Progress Note
Student's Name
*
Date of Service
*
/
Month
/
Day
Year
Date
Topic(s) of Session:
*
Mode of Service
*
Individual
Group
Family
Crisis Intervention
Summary of Activities/Lessons and/or Worksheets Completed:
Evidence Based Intervention Plan (Used in this session):
*
Discrete Trial Training (DTT)
Natural Environment Training (NET)
Pivotal Response Teaching (PRT)
Antecedent Based Interventions(s)
Differential Reinforcement Strategies
Functional Communication Training
Stimulus-Stimulus Pairing
Story Based Interventions
Preparing for Life Curriculum
Tough Kid Social Skills Lesson
Boys Town Social Skills Lesson
UCLA PEER Curriculum
Social Skills Training (Jed Baker)
Exploring Feelings (Tony Atwood)
Social Skills Picture Book
Contingency Contracting
Progressive Relaxation
Modeling
Shaping
Role Play
Visual Schedules
Room 14
Room 28
Token Economy
Skillsstreaming
Other
Assessment of Student
Mood
Happy/Euthymic
Anxious
Depressed
Angry
Irritable
Euphoric/Elated
Other
Participation Level:
Active/Eager
Variable
Only Responsive
Minimal
Resistant
None
Participation Quality:
Expected
Supportive
Monopolizing
Attentive
Sharing
Intrusive
Resistant
Other
Program/Treatment Compliance:
Full
Partial
Low/Noncompliant
Resistant
Denial
Homework/Skill(s) to Practice for Student:
*
Treatment Plan for Next Session(s)/Other Comments/Notes/Concerns:
*
Teacher conference:
Yes
No
Went over Level System Progress:
Yes
No
Physician/CMHC referral/Consult:
Yes
No
Parent Conference/Home Note/Call:
Yes
No
Therapists Signature
*
Session Length
*
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