Client Notes Form Client* Date Counselor * do not use client’s real name for class assignment 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 Worst Best Scaling Questions Participation Progress Participation Quality Affect Cognitive Active Strong progress Attentive Appropriate Rational Minimal Some progress Sharing Hyper-Active Coherent None Stable Supportive Excited Confused Regression Intrusive Anxious Alert None Monopolizing Depressed Paranoid Client Insight Other: Resistant Elated Delusional Good Distracted Drowsy Hallucinating Minimal Other: Flat Other: None Other: Treatment Summary (use SOAP format): Approach Actively Listen Boundary setting Challenging Clarification Confrontation Exploration Goal Setting Limit Setting Orientation Reality-testing Role–play Socialization Support Other: Theoretical Approach Adlerian Behavioral Client-centered Cognitive/CBT Family Systems Narrative Play/Art Therapy Reality/Choice Solution-focused Other: Adapted from Family intake & case notes forms SOAP Notes Format
Client Notes Form Client* Date Counselor * do not use client’s real name for class assignment Scaling Questions Worst 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 Best Participation Active Minimal None Progress Strong progress Some progress Stable Regression None Other: Participation Quality Attentive Sharing Supportive Intrusive Monopolizing Resistant Distracted Other: Affect Appropriate Hyper-Active Excited Anxious Depressed Elated Drowsy Flat Other: Cognitive Rational Coherent Confused Alert Paranoid Delusional Hallucinating Other: Client Insight Good Minimal None Treatment Summary (use SOAP format): Approach Actively Listen Boundary setting Challenging Clarification Confrontation Exploration Goal Setting Limit Setting Orientation Reality-testing Role–play Socialization Support Other: Theoretical Approach Adlerian Behavioral Client-centered Cognitive/CBT Family Systems Narrative Play/Art Therapy Reality/Choice Solution-focused Other: Adapted from Family intake & case notes forms SOAP Notes Format
client_intake-case_notes.docx