Assessment data, crisis management documentation, consultation with other professionals, and telephone and email contacts.

University of Illinois at Urbana-Champaign

* General file information
* Documentation of service
* Other information

Three types of record keeping content

Vinay, B., Lakshmi, J., & Math, S. B. (2016). Ethical and legal issues in psychotherapy. In Ethical Issues in Counselling and Psychotherapy Practice (pp. 199-217). Springer, Singapore. https://doi.org/10.1007/978-981-10-1808-4_13

Ethical and Legal Issues in Psychotherapy

Demographic details, presenting problems, diagnosis, intervention plan, fee agreement, billing information and informed consent.

General file information

The date, duration and type of psychotherapy services and session notes. These notes should be updated for each contact with a client.

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