Client's Name *

First Name

Last Name

Date Of Session *

MM

DD

YYYY

Presenting Complaint *

Client attended individual therapy

Processed client's week

Mental Status Exam (MSE) are within normal limits

Interventions Used *

Actively listened

Assigned homework

Cognitive restructuring

Communications skills

Created treatment plan

Examined benefits/consequences

Explored coping patterns

Explored emotions

Explored options

Explored relationship patterns

Interactive feedback

Mindfulness

Normalized client's feelings

Pointed out consequences

Praised client

Problem-solved

Psychoeducation

Reviewed homework

Reviewed treatment plan/progress

Role-play/behavioral rehearsal

Supportive reflection

Used joining techniques

Response *

Client actively participated in session

Client was somewhat disengaged

Client openly shared

Client reluctantly shared

Plan *

Continue current therapeutic focus

Treatment goals or objectives have been changed

Treatment is currently suspended per client's request

Treatment is terminated / Client does not meet medical necessity

Treatment is terminated / Client has dropped out

Treatment is terminated / Client has graduated

Next appointment has been scheduled

Therapist's Name *

First Name

Last Name