4/11/2023 EnchantaVaughn Approved (AM) Upon arrival, client was observed horseplaying when he first walked in class. Client required redirection from mental health professional for inappropriate behavior. Client required prompts 2-3 times by QMHP to reduce hyperactive behaviors. Client exhibited aggressive behaviors towards peers. Client blamed others for his negative behaviors and appeared unapologetic for participating in disruptive actions. Client did a much better job staying calm once QMHP came to visit. Client tend to get upset and shut down completely, ignoring all authority requests. Client had one on one with QMHP to discuss his previous behaviors. Client was seen frowning and disregarding the teacher’s directives. Client was reminded of his goals and objectives. (PM) Client was observed displaying inappropriate social behaviors in the lunch room. Client was directed to go to his seat several times by cafeteria monitors. Client displayed no control and was escorted to receive a therapeutic break with his counselor. Client had one on one with QMHP. Client attempted to change his attitude by being more serious. Client was witnessed controlling himself around his peers and making better choices. Client joined the school pep rally and seemed to cheer up and get back on track. Client defiant behaviors reoocurred once he returned to academic setting. Client expressed that he did not want to come group session and proceeded to walk away in opposite direction. Client took about 20 minutes to cooperate with instructions. (EOD) Client displayed negative feelings and communicated he tired and ready to go home. Client was seen having difficulty complying to rules, demonstrating inappropriate manners in all settings. As the client prepares for the end of the day, he is observed standing in the hallway and presenting hyperactive behaviors. Client did not respond well to feedback or encouragement. Client understands his teachers and mental health professionals have collaborated to resolve his issues and come up with a plan. Client was able to dismiss without incident, but did not obtain any objectives at school. (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 positive behaviors. (PM) QMHP assited client in developing more social skills. QMHP inquired about possible challenges client can experience with applying this skill. QMHP provided positive 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 occuring in school. (EOD) QMHP explored the client’s capability to cope with his stressors and to get back on track. QMHP modeled the correct behaviors and conduct during session time. QMHP assisted client with finding and utilizing necessary resources. QMHP verbalized the awareness that all people are unique, learn differently, and have various strengths and weaknesses. (AM) Client communicated positive affirmations and self talk. Client verbalized positive feelings about building relationships in school. 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. (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 and was given positive reinforcement for these choices. Client demonstrated expectations and responded well to feedback. 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 implemented his plan for restoring relationships, and this was reviewed.