There are many different progress note templates to choose from and I often find that people are using a psychotherapy note template they don't like... so what do I recommend? Well, that depends on you!
The Bad News: The best case note template will vary with each clinician.
The Good News: The best case note template will vary with each clinician... so you can make some quick changes right now that will improve your progress notes!
Watch the video below or read the summary underneath for some details on how you can do this today.
Here are some quick things to consider before adjusting your progress note template:
What sections of my case note do I like?
What template sections seem insufficient?
What do I write that doesn't seem to fit in one of my current case note template sections?
Then look at ways you can easily make adjustments to just these sections. You don't need to change the whole case note template! Add a section, take a section away, etc. Do what works for you.
Next, add checkboxes... but do it carefully and thoughtfully.
For the psychotherapy interventions section:
Don't go off someone else's list of therapy interventions. Sure, you might use a list to gather ideas but don't include every possible therapeutic intervention, because you won’t use them all regularly. If you're ignoring something all the time it is just getting in your way- delete it and move on!
For your client's response section:
Particularly if you work with similar types of clients, you will often have similar client responses in progress notes over time. Again, if these come up often then create checkboxes. If not, you can ignore this part... do what works for you ;)
For the plan section:
You likely have common recommendations for your clients so why not create checkboxes that will make your life (and your progress notes) easier? You can always leave blank spaces to provide more detail on things like dates or specific recommendations.
Want to see some examples?
Click here to sign up for the FREE Private Practice Paperwork Crash Course and you'll get immediate access to video trainings, case note templates and progress note examples.