4/20/2023 EnchantaVaughn Approved (AM) Upon arrival, client was witnessed by van driver sitting correctly in his seat. Client entered camp quietly. Client put his belongings away. Client joined his group in the library. Client displayed appropriate behavior in the library by sitting down and reading a book. Client enjoyed sharing stories with his peers. Client was observed listening and following directions. Client did a good job transitioning into the next activity without hyperactive or impulsive behaviors. Client was seen coloring and drawing pictures as a way to reduce negative behaviors. Client went into the STEM room to learn about new words and different ways to communicate by using positive affirmations or “I statements”. (PM) Client was observed sitting in his seat eating his breakfast quietly. Client appeared to be in a calm mood, as evidenced by his collective spirit and positive interaction with his peers. Client displayed non aggressive behaviors and was seen following all directions and listening to his teachers, indicating that he was already having a good start to his day. Client displayed an effort to improve his ability to try, learn, and focus on his school work by sitting in his seat facing forward giving his full attention. client demonstrates that he cannot comprehend basic information and continues to look onto his peers for help. client was able to transition to next activity in a respectful manner. (EOD) Client expressed having fun playing during gym time with a scooters and running activity. Client partcipated in verious educational games, such as puzzles, arts and crafts, and coloring. Client displayed appropriate interaction with peers during team building games outside in the community (e.g. duck duck goose, simon says, freeze tag) and group discussion. Client was observed in a cheerful mood during the live musical performance at camp. Client looked amazed at all the band people and music equipment and was seen meeting all objectives.(AM) 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. (PM) 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.(AM) 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. (PM) 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.