7/3/2023 EnchantaVaughn Approved (AM)Upon arrival client was observed walking into camp in an energetic and overactive mood. Client was hyper aggressive and continously shouted inappropriate statements to his peers and mental health professionals; symptoms which directly correlate to his current diagnosis of Attention Deficit Hyperactive Disorder. Client required to be redirected 3-4 times before he followed through with authority directives and prompts. Client had a hard time managing his emotions and staying on task. Client often acts out and ignores instructions displaying low responsible behaviors at camp. Client is constantly prompted to control his temper and calm down. Client was warned that if he continues to misbehave parent will be called. (EOD) Client refused to do what he was asked and QMHP pulled him to the side for one on one. Client presents anger and frustration at this time. Client seem to be irritated and needed a second to cool off before processing. Client disliked having to be with his age group at all times and communicated that he wished he could go into the teen room or stay with his friends. Client was educated that it is important to follow rules and stay with his age group. 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. 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.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. 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.