7/26/2023 EnchantaVaughn Approved (AM) Upon arrival, client was in an energetic mood, as evidenced by him jumping around and hopping on top of furniture. Client was promoted to calm down and relax and save his energy for the gym. Client was seen ignoring prompts and going back into the same hyperactive behaviors. It was reported by staff, client was witnessed getting into a physical altercation with his twin brother. Client was pulled for redirection immediately. Client continued to kick and wrestle as the QMHP was escorting him to the classroom for processing. Client was very disrespectful and defiant toward TDT staff, (I.e. smacking his lips, rolling his eyes, banging on the wall, kicking his shoe off, crawling on the floor, putting his hands and objects in his mouth, and talking back to authority) as witnessed by several adults who were in the room. Client refused to listen or follow directions. Client took 10 minutes to calm down and decrease episode. Client expressed negative feelings and continued to display aggressive and impulsive behaviors. Client did not seem to care about sitting in a corner or being put in time out. Client mimicked his brother who was doing wrong and gave his counselor a hard time. Client could not get himself together and mom was called. Client spoke to mom and continued to horseplay and making silly noises. Client thought it was funny that he was getting in trouble and smirked while sucking his thumb and displaying an obsessive amount of attention-seeking behaviors. Mom was not happy with his choices and offered to stop by to assist. Client was given an additional break before transitioning back into the camp activities. (PM) Client transitioned smoothly into the cafeteria to prepare for lunch. Client was observed being respectful to staff by saying please and thank you. Client was polite, displaying good manners and keeping his/her hands to herself. Client cleaned up behind himself/herself and headed into pm activity with his/her age group. Client was monitored in the gym playing relay races and participating in team building exercise with his/her peers. Client was seen smiling and laughing and cheering for his teammates. Client displayed good sportsmanship by sharing and taking turns. Client expressed positive communication and have been utilizing the appropriate voice volume in the camp building. (EOD) Client is observed listening and following directions. Client have displayed good behaviors throughout the day, as reported and supported by all staff. Client walked quietly into each assigned area, without pushing or shoving. Client demonstrates a positive attitude around his peers, setting a good example and encouraged others to stay on task. Client have had moments where he cannot sit still or be quiet and have to be pulled to the side for redirection. Client needs improvement with handling his emotions when upset or aggravated and is given one on one and alternative ways to deescalate without conflict or harming himself. Client is witnessed helping staff facilitate the group activity and the benefits of this were reviewed. Client stated he loves going to the Aquatic center everyday and looked forward to doing that in camp the most. Client was given positive feedback from his counselor to keep following directions and listening to the adult and rewards will follow. Client thanked the counselor for the support and encouragement, dismissing from camp in a joyful and pleasant manner. Client met ISP objective 3, as observed but failed to meet objectives 1 and 2. (AM) QMHP greeted and welcomed client to camp. QMHP asked about client’s evening and morning. QMHP reviewed goals and objectives to ensure he was on track and understood what was expected in camp. QMHP offered empathy and support to client to ensure his needs are met. QMHP assisted client with tying his shoes and dropping off his belongings. QMHP encouraged client to have a good day. QMHP coordinated morning group to prepare client for his day. QMHP reminded client to tell an adult if they have any questions or concerns. QMHP reflected with client behaviors that will not be acceptable or tolerated in the camp setting. QMHP educates client that coming to camp is a privilege and can be taken away. QMHP answered client questions and escorted him/her to his first activity. (PM) QMHP monitored client in lunch and gym area. QMHP monitored clients individualized behaviors and how well he interacted with his peers. QMHP non verbally communicated with client when he was doing a good job by giving him a thumbs up. QMHP praises client for walking away from conflict and being able to be the bigger person. QMHP helped client to get back on track when he was pulled out for misbehavior. QMHP processed with client about his behaviors. QMHP told client he would not be able to come back if he continues to act up and show out at camp. QMHP reminded client of the rules and regulations and what is to be expected. QMHP supported client with making good decisions and following directions. QMHP interacted with client by playing games and talking about his strengths and attributes so that client is more confident around his peers and feel comfortable communicating with an adult about his thoughts and feelings. QMHP gave positive feedback and encouragement throughout the day especially during challenges or stressful tasks. (EOD) QMHP prepared client for the last part of the day by pushing him to participate and contribute to the group activities offered by the boys and girls club. QMHP observed client negative and positive behaviors to see what new techniques and skills can be taught during psycho educational. QMHP had one on one with client to reflect on his day. QMHP reminded client that tomorrow is a new day. QMHP asked client what will he do different tomorrow. QMHP instructed client to follow directions and listen to all staff. QMHP assisted client with gathering his belongings and preparing for dismissal. QMHP facilitated a group discussion to explore client feelings and things he liked and disliked about camp so that he can have a better day tomorrow. QMHP offered active listening skills and showed client respect while he was sharing his ideas and thoughts. QMHP said goodbye to client and escorted him safely on the van to return home. (AM) Client waved and hugged QMHP. Client stated he had a great evening and a good morning. Client said he was aware of his goals and objectives and would implement them to the best of his ability. Client agreed to follow the expectations and rules of camp. Client responded well to the support provided by QMHP. Client said thank you and joined the other campers in the morning group. Client said he was going to be good and treat others with respect. Client ensured he would listen and follow directions. Client said okay and communicated that when an adult isn’t around it’s hard for him to deal with conflict on his own. Client agreed to be patient and separate himself by walking away, deep breathing, or counting to 10. Client seemed to be coping with his stressors and attempting to correct his mistakes as much as possible. Client have a hard time keeping his hands to himself when playing but promised to respect other peers personal space and boundaries. Client shook his head in agreement. Client gave good eye contact and displaying good listening skills at this time. Client asked appropriate questions related to camp and today’s schedule. Client was ready to play and interact with his peers. Client divided into his age group, preparing for team building exercise and role play activities. (PM) Client displayed inappropriate/ appropriate behavior in the cafeteria and gym areas. Client was seen getting up out of his seat without permission. Client tried walking out of the room unsupervised and following his own routine. Client was able to get back on task after redirection was given by several adult staff. Client displayed good interaction with peers. Client was polite and courteous, cleaning up after himself and throwing his trash away. Client non verbally communicated with QMHP by smiling and waving. Client needed additional prompts to get back on track with his objectives, demonstrating a few symptoms of ADHD (I.e. running and jumping around constantly, being loud, touching other campers after being told stop, horse playing in all social areas, refusing to follow directions given by camp staff, and getting into altercations with his peers). Client had a difficult time processing his feelings and admitting he was wrong. Client communicated camp was a positive place for him to come instead of being in the house and realized he needed to adjust to the new setting and new faces. Client recognized his anger triggers and is working to improve. Client reviewed his expectation with QMHP. Client promised to make good choices and follow directions the first time. Client started opening up and being himself around peers and authority at camp while engaging in therapeutic day treatment activities and social exercises. Client responded well to feedback and seemed to be adapting to the new structure. (EOD) Client displayed low ambition during transitioning and switching rooms. Client was less likely to go into the room with supervision and rules and more likely to stay in the space where there were less rules and free time. Client distances himself away when given directions. Client is prone to stress and negative situations that he responds in the same way to everything, good or bad. Client learned a lot from observing others and wanted to prove he can be a happy camper by participating in all the leisure and fundamental activities. Client talked about things he loves about camp and what things he would love to do before camp ended (I.e. take field trips and go outside). Client expressed positive feelings about a the reward system and earning incentives for good behavior. Client stated he would avoid distractions and stay on task. Client stated he would keep his hands to himself. Client stated he would help when needed. Client stated he would treat others fairly. Client stated he would respect adult figures and do what he is told. Client verbalized positive statements about camp and the campers he has met so far. Client contributed to group discussion and shared his personal expectations and thoughts about his/her camp experience. Client dismissed from camp in a cheerful spirit, exiting the building safely and getting on the van smoothly as evidenced and reported by staff and the van driver.