Group therapy offers a unique experience that can complement individual sessions or even stand alone. In group therapy, your clients can feel the support of others, work through issues with others in a safe environment, and gain important insights. And there’s healing power in the message that group therapy communicates: “You’re not the only one.”
Just as with individual sessions, you’ll need to provide documentation for your group sessions. In this guide, we look at how group therapy notes are different from individual therapy notes, some tips that will help you write them better, and five essential pieces of documentation that you’ll need to include.
While you may be able to provide one set of notes for the group as a whole, most insurers require individualized group therapy notes — a customized version for each client. For each client participating in the group session, you’ll lead with notes describing the group name, topic, interventions, etc., and then follow with individual notes describing the client’s interactions with the group.
Though it may seem daunting to consider writing multiple sets of notes for each client involved in the session, the group-related information will be the same for all involved, so you can use the same material for this section on each note.
Insurers are typically looking for a few important characteristics in group notes. Keep the following best practices in mind to help you write better notes with higher acceptance rates.
1. Use an objective tone — It can be challenging to stay objective as you’re writing your notes, but it’s essential. Be aware of any potential bias towards a particular participant and don’t include anything in the group notes that could suggest favoritism.
2. Maintain client confidentiality — All individualized group notes should anonymize other participants for client confidentiality. For example, if you’re working on John’s individualized group notes, and you want to describe how “John” interacted with “Sam” in the session, you would say something like, “John got angry with another group member when the other member began talking about a personal experience.”
3. Write for other care team members — At some point in time, other current or future providers may need to take over a client’s or group’s treatment. For this reason, you’ll want to be sure your notes are clear and precise. Your analysis of each group meeting, along with the plan for progress should be clearly documented. Well-written notes help other providers to understand the details of past meetings and allow them to pick up future meetings seamlessly.
4. Describe methods and interventions used in the session — Group therapy sessions typically cover a certain topic (for example, methods and strategies used for sobriety management). Based on the group discussion, you might help clients craft a plan that each person can apply to their personal situation. You should include all these details in your notes.
The format you use for your group notes can be the same as the one you use for individual notes — SOAP, DAP, etc. But in addition to the standard information you would chronicle for an individual session (such as outlining the client’s goals and describing relevant behavior of the client), you’ll want to include five additional elements in each individual version of your group notes.
1. Create a summary of the group that you’ll use for each individualized note — Your summary should share the designated name of the group, the primary topic of discussion, the interventions you used, and the schedule that the session followed.
2. Describe how the client interacted with the group — In their individualized version of the notes, it’s important to specify how each client interacted with the group.
3. Specify how the group reacted to and interacted with the client — How did the group respond to the individual client? Describe reactions and interactions in each individual version of group notes.
4. Describe how the client influenced the group — In many cases, you’ll see that a client is influencing the group. In the client’s individual version of the notes, report how this phenomenon occurred.
5. Recount of how the group influenced the client — The group will also influence individual clients. You’ll need to describe the nature of how the group did this and the effect it had.
Group therapy doesn’t allow you to go as in-depth with each client as individual sessions would, but there are many reasons why you might want to offer group therapy. Group therapy can be especially beneficial for those dealing with addiction issues or specific issues such as anger management. It empowers clients to know they aren’t alone in their struggle. And for clients without a strong social support system, group therapy can serve to fill this important role.
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