4/3/2023 EnchantaVaughn Approved (AM) Upon arrival to the Spring Break Program client was in a hyperactive mood. Client walked in loud and needed redirection from QMHP. Client was easily distracted as QMHP was talking to him. Client required to be refocused by QMHP 2-3 times. Client stated he was confused about the topic of discussion. Client was observed utilizing strategies to assist him to comprehend feelings and expressions by being involved in conversations and activities available to him. (PM) Client was put in time-out in the gym, due to not listening to the gym coach and refusing to wait his turn. Client jumped in front of people during group activity. Client attended the baseball activity with his group. During break, client was supporetd with lisrtening to African American history and being respectful. Client transitioned smoothly and safely into the nutrition class to learn about healthy diet and choices. (EOD) Client often displays aggressive behaviors as he interacts with peers through the day. Client required 2-3 prompts to acknowledge or carryout a prompt. Client required to be refocused 3-4 times by QMHP. Client did not meet ISP objectives 1, 2 and 3, although client reduced hyperactive behaviors throughout the day. Client's aggressive attitude towards peers and mental health professionals did not decrease. Client dismissed without incident. (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 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 processed with client about not participating in psychoeducational activity and expressed the importance of listening to authority. (AM) Client was projecting a distanced and disrespectful demeanor with QMHP as he was disengaging out of the conversation. Client shrugged his shoulders when asked if he understood the difference between informed decisions and impulsive decisions. Client was able to name several positive outcomes and strengths after much encouragement from QMHP. (PM) Client did not meet ISP objectives as evidenced by the client requiring prompts 3-4 times by QMHP and mental health professionals to reduce hyperactive behaviors. (EOD) Client participated in the review in a positive manner as evident by the client being engaged and on task. The client feedback provided was positive as evident by the client stating, “I plan on working on using my coping skills more often”. The client then stated, “it relates to my goals because if I am staying out trouble and respecting authority figures I am making progress”. The client responded by thanking the QMHP for the praise given. Client dismissed without incident.