Child Therapy Session Report
Document a child therapy session, including presenting concerns, observations, interventions, progress, and follow-up.
Child and Session Details
Child/Client Name
*
First Name
Last Name
Preferred Identifier
Age
*
Session Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Session Start Time
Hour Minutes
AM
PM
AM/PM Option
Session End Time
Hour Minutes
AM
PM
AM/PM Option
Session Duration
Therapist Name
*
First Name
Last Name
Session Type
*
Please Select
Individual
Family
Group
Dyadic
Other
Location / Delivery Mode
*
Please Select
In-person
Telehealth
Hybrid
Other
Referral Source
Presenting Concern and Session Goals
Presenting Issue
*
Summary of Concerns
*
Session Goals / Focus Areas
*
Behavioral and Emotional Observations
Observed mood/affect
*
Please Select
Very low mood
Low mood
Neutral
Positive mood
Very positive mood
Labile
Not observed
Attention and engagement level
*
Very low
1
2
3
4
Very high
5
1 is Very low, 5 is Very high
Cooperation during session
*
Not cooperative
1
2
3
4
Highly cooperative
5
1 is Not cooperative, 5 is Highly cooperative
Communication style
Please Select
Verbal and age-appropriate
Limited verbal responses
Quiet but responsive
Nonverbal/gestural
Highly expressive
Mixed
Other
Notable behaviors observed
Therapeutic Interventions
Interventions Used
*
Play therapy
CBT skill practice
Art activity
Psychoeducation
Breathing exercise
Role-play
Mindfulness exercise
Social skills practice
Sensory activity
Other
How the Child Responded
*
Notes on Play Therapy Activities
Notes on Skill Practice or Activities
Progress and Risk/Support Notes
Progress Since Previous Session
*
Skills Demonstrated
Barriers or Challenges
Follow-up Support Needed?
*
No
Yes
Plan and Follow-up
Preferred Follow-up Date and Time
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Plan for Next Session
*
Homework or Practice for Home
Referrals or Coordination Notes
Therapist Documentation
Therapist Name
*
First Name
Last Name
Credentials / Professional Title
*
Submit Report
Should be Empty: