Therapist Recurring Session Form

Therapist First Session Form

Status of Session
Was this your first session with this client?
Did the session start and end on time?
How did the session happen?
Was this session observed
Does the client come with a diagnosis
What are their diagnoses?
Provisional Diagnosis: Organic & Symptomatic Mental Disorders
Provisional Diagnosis: Mental & Behavioural Disorders due to Psychoactive Substance Use
Provisional Diagnosis: Schizophrenia, Schizotypal, & Delusional Disorders
Provisional Diagnosis: Mood [Affective] Disorder
Provisional Diagnosis: Neurotic, Stress-Related, & Somatoform Disorders
Provisional Diagnosis: Behavioural Syndromes Associated with Physiological Disturbances & Physical Factors
Provisional Diagnosis: Disorders of Adult Personality & Behaviour
Provisional Diagnosis: Intellectual Disability
Provisional Diagnosis: Disorders of Psychological Development
Provisional Diagnosis: Behavioural & Emotional Disorders with Onset in Childhood and Adolescence
Provisional Diagnosis: Unspecified Mental Disorder
What primary concern did the client come with?
What secondary occupational concern did the client come with?
What secondary financial concern did the client come with?
What secondary Social concern did the client come with?
What secondary Environmental concern did the client come with?
What secondary Spiritual concern did the client come with?
What secondary Intellectual concern did the client come with?
What secondary Physical concern did the client come with?
What secondary Self & Personhood concern did the client come with?
What secondary Geriatric concern did the client come with?
What secondary Medical &/or Physical Health concern did the client come with?
What secondary Emotional concern did the client come with?
What secondary Supervision (Psychology) concern did the client come with?
Is the client at risk of suicide
Who encouraged the client to come for therapy?
What was the focus of the session?
What stage is the client at?
Is there a barrier for the client to continue therapy
What do you think is the biggest barrier for the client to seek therapy further?
Homework This Session
What type of homework you have been given
What kind of Behaviour Focused Homework you are given
What kind of Thought Focused Homework you are given
What kind of Written Homework you are given
What kind of Psychiatric Homework you are given
Did you experience Transference at any moment during the session ?
Did you experience Counter transference at any moment during the session ?
Do you need supervision for this client / concern
Was this the termination session?
Would you recommend Therapy packages to them ?
Which one would you recommend ?
How did you feel about the session?
What Self Help Product would help the client after this session?
How do you feel as a therapist after the session? :)
How do you feel as a human after the session? :)