6/29/2023 EnchantaVaughn Approved Behavior: (AM) Upon arrival, client was observed being disruptive while others were trying to start their morning work. Client was not on task and exhibiting inappropriate social skills. Teacher reports client constantly interrupts her when she is trying to teach, yelling and being disrespectful during group activity. After several prompts, client continued to display a negative attitude in class. (PM) Client transitioned to lunch. Client displayed aggressive manners by pushing and shoving and skipping people in line. Client implemented low self control at his table and is seen running around out of his seat. Client is reminded of safe behaviors and how to be respectful. Client joined his session and was redirected back on task. Client did not demonstrate a cooperative attitude during group activity. Client was provided with feedback about how his behavior and verbal messages have an impact on others. Client expressed negative “I statements” in academic setting (e.g. "I hate school"). Client was encouraged to think positive and reminded to relax when he feels overwhelmed. (EOD) Client was having a hard time listening and following instructions. Client would not listen to mental health professional. Client displayed defiant and impulsive behaviors throughout 90% of the day and feedback was given in this area. Client was in a tempered mood, as evidenced by frowning face and balling up fist. Client needed time to cool off and was given appropriate space. Client left school early. Client did not met objectives 1, 2, and 3, as evidenced by failing to reduce symptoms of ADHD, aggressive tone and verbally attacking mental health professional. Intervention: (AM) QMHP had one on one with client. QMHP reviewed yesterday's activities. QMHP provided support and encouragement to ensure goals and objectives are met. QMHP monitored client individualized behaviors in collaboration with his teacher and social environment. QMHP encouraged client to make good choices and to avoid negative thoughts about himself. QMHP processed client negative behaviors. (PM) QMHP assisted client in developing more social skills. QMHP inquired about possible challenges client can experience with applying this skill. QMHP redirected client negative behaviors. QMHP reflected on client goals and objectives and what he needs to do to achieve them. 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. (EOD) QMHP explored the client’s capability to cope with his stressors and to get back on track. QMHP did not model the correct behaviors and conduct during quiet time. QMHP assisted client with finding and utilizing necessary resources. QMHP encouraged classroom management. QMHP verbalized the awareness that all people are unique, learn differently, and have various strengths and weaknesses. Response: (AM) Client reflected on weekend activities. Client remembered what we discussed yesterday and plans to apply those strategies today. Client was acceptive to support and encouragement. Client expressed negative thoughts about himself. Client was seen making poor choices. Client refused to listen to teacher and counselor and exhibited a disrespectful attitude. (PM) Client was not interacting well with peers. Client is still learning to build relationships and contribute to conversation. Objectives were not being met at this time, due to stressful environment. Client entertained others who were doing wrong. Client did not acknowledge interventions and help that was given. Client expressed negative feelings about changes occurring at school. (EOD) Client engaged in reflective thinking. Client communicated the do's and don'ts. Client was acceptive of feedback. Client is back on track but needs improvement. Client was able to comply with authority rules and regulations for a short while before getting on track again. Client ignored positive reinforcers that was provided by QMHP. Client displays low confidence and self-esteem in school setting and feedback was given in this area.