FAMILY SESSION PROGRESS NOTE: CARIS COUNSELING
CLIENT:
CLIENT:
DATE
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
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1996
1995
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1981
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1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
LENGTH OF SESSION
SESSION NUMBER
MODALITY CLIENT #1
Please Select
Individual
Family
Group
Consultation
Parent consult
Teacher consult
IEP meeting
Peer Mediation
Meeting: Type
Other
MODALITY Client #2
Please Select
Individual
Family
Group
Consultation
Parent consult
Teacher consult
IEP meeting
Peer Mediation
Meeting: Type
Other
TREATMENT/INTERVENTIONS
Please Select
Solution-Focused
Person Centered
REBT
CBT
Hip Hop Therapy
Music Therapy
Biblotherapy
Reminiscence Therapy
Interpretation
Behavioral
Homework Given
Family Meeting
Relationship
Role Play
Problem Solving
Reframing
Psychoeducation
Provide Alternatives
Confrontation
Limit setting
Exploration of thoughts/feelings
Facilitated Expression
Encouraged Participation
Support/Empathy
Validation
Reflection
Building trust
Facilitated play
Contracted
Other:
TREATMENT/INTERVENTIONS
Please Select
Interpretation
Behavioral
Homework Given
Family Meeting
Relationship
Role Play
Problem Solving
Reframing
Psychoeducation
Provide Alternatives
Confrontation
Limit setting
Exploration of thoughts/feelings
Facilitated Expression
Encouraged Participation
Support/Empathy
Validation
Reflection
Building trust
Facilitated play
Contracted
Other:
SUIDICALITY
Please Select
NO SI
WISHES TO BE DEAD
IDEAS, NO INTENT
IDEAS & INTENT
NO PLANS
HOMICIDE IDEATIONS
Please Select
YES
NO HI
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COMMUNICATION
COMMUNICATIVE
MINIMAL COMMUNICATION
UNCOMMUNIVATIVE
DISTRACTED
INATTENTIVE
ATTENTIVE
& RELAXED
& SLOW
& TENSE
& ANXIOUS
& UNHAPPY
& HAPPY
& OTHER
MOOD
ELEVATED
DEPRESSED
EUTHYMIC (NORMAL)
BEHAVIOR
OPPOSITONAL
DEFIANT
UNCOOPERATIVE
INTRUSIVE
POOR EYE CONTACT
NOISE SENSITIVE
DISTRUSTING
Other
APPERANCE
ANGRY
CALM
FRIENDLY
FLAT
SAD
DOWNCAST
GUARDED
HAPPY
IRRITABLE
WELL-GROOMED
CASUAL GROOMED
DISHEVELED
UNDER WT
NORMAL WT
OVER WT
Other
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RESPONSE TO TREATMENT
Please Select
SAME
WORSE
BETTER
STABLE
RECOVERING
IMPROVING
NONE
MINIMAL
SLIGHT
PARTIAL
INADEQUATE
UNIMPROVED
AGITATED
ASSERTIVE
LABILE
TOPICS/THEMES DISCUSSED
Please Select
Gender Identity
Behavior Modification
Problem Solving
Self-Esteem
Stress/Relaxation
Conflict Resolution
Grief Loss
Good Touch/Bad Touch
Social SkillsLife Skills
Coping Skills
Patience/Tolerance
Personal Boundaries
Trust Building
Connections:Thoughts, Feelings, Actions
Communication
Anxiety
Anger management
Relationship(s)
Work problems
School Problem
Substance Related Issues
Childhood/Family of Origin
Identity/Role
Dreams
Parenting
Other
RESPONSE TO TREATMENT
Please Select
SAME
WORSE
BETTER
STABLE
RECOVERING
IMPROVING
NONE
MINIMAL
SLIGHT
PARTIAL
INADEQUATE
UNIMPROVED
AGITATED
ASSERTIVE
LABILE
TOPICS/THEMES DISCUSSED
Please Select
Gender Identity
Behavior Modification
Problem Solving
Self-Esteem
Stress/Relaxation
Conflict Resolution
Grief Loss
Good Touch/Bad Touch
Social SkillsLife Skills
Coping Skills
Patience/Tolerance
Personal Boundaries
Trust Building
Connections:Thoughts, Feelings, Actions
Communication
Anxiety
Anger management
Relationship(s)
Work problems
School Problem
Substance Related Issues
Childhood/Family of Origin
Identity/Role
Dreams
Parenting
Other
Notes/Summary
Theme of session/Topic/Treatment Goal:
Response to Intervention
Rows
Very Good
Good
Somewhat Good
Poor
Level of trust/counseling relationship
1
2
3
4
Level of Skill Acquisition
5
6
7
8
Level of Acceptance of Responsibility for Behavior
9
10
11
12
Level of Responsiveness
13
14
15
16
Shellie Cheirs, M.Ed, LPC
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