7/17/2023 EnchantaVaughn Approved (AM) Client was observed displaying inappropriate social behaviors when playing one on one with peer almost getting into a physical altercation upon arrival to the summer program. Client was given redirection but refused to sit in timeout. Client expressed a negative attitude in group settings (i.e. frowning his face and talking back to authority). Client was not having a good start to his day, as evidenced by low level of energy and unpleasant behaviors. Client kept getting out of his seat and interrupting others who were trying to learn the educational games on the tablets. (PM) Client did not comply to directions or requests and was told to sit with male mentor during lunch and gym activities. Client appeared to be in an upset mood and was very defiant toward TDT staff. Client was seen having difficulty complying to camp rules, demonstrating inappropriate manners in all settings. Client lacked self-control during the STEM exercise and reading time with movie “Who will help me”. (EOD) Client was monitored in the gym (Boys and Girls Club) interacting with his peers and waiting for activity to begin. Client seemed to be very inpatient and aggressive when it wasn't his turn to play. Client transitioned to community setting with a careless attitude. Client collaborated with all age groups in the Community room to handcraft Nachos with peers and taking turns test tasting. Client was upset he couldn't take his food home and presented a negative attitude. Client exhibited impulsive defiant behaviors and was taken out of the pool as a consequence. Client did not meet objectives 1, 2, and 3, as evidenced. (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 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 processed with client about not participating in psychoeducational activity and expressed the importance of listening to authority.(AM) Client was projecting a shy and unassuming demeanor with QMHP as he was engaging in conversation. Client nodded his head in agreement when asked if he understood the difference between informed decisions and impulsive decisions. Client was able to name several positive outcomes and strengths after much encouragement from QMHP. (PM) Client did not meet ISP objectives as evidenced by the client requiring prompts 3-4 times by QMHP and mental health professionals to reduce hyperactive behaviors. (EOD) Client participated in the review in a positive manner as evident by the client being engaged and on task. The client feedback provided was positive as evident by the client stating, “I plan on working on using my coping skills more often”. The client then stated, “it relates to my goals because if I am staying out trouble and respecting authority figures I am making progress”. The client responded by thanking the QMHP for the praise given. Client dismissed without incident.