4/4/2023 EnchantaVaughn Approved (AM) Upon arrival to the Spring Break Program client displayed poor decision making skills, due to unhealthy eating habits, flipping over bleachers unsafely, lack of motivation in academic setting, fails to follow rules, displays attention seeking behaviors, and thinks its funny to give QMHP a hard time. Client verbalizes negative thoughts about himself and others. Client talks down about himself and expresses poor social skills. (PM) Client avoids eating his breakfast and lunch but constantly begs for food from authority especially snacks, candy, and fast food. Client tried to play the victim by acting like he is helpless or hungry to get attention and incentives. Client is seen horse playing a lot and getting off task. Client peer pressures his team to act out and be involved in things not good for them. Client often laughs at his peers when they get in trouble showing no remorse or consideration for their feelings. Client can be very aggressive and impatient when interacting with his group, always wanting things to go his way or wants to be the first person to play al the games. Client fails to work as a team when he’s focused on winning and competing against others. Client is challenged to play fair and treat others how he wants to be treated. (EOD) Client responds well to feedback and is seen making better decisions. Client did not meet objectives 1 and 2, due to physical aggression with peers and educators, as well as, not listening to QMHP when promoted to sit up and be more responsible and productive. (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. (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.