8/7/2023 EnchantaVaughn Approved (AM) Upon arrival, client entered camp with hyperactive and impulsive behaviors, as evidenced by him jumping, running, and chasing his brother. Client was promoted to slow down and act more civilized. Client started his morning off causing trouble. Client was witnessed in the gym horse playing and displaying inappropriate behavior (I.e. pushing and shoving people in line, throwing his shoes across the floor, falling out, crawling over people, and kicking and yelling. Client was given redirection and confronted about his behaviors. Client was reminded of the expectations and rules. Client nodded in agreement and sat down to prepare for the camp trip. Client did not do a good job walking out of the building and controlling himself. Client was observed playing with his peers and conducting himself appropriately. Client was witnessed by staff of aggressive behavior and defiance of authority. Client was given a 20 minute timeout by mental health professional. Client did a poor job listening and following directions today. Client had to be told over and over to stop or to make better choices. Client continued to follow his brother and internet in negative and unpleasant behaviors. Client was pulled and separated from his twin brother who was encouraging him to act out. Client was seen throwing sand and rocks at female peers. Client was also witnessed pouring water over the park walls and leaving trash on the ground. Client gave his counselor an attitude when asked to pick it up and throw it away. Client was redirected again and sent to a corner to think about his actions. Client had to be taken out of every activity due to having on the wrong shoes and poor behavior. (PM) Client was observed going to lunch with his age group. Client presented appropriate behaviors in the lunch room. Client was witnessed by staff using good manners and being respectful. Client transitioned to next activity without conflict or getting in trouble. Client was given a thumbs up and applauded for his efforts. Client walked safely in the hallways and made sure to use his inside voice in the building. Client entertained himself with different games and objects. Client had trouble staying focused and staying in his area. Client kept hopping on other camper’s chairs. Client was observed tossing game pieces on the floor and ignoring prompts. Client was given redirection and a final warning that if he does not control himself, he will sit out for the rest of the day. Client apologized, picked the block up, and headed into the STEM room to begin activity. (EOD) Client transitioned into the gym and participate in a relay race and other team building exercises with his peers. Client was seen utilizing appropriate interaction with peers and playing fairly. Client presents himself in a good manner and is seen helping others. Client prepared for dismissal by lining up and waiting for his counselor to escort him to the pick up area. Client left camp in a positive and calm mood, as evidenced by his demeanor and posture. Client did not meet objectives, as observed throughout the day. (AM) QMHP greeted and welcomed client to camp. QMHP asked about client’s evening and morning. QMHP reviewed goals and objectives to ensure he/she was on track and understood what was expected in camp. QMHP offered empathy and support to client to ensure his/her needs are met. QMHP assisted client with tying his shoes and dropping off his/her belongings. QMHP encouraged client to have a good day. QMHP coordinated morning group to prepare client for his/her day. QMHP reminded client to tell an adult if they have any questions or concerns. QMHP reflected with client behaviors that will not be acceptable or tolerated in the camp setting. QMHP educates client that coming to camp is a privilege and can be taken away. QMHP answered client questions and escorted him/her to his/her first activity. (PM) QMHP monitored client in lunch and gym area. QMHP monitored clients individualized behaviors and how well he interacted with his peers. QMHP non verbally communicated with client when he/she was doing a good job by giving him/her a thumbs up. QMHP praises client for walking away from conflict and being able to be the bigger person. QMHP helped client to get back on track when he was pulled out for misbehavior. QMHP processed with client about his behaviors. QMHP told client he would not be able to come back if he continues to act up and show out at camp. QMHP reminded client of the rules and regulations and what is to be expected. QMHP supported client with making good decisions and following directions. QMHP interacted with client by playing games and talking about his strengths and attributes so that client is more confident around his peers and feel comfortable communicating with an adult about his thoughts and feelings. QMHP gave positive feedback and encouragement throughout the day especially during challenges or stressful tasks. (EOD) QMHP prepared client for the last part of the day by pushing him to participate and contribute to the group activities offered by the boys and girls club. QMHP observed client negative and positive behaviors to see what new techniques and skills can be taught during psycho educational. QMHP had one on one with client to reflect on his day. QMHP reminded client that tomorrow is a new day. QMHP asked client what will he do different tomorrow. QMHP instructed client to follow directions and listen to all staff. QMHP assisted client with gathering his belongings and preparing for dismissal. QMHP facilitated a group discussion to explore client feelings and things he liked and disliked about camp so that he can have a better day tomorrow. QMHP offered active listening skills and showed client respect while he was sharing his ideas and thoughts. QMHP said goodbye to client and escorted him safely on the van to return home. (AM) Client waved and hugged QMHP. Client stated he had a great evening and a good morning. Client said he was aware of his goals and objectives and would implement them to the best of his ability. Client agreed to follow the expectations and rules of camp. 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 seemed to be coping with his stressors and attempting to correct his mistakes as much as possible. Client have a hard time keeping his hands to himself when playing but promised to respect other peers personal space and boundaries. Client shook his head in agreement. Client gave good eye contact and displaying good listening skills at this time. Client asked appropriate questions related to camp and today’s schedule. Client was ready to play and interact with his peers. Client divided into his age group, preparing for team building exercise and role play activities. (PM) Client displayed inappropriate/ appropriate behavior in the cafeteria and gym areas. Client was seen getting up out of his seat without permission. Client tried walking out of the room unsupervised and following his own routine. Client was able to get back on task after redirection was given by several adult staff. Client displayed good interaction with peers. Client was polite and courteous, cleaning up after himself and throwing his trash away. Client non verbally communicated with QMHP by smiling and waving. Client needed additional prompts to get back on track with his objectives, demonstrating a few symptoms of ADHD (I.e. running and jumping around constantly, being loud, touching other campers after being told stop, horse playing in all social areas, refusing to follow directions given by camp staff, and getting into altercations with his peers). Client had a difficult time processing his feelings and admitting he was wrong. Client communicated camp was a positive place for him to come instead of being in the house and realized he needed to adjust to the new setting and new faces. Client recognized his anger triggers and is working to improve. Client reviewed his expectation with QMHP. Client promised to make good choices and follow directions the first time. Client started opening up and being himself around peers and authority at camp while engaging in therapeutic day treatment activities and social exercises. Client responded well to feedback and seemed to be adapting to the new structure. (EOD) Client displayed low ambition during transitioning and switching rooms. Client was less likely to go into the room with supervision and rules and more likely to stay in the space where there were less rules and free time. Client distances himself away when given directions. Client is prone to stress and negative situations that he responds in the same way to everything, good or bad. Client learned a lot from observing others and wanted to prove he can be a happy camper by participating in all the leisure and fundamental activities. Client talked about things he loves about camp and what things he would love to do before camp ended (I.e. take field trips and go outside). Client expressed positive feelings about a the reward system and earning incentives for good behavior. Client stated he would avoid distractions and stay on task. 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/her camp experience. Client dismissed from camp in a cheerful spirit, exiting the building safely and getting on the van smoothly as evidenced and reported by staff and the van driver.