2/14/2023 EnchantaVaughn Approved (A) During morning class the client was observed displaying on-task behavior, characterized by sitting quietly with his 1 to 1 counselor helping him to complete his assignments. (P) Client was observed demonstrating off-task behaviors, as evidenced by having to be prompted several times to pay attention and stop drawing pictures and sharing them across the room. (ED) Client presented with a high energy level that made it very difficult for him to sit still and refrain from lifting his head up and chatting with peers during the "quiet" period. (A) The QMHP provided the client with support and encouragement as he was completing his assignments. QMHP motivated the client to continue making good choices. (P) QMHP processed with the client about being rude and disruptive in the class while the teacher is trying to teach. The QMHP discussed with him the importance of being attentive in class (better grades, more positive self estem). QMHP encouraged him to take more breaks. (ED) The QMHP firmly and consistently confronted client with the fact that his impulsive behavior negatively affects himself and the entire class. QMHP processed with him the importance of channeling his energy into constructive and purposeful activities, such as, breaks, recess, and gym class. (A) Client accepted the QMHP's positive verbal reinforcement with a "high five" and big smile. The client was able to maintain on-task behavior throughout the rest of the morning. (P) The client presented in an emotional state (sad, crying) during redirection. He stated he knew he should have been paying attention, and is afraid the QMHP will tell his mother. The QMHP assured him what was more important (compliance). Client was able to stop the negative behavior and get back on-task. (ED) Client appeared uncomfortable and unable to relax while being redirected and instructed in the use of progressive relaxation. He kept saying he didn't want to get in trouble. After that he really put forth effort during the "quiet" period.