4/5/2023 EnchantaVaughn Approved (AM) Upon arrival to the Spring Break Camp client fails to interact with peers his age, constantly mocks others, presents silly actions and verbalizes inappropriate statements, lacks independent skills and is very clingy to QMHP. Client exhibits low confidence when faced with stressful situation. Client have been doing a good job being a leader to his peers and being a team player. Client helps QMHP with organizing the activities and cleaning up. Client mood is viewed as happy and calm. Client is often quiet when talking about his feelings and tries to change subjects to avoid dealing with his emotions. (PM) Client enjoys camp, often communicating that he does not want to leave or go home. Client stated his favorite part of the day is going to the pool. Client is observed playing basketball and board games with his group while waiting for lunch. Client displays excellent teamwork skills and shows his support for his peers by helping them and sharing things together. (EOD) Client went into the community with a positive outlook and facial expressions, indicating he was in a good mood and building rapport with his group members. Client has improved his positive communication skills by being able to articulate his words and display appropriate hand gestures and body cues. Client met all objectives, as observed reducing outbursts and maintaining a positive attitude throughout the day. (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 (i.e. asking appropriate questions, giving feedback, and verbalizing his work) 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 offered timeout as an alternative to help client make better choices. QMHP processed with client about not participating in psychoeducational activity and expressed the importance of listening to authority. QMHP educated client that he needs to a better job at handling his emotions but there is no reason to get upset or frustrated. QMHP expressed disappointment at client for continuing to act like a baby after returning back to camp. (AM) 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 acknowledged QMHP's redirection after 4-5 prompts. client stated ok and then began to calm down his actions. Client proceeded to reduce the aggression in his voice while calming down. Client took over 45 minutes to display fully deescalated behaviors. (PM) Client became more impulsive and started to cause more disruptions. Client was eventually separated from his peers and endured his consequences of solitude from the community outing for 15-minutes. (EOD) Client accepted suggestions from QMHP as evidenced by the client smiling and saying thank you. 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 camp experience. Client dismissed without incident.