Free Therapist Training›Family Therapy Toolkit›Session Note
Last updated: November 11, 2026
A family therapy progress note records a session with several people in the room. Like any progress note, it documents the date, the focus, the interventions, the response and the plan, but it also has to say whose record it belongs to, who attended, what happened between family members and how each of them responded. The template below has a narrative version and a SOAP version, and a completed example of both follows.
The note's hardest question comes before the first session: who is the client? The second half of this page explains how to answer it and how the HIPAA definition of psychotherapy notes applies to family and joint sessions. The template is part of the Sentio MFT program's free family therapy toolkit.
An optional template from the Sentio MFT program's family therapy toolkit, free to adapt.
Download the PDFCopy in Google Docs
| Field | Entry |
|---|---|
| Record | Whose record this note is filed in, and the member named for billing if the payer requires one |
| Date; start and end time; session number | |
| Format | In person / Telehealth (each participant's location) |
| Present | Name and role of each person present; who was absent and why |
| Focus of the session | The goal or problem the session addressed, with the treatment plan goal numbers |
| Interaction observed | The sequence between members in the session: who did what, then who responded |
| Interventions | What the therapist did, for example joining, tracking, circular questions, an enactment, boundary making or a reframe |
| Response | How each member responded, and any change from previous sessions |
| Progress toward goals | Each goal number with a word or two on movement and any measure collected |
| Risk and safety | Screened: yes / no. Changes. Safety plan reviewed. Any mandated report made or considered. |
| Individual time and disclosures | Any separate time with a member, and how information was handled under the family's agreement |
| Plan | Tasks agreed, who will attend next, date of the next session |
| Signature, license or registration, date |
SOAP version
| Section | What to write |
|---|---|
| S, subjective | What each member reported, in their own words where it matters |
| O, objective | Who attended; what the therapist observed: the interaction sequence, affect, who spoke to whom; any measure collected |
| A, assessment | The therapist's understanding of the pattern this session; progress toward each goal; risk |
| P, plan | Tasks, next session, who will attend, any referral or coordination |
Write the note in the record you and the family agreed on. Describe what members did and said in the session, and leave out details about one member that the others' treatment does not need.
Family Therapy Progress Note Example
The note below records the fourth session with the Hale-Carter family, the invented blended family used throughout the toolkit, first in the narrative format and then as a SOAP note. The family is the client and the note is filed in the family's record, and Ava is named as the patient for billing because the family's health plan pays for the sessions as treatment of her condition.
| Field | Entry |
|---|---|
| Record | Hale-Carter family record. Named for billing: Ava Carter. |
| Date; start and end time; session number | November 5, 2026; 4:00 to 4:55 p.m.; session 4 |
| Format | In person |
| Present | Jenna Hale (mother), Chris Hale (stepfather), Ava Carter (15). Ben Carter (12) joined for the last 20 minutes. |
| Focus of the session | Goal 1, the parents agreeing on evening rules; goal 2, reducing escalations |
| Interaction observed | When Chris proposed a 10 p.m. phone rule, Ava turned to Jenna and said, "You said eleven." Jenna began to soften the rule. Chris folded his arms and stopped talking. |
| Interventions | Blocked Ava's appeal and asked Jenna and Chris to agree on the rule between themselves (enactment) while Ava listened. Tracked the sequence with circular questions to Ben. Reframed the evening fights as the family adjusting to Jenna's night shifts. |
| Response | Jenna and Chris agreed on 10:30 p.m. on school nights after two attempts. Ava protested, then asked whether the weekend rule would differ. Ben said evenings were "quieter this week." |
| Progress toward goals | Goal 1: first agreed rule. Goal 2: family log shows three escalations this week, down from six at intake. |
| Risk and safety | Ava screened alone: denies suicidal thoughts; no change. No violence reported. No report indicated. |
| Individual time and disclosures | Ten minutes alone with Ava. She said she misses her grandfather and that the anniversary of his death is next week; she agreed to raise it in the family session. |
| Plan | Jenna and Chris present the 10:30 rule together on Sunday; family keeps the escalation log. Next session November 12, all four members. |
| Signature | J.R., AMFT, supervised by A.B., LMFT. November 5, 2026. |
The same session as a SOAP note
| Section | Entry |
|---|---|
| S | Jenna: evenings "a little calmer." Chris: "I still feel like the bad guy." Ava: the rule is "unfair." Ben: "quieter this week." |
| O | Jenna, Chris and Ava present for 55 minutes; Ben for the last 20. When Chris raised the phone rule, Ava appealed to Jenna and Jenna began to concede; Chris withdrew. After the therapist blocked the appeal, Jenna and Chris negotiated directly and agreed on 10:30 p.m. Family log: three escalations this week, six at intake. |
| A | The appeal-and-reversal sequence appeared in session and changed when the parents negotiated directly, which supports the working hypothesis that the problem continues while the adults have not agreed how to parent together. Progress on goals 1 and 2. Ava's risk is low; the anniversary of her grandfather's death falls next week. |
| P | Parents present the rule together on Sunday. Continue the log. Next session November 12 with all four members; plan time to talk about the anniversary of Ray's death. |
Who Is the Client in a Family Therapy Record?
The client is whoever the therapist and the family agree is the client: the family as a whole, a couple, or one member with other relatives taking part in that member's treatment. The APA, ACA and NASW codes ask the clinician to settle this at the start. The American Psychological Association's code asks psychologists who serve several related people to clarify at the outset which of them are clients and the relationship the psychologist will have with each (Standard 10.02). The American Counseling Association's code asks counselors to define who the client is and to record in writing the agreement on confidentiality reached with everyone involved, and where there is no other agreement it treats the couple or family as the client (Standards A.8 and B.4.b). The National Association of Social Workers' code asks social workers to clarify with all parties which individuals will be considered clients (Standard 1.06(d)). The AAMFT code, revised effective January 1, 2026, recognizes that the client may be more than one person; when a therapist serves someone at a third party's request, it asks the therapist to clarify at the outset the nature of the relationship with each party (Standard 1.12). In couple, family or group treatment it bars disclosing information outside the treatment context without written authorization from each person competent to give it, apart from disclosures the law requires or permits (Standard 2.2).
That decision answers the question the record keeps asking, which is who is the primary focus of the documentation. If the family is the client, keep one family record and write each note about the family's work, naming each participant. If one member is the client and others attend in support, the notes go in that member's record and describe the others only as far as the client's treatment needs. Billing can add a second answer. Medicare covers family psychotherapy, with or without the patient present, when the patient's treatment is its primary purpose, and one Medicare contractor's coverage policy lists what the note should show: the patient's symptoms, the patient's participation, the family's reaction to the patient and any change in the patient, with the documentation kept in the patient's chart. Other payers set their own rules, so check how a family's plan pays for family sessions before the first one.
Progress Notes, Psychotherapy Notes and Family Sessions
HIPAA separates two kinds of notes. Psychotherapy notes are notes a mental health professional writes to document or analyze the contents of conversation during a counseling session, kept separate from the rest of the record, and the federal definition expressly includes notes on "a group, joint, or family counseling session" (45 CFR 164.501). The definition excludes medication prescription and monitoring, session start and stop times, the modalities and frequencies of treatment, results of clinical tests, and any summary of diagnosis, functional status, the treatment plan, symptoms, prognosis and progress to date.
In practice, the template on this page is a progress note: it belongs in the record and is subject to the ordinary rules on access and release. Detailed observations of what each family member said, kept apart from the record for the therapist's own use, can qualify as psychotherapy notes. Most disclosures of psychotherapy notes require a specific authorization, although a covered entity may use them without one in its own supervised training programs, and they fall outside a client's right to inspect their records under HIPAA. Two cautions apply to families. Psychotherapy notes about a family session describe several people at once, so decide in advance how you will handle a request from one of them. And HIPAA applies to a practice only if it is a covered entity or a business associate of one: our guide to whether HIPAA applies to California therapists explains when it does and how California's Confidentiality of Medical Information Act applies.
What to Include in a Family Therapy Progress Note
Record whose record the note belongs to and who attended, with each person's role, and note any change in who is being treated, such as a member joining or leaving the sessions. Describe the focus of the session in terms of the treatment plan's goals, then the interaction you observed: the sequence between members, not just the identified patient's behavior. Name the interventions, such as an enactment, a reframe, boundary making or circular questions, and how each member responded. Note any risk screening and its result, any time spent alone with one member and how information from it was handled, and the plan.
Write about what members did and said, and leave out details about one member that the others' treatment does not need, since in a family record every adult who is a client may later ask to see it. HIPAA lets a licensed professional deny access to parts of a record that refer to another person when access is reasonably likely to cause that person substantial harm, but the patient can ask for the denial to be reviewed, so write each note as though every adult client named in it may read it. A note that could be read aloud to the whole family without harm is usually a well-written family note.
How Long Must California Therapists Keep Family Records?
California requires a licensed marriage and family therapist to keep a client's health service records for at least seven years from the date therapy ends, and for a minor, at least seven years from the date the client turns 18 (Business and Professions Code section 4980.49). Clinical social workers and professional clinical counselors have the same rule in section 4993 and section 4999.75. In a family record that includes a child, the minor's rule usually sets the longer date.
Practice next: interrupting escalation
The session in the example turned when the therapist stopped an exchange that was heading toward a familiar fight. A note can record that moment, but rehearsal is what makes it possible.
Watch episode 15: Systemic De-escalationSystemic therapy pagePractice set in the toolkit
Rehearse the de-escalation statements in the toolkit's practice set until you can interrupt a rising exchange calmly, name each person's concern and restore turn-taking.
Keep reading
Family Therapy Treatment Plan, the goals each note's progress section refers to
Family Therapy Intake Form, where the client and the record are decided
Does HIPAA Apply to Your California Therapy Practice?, covered entities, the Confidentiality of Medical Information Act and retention
Free Family Therapy Toolkit, all eight templates on one page
Frequently Asked Questions
What should a family therapy progress note include?
Whose record it belongs to, the date and length, who attended, the focus of the session tied to treatment plan goals, the interaction observed between members, the interventions used, each member's response, progress toward each goal, risk screening, any individual time and how information from it was handled, and the plan.
Who is the primary focus of the documentation in family therapy?
The client the therapist and family agreed on at intake: the family as a whole, a couple, or one member with relatives taking part. If the family is the client, the notes focus on the family's work and go in one family record; if one member is the client, the notes go in that member's record and describe others only as far as the client's treatment needs. When a payer covers the sessions as treatment of one member's condition, as Medicare does, the note also shows how the session served that member's treatment.
Is a family session note a psychotherapy note under HIPAA?
A progress note kept in the record is not. HIPAA's psychotherapy notes are notes documenting or analyzing the contents of conversation in a counseling session, including a joint or family session, that are kept separate from the rest of the record, and they exclude summaries of diagnosis, the treatment plan, symptoms and progress.
Do I write one note per family session or one for each member?
One note per session in the record you agreed on. If each member is an individual client with their own record, the note in each record should describe that member's participation and avoid recording others' private information beyond what their treatment needs.
How do I write a SOAP note for family therapy?
Under S, record what each member reported; under O, who attended and the interaction you observed; under A, your understanding of the pattern and progress toward each goal; under P, the tasks, next session and who will attend.
How long do California therapists keep family therapy records?
At least seven years from the date therapy ends, and for a minor at least seven years from the date the client turns 18, under Business and Professions Code section 4980.49 for marriage and family therapists and the matching sections for clinical social workers and professional clinical counselors.
References
American Association for Marriage and Family Therapy. (2026). AAMFT code of ethics. https://www.aamft.org/web/Action-Advocacy/Code-of-Ethics-New.aspx
American Counseling Association. (2014). ACA code of ethics. https://www.counseling.org/docs/default-source/default-document-library/ethics/2014-aca-code-of-ethics.pdf
American Psychological Association. (2017). Ethical principles of psychologists and code of conduct (2002, amended effective June 1, 2010, and January 1, 2017). https://www.apa.org/ethics/code
California Business and Professions Code § 4980.49. https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=BPC§ionNum=4980.49
California Business and Professions Code § 4993. https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=BPC§ionNum=4993
California Business and Professions Code § 4999.75. https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=BPC§ionNum=4999.75
Centers for Medicare & Medicaid Services. (2026). Medicare mental health (MLN1986542). https://www.cms.gov/files/document/mln1986542-medicare-mental-health.pdf
Electronic Code of Federal Regulations. 45 C.F.R. § 164.501, Definitions. https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.501
Electronic Code of Federal Regulations. 45 C.F.R. § 164.508, Uses and disclosures for which an authorization is required. https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.508
Electronic Code of Federal Regulations. 45 C.F.R. § 164.524, Access of individuals to protected health information. https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.524
First Coast Service Options. (2020). Psychiatric diagnostic evaluation and psychotherapy services (LCD L33252) [Local coverage determination]. Centers for Medicare & Medicaid Services, Medicare Coverage Database. https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33252
National Association of Social Workers. (2021). Code of ethics of the National Association of Social Workers. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English
