MBP Faith – FBT Session (Final)

FBT - Treatment Session [text name="treatmentsession" default=""]
Clinician: Faith San Diego (Clinical Psychology Registrar)
Date: [date name="date" date="01-11-2024"]
Referral Type: [checkbox name="referral" value="MHCP|EDTP|Private"]
Location: The Mind Body Practice - Bella Vista; [checkbox name="location" value="In-Person|Telehealth|Phone Consultation"]
Present: Faith; [checkbox name="present" value="Client|Mother|Father"] [text name="parentname" default=""]; [checkbox name="present" value="Mother|Father"] [text name="parentname" default=""]

Current FBT Phase: [text name="fbtphase" default="1"]
Current Weight: [text name="WEIGHT" default="kg"] 
Change from last session: [select name="CHANGE" value="weight increased|weight decreased|weight remained the same"] [textarea name="grams" default="grams"]

INDIVIDUAL SESSION SUMMARY
- [text name="NAME" default="NAME"] was feeling [checkbox name="feeling" value="okay|upset|angry|disappointed|happy|relieved|feeling conflicted"] at the change in weight. 
-    [text name="NAME" default="NAME"]'s affect was [select name="affect" value="congruent|incongruent"] with reported feeling.

A. Client Discussion:
[textarea name="1on1" default=""]
- Percentage of AN vs Client in session: [text name="ANsession" default="% and %"]
- Percentage of AN vs Client on average during the week: [text name="ANweek" default="% and %"]
- [text name="NAME" default="NAME"] attributed weight changes/no changes to: [text name="changes" default="-"]

B. Risk Assessment
Suicide: [checkbox name="variable_14" value="denied any thoughts of suicide, intent, plans or access to means|voiced indistinct thoughts of ending their life, albeit with no serious intent|shared intense thoughts of suicide lacking in serious intent| conveyed thoughts of suicide, inclusive of a plan, but lacking a resolute intent|expressed a potent intent to commit suicide, but without a specified plan| unveiled a determined intent and a devised plan for suicide| expressed an immediate crisis of suicidal urgency and a need not to be left unattended"]
[textarea name="SI" default="-"]

Self-harm: [checkbox name="variable_15" value="denied any thoughts of DSH, intent, plans or access to means|revealed occasional thoughts of self-harm without suicidal ideation|confessed to sporadic self-harm thoughts accompanied by suicidal ideation, yet without definitive plans or earnest intent|reported engaging in non-suicidal self-injury"]
[textarea name="DSH" default="-"]

- Adolescent concerns/requests raised before family session: [textarea name="request" default="-"]

FAMILY SESSION SUMMARY
- Parent's [checkbox name="which" value="(mother)|(father)|(mother and father)"] instinct/s was that weight will [select name="instinct" value="increase|decrease|stay the same"]
A. Family Discussion
[textarea name="famsesh" default=""]
- Episodes of distress and risk reported by parent: [textarea name="parentdistressreport" default="nil reported."]
- What family found easy: [textarea name="easyformum" default="-"]
- What family found difficult: [textarea name="difficultformum" default="-"]
- Parent/s attributed weight changes/no changes to: [textarea name="parentsthink" default="unsure."]

B. Ongoing Risk and Family Assessment
- Parent/s' overall presentation in regards to treatment:    [checkbox name="parentpresentation" value="no    concerns|hopeful|distraught|neutral|indifferent|exhausted|teary|angry|upset"]
- Risk assessment & safety planning undertaken with family. 

PLAN SUMMARY
Food: [textarea name="foodplan" default="Parents to continue to be in charge of food preparation, meal planning, meal supervision 6x a day."]

Physical Activity: [textarea name="variable_8" default="nil changes from last session."]

Other: [textarea name="variable_10" default="N/A."]

FBT - Treatment Session
Clinician: Faith San Diego (Clinical Psychology Registrar)
Date:
Referral Type:
Location: The Mind Body Practice - Bella Vista;
Present: Faith; ;

Current FBT Phase:
Current Weight:
Change from last session:


INDIVIDUAL SESSION SUMMARY
- was feeling at the change in weight.
- 's affect was with reported feeling.

A. Client Discussion:

- Percentage of AN vs Client in session:
- Percentage of AN vs Client on average during the week:
- attributed weight changes/no changes to:

B. Risk Assessment
Suicide:


Self-harm:


- Adolescent concerns/requests raised before family session:


FAMILY SESSION SUMMARY
- Parent's instinct/s was that weight will
A. Family Discussion

- Episodes of distress and risk reported by parent:

- What family found easy:

- What family found difficult:

- Parent/s attributed weight changes/no changes to:


B. Ongoing Risk and Family Assessment
- Parent/s' overall presentation in regards to treatment:
- Risk assessment & safety planning undertaken with family.

PLAN SUMMARY
Food:


Physical Activity:


Other:


Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.35, 37 form elements, 164 boilerplate words, 11 text boxes, 13 text areas, 1 dates, 9 checkboxes, 3 drop downs, 69 total clicks
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