Mid-Term 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)

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)
As above
As above

2

Only use if multiple issues
As above
As above

3

Only use if multiple issues
As above
As above

Addictions

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

New Request for Sessions

Does this report indicate an request for additional sessions?
The NHS do not like requests for more sessions, will apply if required
If yes, how many are you requesting?
Any additional Information?

Section

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)

Section

Any additional Information?
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