5/5/2023 EnchantaVaughn Approved (AM) Upon arrival, client was observed at his desk eating breakfast and getting along with his classmates. Client was respectful and courteous of others by using inside voice and sharing his supplies. Client verbalized positive thoughts about his schoolwork and was seen enjoying specials. Client was in a jovial mood, as evidenced by him laughing and engaging with his peers. Client displayed appropriate social behaviors during all leisure activities and was supported for his excellent participation. Client was observed utilizing the positive reinforcers given by authority figures and transitioned into the afternoon in a great mood. (PM) Client exhibited excellent communication skills by being polite and patient creating a positive working atmosphere. Client was monitored at lunch following cafeteria rules by staying in his seat, cleaning up his trash and eating his own food. Client was respectful to staff. Client was observed making good choices and avoiding negative behaviors. Client is observed staying away from others who are doing wrong. Client was provided with positive feedback as he displayed more attempts to use his independent ability to take care of his personal needs. Client was supported for taking advantage of one on one help. Client was witnessed transitioning from lunch to class in a good mood, as evidenced by his calm and content demeanor. Client is observed working well with his peers and being a team player. Client learned to use assertive tone instead of aggressive tone when expressing his feelings and emotions about his day. The client described increased self-esteem as he has been reinforced for taking responsibility for his behavior. Client displayed good interaction at recess and was praised for doing a good job in school today. Client maintained self-control when going back to his seat to finish his classwork. (EOD) Client was seen in class on task and following directions. Client participated in all individual and group activities throughout the day. Client responded well to authority requests and demands. Client was observed exhibiting good manners and preparing for dismissal, Client displayed low impulsive behaviors and was attentive to announcements, leaving school safely. Client met objectives 1, 2, and 3. (AM) QMHP welcomed client to school. QMHP inquired about evening and morning. QMHP asked how client was feeling. QMHP asked if client needed help with anything. QMHP encouraged client to have a good day. QMHP monitored individualized behaviors for acquisition of objectives. QMHP encouraged client to listen to his teacher. QMHP encouraged client to be the example for others. QMHP encouraged client not to follow others he sees that are doing wrong. QMHP reminded client of goals and objectives. QMHP intervened to assist in explaining behaviors to client and what he needs to work on if he wants to meet his goals and objectives. (PM) QMHP will provide strategies for coping and self-control when faced with conflict. QMHP will review and give feedback regarding ADHD and its causes and effect to well-being and school performance. QMHP will teach client meditation skills to decrease anger and frustration. QMHP assisted client in developing more social skills. QMHP inquired about possible challenges client can experience with applying this skill. QMHP provided feedback. QMHP reflected on client goals and objectives. QMHP isolated client from distractions to decrease disruptive behaviors and to reduce episodes. QMHP assisted client in normalizing the changes that are occurring in school and session. QMHP will implement a routine that will encourage client to be responsible and promote self confidence in academic and social settings. (EOD) QMHP reflected with client on his day, reviewing both good and bad experiences. QMHP processed with client, "what would you do different tomorrow”. QMHP encouraged client to have a good evening. QMHP encouraged client that tomorrow is a new day. QMHP praised client for utilizing acquired skills and being able to get back on track without episode. QMHP supported client with displaying positive social interactions with peers and authority. QMHP reinforced appropriate coping skills in dismissal setting. QMHP processed client positive responses and challenged client to maintain appropriate behaviors throughout the entire week. (AM) Client had one on one with QMHP. Client verbalized positive feelings about evening and morning. Client said he was feeling good and plans to have a good day. Client shook his head and returned to his work. Client displayed management of individualized behaviors. The client has not overreacted with anger to minor frustrations or irritants. Client responded in a pleasant manner acknowledging the positive reinforcement that the QMHP provided. Client is making progress with expressing his feelings and showing others respect and courtesy by talking with appropriate tone, initiating conversation with peers, and waiting for his turn to talk before blurting out loud. Client said he loves coloring activities and utilizes this to relax and stay focused in class. Client was honest about his wrong doing and is working to change these behaviors. (PM) Client was able to reevaluate himself and display a more positive attitude toward peers and authority. Client has become more involved in age appropriate social activities while being supportive of others. Client did not display any outbursts during the role play exercise. Client learned to look for similarities rather than differences in others. Client demonstrated expectations and responded well to redirection from teacher and TDT staff. Client did not run away from group or get frustrated like he normally does during room changes. Client reported a decreased stress level due to his modulation of social contact, and the success of this was reviewed. (EOD) As the client developed understanding of academic expectations, he reported increased satisfaction and function. Client responded well to feedback, interacting well with others. Client was able to speak calmly and demonstrate his improved communication skills while engaging in self-reflection. Client implemented his plan for restoring relationships, and this was reviewed. Client engaged in self-reflection, discussing good and bad parts of his day. Client said, "thank you". Client chose to get back on task, as observed by him listening and following directions. Client appeared to be learning from his mistakes and correcting them throughout the day. Client dismissed without incident.