Therapists Client Report

Client Information

General information
Client ID number given by the NHS, get this from Simon
Today's date
Therapist selection
Who is the report for? (use other if not listed)

New Request for Sessions

Does this report indicate an request for additional sessions?
If yes, how many are you requesting?
Are there any suicidal or self-harm risks (other can be used for anything different)
What is the risk? (use other to explain in more depth or another risk reported if required)

Learning

Major unavoidable factors, school education
Only complete this if the client has any of the listed, use other if it is not listed
Only complete if more than 1 (use other to list more than 2 if required)

Deaf Specific

Does the patient have specific mental health factors that are in relation to exclusion?
Old info but need it entered
Type of education
Employer support
Work attendance

Mental Health Issues

The major mental health condition/issue (the number 1 reason for counselling?
Number 1 mental health Issue identified after first few sessions (this could of changed from the original assessment)
Counsellors assessment of the mental health of the client. (use other if required)
Counsellors assessment of the client on date of report.

Mental Health Issues

Co-existing mental health issue
Additional mental health issue (only use, if this is in addition to the one above, in my experience clients have multiple issues which we can highlight and help with the funding for additional sessions)
As above
As above

Mental Health Issues

Co-existing mental health issue
Additional mental health issue if more than 2 listed (only use, if this is in addition to the one above)
As above
As above

Contributing factors

Emotional Factors for Mental Health Decline
Explains how the patient feels from the counsellors sessions (counsellor assessment)
Only use if multiple issues
Only use if multiple issues

Disabilities/Pain/Illness

Explains any additional factors that can be contributing to poor mental health
Only use if more than 1
Only use if more than 2

Victim

Major contributing factors to mental health decrease
Major causes of mental health disorders, use other if not listed
As above if more than 1
As above, use other if more than 3

Addictions

Does the client have any addictions that contribute to the mental health condition?
Does the client have any addictions
Additional addictions if any?
Frequency of use

Client Support Network

Who helps the client
Explain if there is something we need to bring to the attention of the doctor or social worker for example (client consent must be obtained to complete this section)

Risk

Life or harm risk
Possible injury to others
Any additional Information?
Page Reader Press Enter to Read Page Content Out Loud Press Enter to Pause or Restart Reading Page Content Out Loud Press Enter to Stop Reading Page Content Out Loud Screen Reader Support
Skip to toolbar