Appleseed Community Mental Health Center, Inc. Counseling Progress Note Page 2
ADVERTISEMENT
1
2
3
4
5
6
7
8APPLESEED COMMUNITY MENTAL HEALTH CENTER, INC.
COUNSELING PROGRESS NOTE
Client Name (First, MI, Last)
Client No.
Betty Borderline
5.0.5.
Others Present at Session: If others present, please list name(s) and relationship(s) to the client:
Client Present
Client No Show/Cancelled
Stressor(s)/ Significant Changes in Client’s Condition (for face-to-face visit)
No Significant Change from Last Visit
Mood/Affect
Thought Process/Orientation
Behavior/Functioning
Substance Use
Danger to:
Ideation
Plan
Intent
Attempt
Other:
None
Self
Others
Property
oal 1/objective 1
Goal(s)/Objective(s): G
Client reported she had strong thoughts of self-harm this week but had not
Therapeutic Intervention and Progress Toward Goal/s
:
acted on them. I asked how she had done this and labeled the skills she had used to assist her in circumventing these thoughts.
Affirmed validated her feelings noting she had done this without the people who usually are available to help her get through these
difficult times. Discussed the reason for thoughts of self-harm to increase awareness of when thoughts could re-occur in order to plan
to effectively manage these thoughts. Client commended for gaining the ego-strength to counteract urges to harm herself. Client
recognized her dysfunctional thoughts were, in part, the result of a disrupted routine that created anxiety which triggered self-
injurious thoughts. Client states that she does not currently have thoughts of self –harm.
Recommendation for Modification and Update of the ISP if Applicable: NA
Provider Signature/Credentials
Date
Supervisor Signature/Credentials (if needed)
Date
Thomas Therapist, LPC
12/23/10
Date
Medicare “Incident to” Services Only
Supervisor Signature/Credentials (if needed)
Supervisor Consultation (if needed)
Staff ID
Date of
Loc.
Prcdr.
Mod
Mod
Mod
Mod
Start
Stop
Total
Diagnostic
No.
Service
Code
Code
1
2
3
4
Time
Time
Time
Code
12/23/10
007
11
15
HE
-
-
-
1:00
-
:60
301.83
Rev 03/2010
ACMHC COUNSELING PROGRESS NOTE
Page 1
of
1
ADVERTISEMENT
0 votes
Related Articles
Related forms
Application Form For Sale/use Tax Exemption Certificate ( ) Community Mental Health Facility Or ( ) Community Mental Retardation Facility Or ( ) Community Substance Abuse Facility
Legal
Form St-r-06 - Application For Sale/use Tax Exemption Certificate Community Mental Health Facility Or Community Mental Retardation Facility Or Community Substance Abuse Facility
Financial
Related Categories
Parent category: Medical