression and using creativity to avoid negativity. (EOD) QMHP reminded client of his goals and objectives. QMHP explored positive behavior options he was exhibiting with client to support his willingness to continue to make good decisions and have positive behaviors in school. QMHP encouraged client to reframe from displaying defiance of authority toward teachers, to talk calmly and express himself without anger and frustration. QMHP talked with client about the importance of adhering to rules and expectations in school, at home, and in his community. (AM) Client smiled as he saw QMHP's positive gestures. Client continued to work on the classroom activity. Client continued to interact in a positive manner with his teachers and classmates. Client nodded in agreement. Client demonstrated understanding. Client discussed the reasoning behind his negative behaviors towards others with QMHP. Client agreed that he would refrain from displaying negative behaviors towards his teacher. Client calmed down and went into his classroom. (PM) Client required additional redirection from QMHP to get him to focus on the classroom assignment. Client was able to settle down and return to classroom activity. Client was responsive to teachers lesson. Client acknowledged that he tends to engage in disruptive behavior when he begins to become frustrated with schoolwork. Client accepted responsibility for his angry outbursts and aggressive behaviors. Client stated he will display anger control and not threaten or intimidate others. (EOD) Client was observed and reported to have been pleasant and cooperative during classroom activities and demonstrated a willingness to adhere to school and classroom rules and expectations. Client listed 3-4 classroom behaviors that he was going to utilize in efforts to remain positive behaviors. Client appeared to be receptive to recieving positive reinforcement from his teacher as demonstrated by his smiling and inviting body language. The frequency and intensity of the client's defiant affect decreased. Client dismissed without incident.