Progress Notes

Please open an email, address it to “anne@annegiles.com,” type “I learned” into the subject line, then copy and paste the text in quotes between the sets of asterisks into the body of the message, back over the underlines, and fill in the blanks. Feel free to note progress towards your primary goal or towards other goals. Please send me the email after you share its content aloud.

Brief statement of progress

  1. The concerns I brought to the session today were __________, __________, and __________.
  2. As a result of the session, I learned __________.
  3. I think what I learned will be of value to me because it will help me __________.
  4. My next steps are to __________, __________, and __________.

Comprehensive statement of progress

“I engage in counseling to help myself primarily with __________.

The concerns I brought to the session today were __________, __________, and __________.

In today’s session, I learned __________.

This will be of value to me because/when __________.

Adding in my work today, I estimate I’ve reached ____% progress toward my goal to __________.

Between now and the next session, to possibly increase the efficiency with which I make progress, I might want to focus on/pay attention to __________.

My assignment to myself between now and the next session is to __________.

A self-care practice I intend to engage in between now and the next session is __________.

The self-care practice I recommended to myself last session was __________. I engaged in this self-care practice _____ times.”

. . . . .

Statements are recorded in progress notes with introductions such as these:

“Self-report of progress for collaboratively-created progress notes copied verbatim from client’s summary email:”

and are introduced with a related summary.

Sample summary for group session

The client participated in a CPT-based/CBT-based telehealth group counseling session via Zoom. Within the limits of cursory observations occurring within an online group counseling session, and without the possibility of individual interviews, with regard to mental status, suicidality, and homicidality, the client appeared stable.

Sample summary for individual session

The client participated in an individual telehealth session via Zoom/SimplePractice Telehealth. Counseling modalities included elements of cognitive behavior therapy (CBT), dialectical behavior therapy (DBT), cognitive processing therapy (CPT), motivational interviewing, and strengths-based therapy. Within the limits of observations occurring within an online counseling session, with regard to mental status, suicidality, and homicidality, the client appeared stable.

For individual CPT sessions

At the end of the session, please open an email. In the subject line, please write “CPT Session #_____,” then copy and paste the text in quotes between the sets of asterisks into the body of the message. Take two minutes, back over the underlines, and fill in the blanks.

“My PCL-5 score was __________. My PHQ-9 score was __________. Today, I learned __________. So far in CPT, I have learned _________. I think what I have learned will be of value to me because it will help me __________. My next steps will be to __________.”

For family of origin issues group

  1. What issues did I bring to the session?
  2. How have I gained freedom and power?
  3. How will I apply these insights in the coming week?

Last updated 6/3/22

This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.