8/7/2023 EnchantaVaughn Approved (AM) Upon arrival, client was seen preparing for morning routine. Client was observed in group working on an assignment along with his peers. Client appeared to be in studious mood, as evidenced by his focus and concentration in the program. Client displayed a positive attitude while waiting for counselor to start the next activity. Client was acknowledged for his patience. Client was encouraged to keep up the good work. Client displays good sportsmanship and demonstrates responsible behavior. Client was seen transitioning into lunchtime with excellent manners, helping set up chairs and using proper voice control. Client was observed exhibiting good table manners by cleaning up his trash and holding meaningful conversations with his peers. Client was praised for making age appropriate choices, such as walking to his seat, listening to authority, and helping others pass around bag lunches. (PM) Client transitions back into session in a pleasant manner, saving a seat for his peers and waiting patiently for instruction. Client walks over to his counselor to engage in psycho educational activity and reflect about his day. Client communicated that he was on green and being good in class. Client was supported for his cooperation and staying out of trouble. Client was very attentive and engaged with group of peers. Client exhibits a good attitude toward peers during group activity. Client is seen working together and being fair to others. Client gave his undivided attention and waited his turn to speak. Client utilized stress management techniques, such as counting to ten and recording his thoughts when he felt discouraged. Client is observed getting along with his group members, demonstrating good teamwork skills. Client was observed exhibiting appropriate manners and returning to group in an uplifted mood. (EOD) Client displays good self-control utilizing the reinforcers provided by QMHP. Client seems to be interested in learning new things and finds motivation in watching others succeed and execute their objectives. Client is no longer triggered by internal distractions and is starting to develop impulse-control. Client follows QMHP prompts well increasing desirable behaviors in social and academic environments. Client verbalizes positive self-affirmations in class, by saying "I am proud of myself", "I can do whatever I put my mind too", and "I am perfect just the way I am. Client reported a decrease in symptoms following positive self-talk. Client acknowledged gains he had made in his interpersonal relationships and says there are a lot of people he look up too. Client is making progress with his objectives on a daily basis. Client displayed appropriate social skills, communication skills, and table manners at this time. As the client prepares for dismissal, he is seen packing and cleaning up behind himself. Client was reported to have dismissed with normal activity and leaving safely from the program. All objectives were achieved. (AM) QMHP monitored client individualized behavior modifications. QMHP motivated client to respond to exercise and express his feelings. QMHP offered active listening skills. QMHP provided client with encouragement to demonstrate the positive behaviors and expectations they had been talking about. QMHP encouraged client to communicate to his teacher when he needs help. QMHP praised client for staying on task. QMHP complimented client for utilizing acquired skills, paying attention, and focusing on the importance of the assignment. QMHP supported client displaying positive social interaction with peers and authority. QMHP provided redirection when needed and processed with client on what he needs to do to achieve ISP objectives. (PM) QMHP led the group through each therapeutic day treatment exercise. QMHP inquired about client’s day in class and what things are he doing to make it a good day. QMHP educated client about what he can do to make the program fun and interesting, such as reading his favorite book, drawing in a journal, or putting his head down close his eyes and practice the mindful behaviors learned in session. QMHP modeled pro-social behaviors for client to strengthen his understanding of what to do in school, at home, and in the community. QMHP prompted client to refrain from impulsive, hyperactive, defiant, and aggressive behaviors especially running, refusing authority instruction, and interrupting others who are trying to learn. QMHP utilized behavior modification strategies including removing client from the stimulant environment in efforts for him to reduce inappropriate behaviors. QMHP will monitor effects of meditation and coping practices daily and report progress to all parents, teachers, and administrative staff. QMHP will assist with reducing anger-provoking situations through self talk and role play scenarios in order to prevent escalation and dealing with anger assertively. (EOD) QMHP will continue to assist client with managing anger and frustration by reviewing and role-playing effective coping skills. QMHP helped client problem solve when he began displaying negativity towards himself and others. QMHP modeled proper positive behavioral expectations for the client to encourage additional layers of support and understanding of rules and expectations. Although client needs improvement, QMHP commended client on his efforts to maintain his ISP objectives throughout the day. QMHP observed client dismissing without incident and preparing to transition back home in a positive manner, as witnessed by all staff.(AM) Client displays normal behavior in office setting. Client exhibited a positive attitude toward mental health professionals and peers. Client said it’s boring and he is having challenges with certain activities and needs help. Client said he was being good in class but got in trouble for talking out of turn. Client knows what is expected of him and is trying to make better choices. Client verbalizes positive feelings about himself but recognizes areas he needs to work on. Client smiled and hugged QMHP. Client was observed in his seat and raising his hand. Client interacted well with peers and demonstrates good team building skills. Client displays good attitude by saying “thank you”. Client did an excellent job by showing interest in the session by asking appropriate questions. Client admits when he was wrong and apologizes. Client is learning to calm down, think first, and respond without anger and frustration. Client continues to make progress with ISP objectives. (PM) Client transitions smoothly and safely to session area, displaying appropriate behaviors. Client greets his group members and waits for instruction. Client expresses good statements about his day saying he was doing his work, using his manners, and being fair to others. Client is more confident at school, as evidenced by assertive and proud tone. Client have been doing a better job controlling impulsive and hyperactive behaviors, due to keeping his hands to himself and staying in designated area. Client reduces sadness and finds more excitement in learning about mindful smelling. Client displays good participation in session. Client walks appropriately down the hallway. Client understands that breaks are a privilege and he has to earn it. Client displays coping skills when faced with conflict due to deep meditation exercises. Client anger is moderate to intense, 2-3x per week. (EOD) Client is working on walking away and telling an adult before responding to anger provoking situations. Client understands that problem solving starts with thinking before acting. Client demonstrates problem solving by staying calm and using his senses. Client acknowledges expectations and reviews goals and objectives with counselor and parent daily. Client displays good social behavior in the program, as observed and supported by mental health professionals. Client is reported building healthy relationships in TDT program and performing a lot better on academic exercises given on his grade level.