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Form44 - q Much worse 9 Other observations/evaluations...

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[ FORM 44 —Use the top of this page for your letterhead.] Group Therapy Progress Note Client and group information Client: Date: Meeting attended is #: for this client. Group’s name: Time: A.M./P.M. Location: # present: Leader(s): Signature(s): Assessment of client 1. Participation level: q Active/eager q Variable q Only responsive q Minimal q Withdrawn 2. Participation quality: q Expected q Supportive q Sharing q Attentive q Intrusive q Monopolizing q Resistant q Other: 3. Mood: q Normal/euthymic q Anxious q Depressed q Angry q Euphoric q Other: Affect: q Normal q Intense q Blunted q Inappropriate q Labile q Other: 4. Mental status: q Normal q Lessened awareness q Memory deficiencies q Disoriented q Disorganized q Confused q Vigilant q Delusional q Hallucinating q Other: 5. Suicide/violence risk: q None q Ideation only q Threat q Rehearsal q Gesture q Attempt 6. Change in stressors: q Less severe/fewer q Different stressors q More/more severe q Chronic stressors 7. Change in coping ability/skills: q No change q Improved q Less able q Much less able 8. Change in symptom severity: q Same q Less severe q Resolved q More severe
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Unformatted text preview: q Much worse 9. Other observations/evaluations: Modes of interventions/treatments q Support q Clarification q Education q Exploration q Problem solving q Limit setting q Role play q Socialization q Orientation q Reminiscence q Reality testing q Activity q Confrontation q Other: Topics/themes/critical incidents q Relationship(s) q Work problems q Alcohol/drug problems q Parenting q Abuse q Childhood/family of origin q Sexual q Homework assignments q Process q Logistics/structure q Other: Further comments: This is a strictly confidential patient medical record. Redisclosure or transfer is expressly prohibited by law. FORM 44. Structured progress note form for group therapy. From The Paper Office . Copyright 2008 by Edward L. Zuckerman. Permission to photocopy this form is granted to purchasers of this book for personal use only (see copyright page for details)....
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  • Spring '10
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  • Edward L. Zuckerman, group information Client, Group Therapy Progress, progress note form, strictly confidential patient

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