Counseling Session Note (School Setting)

Date of Service: [date]

Start/End Time: [start time] – [end time] (If exact time unavailable, note reason and provide best estimate)

Student: [student name]

Counselor: [name and credentials]

Encounter Type: [routine session / brief check-in / crisis evaluation / re-entry meeting]

Modality: [in-person / phone / video]

Location: [location]

Participants: [names and roles of individuals present]

Confidentiality: [Student reminded of limits of confidentiality / Student previously informed of limits]

Consent Status: [student assent / parent consent / ROI on file] (Select all that apply)

Session Context

Referral: [self-referral / teacher / parent / administrator / IEP-504 team / crisis referral]

Domain: [academic / social-emotional / behavioral / attendance / postsecondary / safety] (Select all that apply)

Plan Linkage: [relevant IEP/504/MTSS goal or counseling episode goals] (Include only if applicable)

Session Focus: [what prompted today's visit, student's stated aim, and any immediate school impact] (1–3 sentences. If student declines to state a focus, document the attempt and observed behavior instead.)

Session Content

Student Report: [student-reported mood, stressors, functioning updates, skill use since last session, progress toward goals] (Use student language; include direct quotes only for high-importance statements)

Counselor Observations: [brief objective observations of affect, engagement, speech, and appearance if relevant] (Use neutral, behaviorally anchored language)

Interventions: [interventions provided and brief rationale] (e.g., psychoeducation, skill practice, role-play, problem-solving, supportive counseling)

Response: [student engagement, skill acquisition, insight, and progress toward goals]

Safety Assessment

Disposition: [No acute safety concerns endorsed or observed today / Safety concerns identified – see below]

(Complete the following only if safety concerns are present or unclear:)

• Concern: [what was said or observed, immediacy, intent, plan, access, protective factors]
• Actions Taken: [supervision, parent/guardian notification, safety planning, referrals, emergency response, final disposition]
• Contacts: [who was contacted, purpose, information shared, and outcome]
• Monitoring: [re-evaluation timing and monitoring plan]

Plan

Next Session Focus: [1–2 priorities for next meeting]

Student Tasks: [skills practice or coping strategies to try before next session]

Coordination: [who was contacted, purpose, what was shared, and outcome] (Include only if applicable. If unsuccessful, note "Left voicemail" or "Will reattempt" with timeline.)

Referrals: [outside counseling, evaluations, or school services with status: offered / accepted / declined]

Follow-up: [interval or scheduled date and contingency plan if concerns exist] (If no follow-up planned, document closure rationale.)

Counselor Signature: [typed name and credentials]

Date/Time Signed: [date and time]

Supervisor Co-sign: [supervisor name and review statement] (Include if trainee)