A session and a case note

Date:

Client #:

Session #:

Clients Present:

Length of Session_____ Start Time_______ Stop Time_______

Modality FORMCHECKBOX Ind. FORMCHECKBOX Couple FORMCHECKBOX Family FORMCHECKBOX Group

Identified Ethical Concerns:

Goals Addressed in session: Progress displayed:

1. ________________________________________________ FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Yes FORMCHECKBOX No

2. ________________________________________________ FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Yes FORMCHECKBOX No

3. ________________________________________________ FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Yes FORMCHECKBOX No

Intervention Domains and Notes

FORMCHECKBOX Therapeutic Alliance FORMCHECKBOX Problem Assessment FORMCHECKBOX Emotion Management FORMCHECKBOX Cognitive Processes FORMCHECKBOX Behavior Patterns FORMCHECKBOX Relational Patterns

Narrative:

Signature of Student Therapist

Date