You can add a psychotherapy note for a client's appointment to record various information, such as therapeutic interventions used, the client’s response, or other significant insights. Unlike progress notes, psychotherapy notes aren’t tied to the medical record of the client, and don’t need to be shared with others unless your records are subpoenaed.
Note: For more information on adding progress notes, see Adding progress notes for individual appointments.
In this guide, we'll cover:
- Accessing psychotherapy notes
- Adding a psychotherapy note
- Editing, printing, downloading, or deleting a psychotherapy note
Accessing psychotherapy notes
Psychotherapy notes can only be added to an appointment if it's assigned to a clinician with one of the following specialties:
Applied behavior analysis
Behavioral health therapy
Counseling
Marriage and family therapy
Other
Psychiatric-Mental Health Nursing
Psychiatry
Psychology
Social work
Substance use counseling
If a clinician with another specialty is changed to one of those listed above, the clinician will be able to create and save psychotherapy notes for past and future appointments.
If a clinician's specialty is updated from one of those listed above to a different specialty, they’ll still be able to add psychotherapy notes for the client.
Adding a psychotherapy note
To add a psychotherapy note:
- Navigate to the appointment page by clicking the appropriate Appointment for their date of service
Note: For more information, see Navigating the appointment page.
- Verify that you're in the Note tab
Note: The updated appointment page is gradually being released to customers. This page may look slightly different in your account and will be updated within a few days.
- Begin typing in the text field to add the Psychotherapy note
- Click Save
Editing, printing, downloading, or deleting a psychotherapy note
After saving a psychotherapy note, you can click Edit to edit the note.
You can also click More to print, download, or delete the psychotherapy note.