Private Practice Progress Note

Client Name: 
[text name="name" default="client name"]
Session Date: 
[date name="date" default="00/00/2022"]
Session Time: [time name="time" default="00:00"]
[select name="time" value="AM|PM"]
Session Length: [select name="time elapse" value="15 minutes|30 minutes|45 minutes"]

Mode of Treatment [checklist name="Mode of Treatment" value="Individual|Couples|Family|Group"]
Session Format [checklist name="format" value="In Person|Teletherapy Audio|Teletherapy Video|Other"]
Session Frequency [checklist name="frequency" value="1x/week|2x/week|1x/month|2x/month|Other"]
Client's location of current physical address: 
[select name="state" value="Maryland|California|Other"]

Therapeutic Interventions
[checkbox name="intervention" value="Psychodynamic|Cognitive Behavioral|Attachment-Oriented|Behavioral|Crisis Intervention|Modeling and Skills Training|Psychoeducation|Therapeutic Exercises and Activities|Mindfulness|Supportive|Other"]

Target Problem Areas Identified 

Narrative Session Summary
[textarea name="summary" default="sample text"]

Next Appointment Scheduled: [date name="date_2" default="00/00/2022"], [time name="time_2" default="00:00"]

Treatment Goals
[checklist name="goals" value="Reduce distress in identified problem areas.|Symptom stabilzation.|Enhance self-awareness."|

Treatment Objectives
[checklist name="objectives" value=Explore and understand the influence of the past on present behavior and emotions.|Examine and repair unresolved conflicts.|Recognize and address defense mechanisms.|Recognize and challenge cognitive distortions.|Learn and utilize healthy coping strategies."]

Recommendations
1) Client will attend all scheduled individual teletherapy appointments.
2) Client will contact therapist with any questions/concerns that may arise between sessions. 
3) Client will notify therapist if change in safety risk occurs and will follow safety plan in event of crisis. 
4) Client will complete weekly assignments.
5) Client will engage in weekly reflective journaling.

Homework Assignment: 
[text name="homework" default="homework"]