RSW SESSION PROGRESS NOTE:
RSW:
First Name
Last Name
RSW Certification Number
Client Name
First Name
Last Name
Session Date
-
Month
-
Day
Year
Date
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
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:
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
APPERANCE
ANGRY
CALM
FRIENDLY
FLAT
SAD
DOWNCAST
GUARDED
HAPPY
IRRITABLE
WELL-GROOMED
CASUAL GROOMED
DISHEVELED
UNDER WT
NORMAL WT
OVER WT
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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
Very Good
Good
Somewhat Good
Poor
Level of trust/counseling relationship
Level of Skill Acquisition
Level of Acceptance of Responsibility for Behavior
Level of Responsiveness
Next Session Date
-
Month
-
Day
Year
Date
Next Session Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Type a question
Session Type
INHOME
INCOMMUNITY
VIRTUAL
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