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Local Resource for Personality Disorders

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Local Resource for Personality Disorders

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Borderline personality disorder (BPD) is a complex condition that impacts how a person thinks, feels, and behaves.

People who live with BPD often have difficulty maintaining stable relationships, and several symptoms can be dangerous. While some are similar to other mental illnesses, the combination of BPD symptoms can feel overwhelming.

If you or someone you love is struggling with BPD, we can help.

What Is Borderline Personality Disorder?

BPD is a serious illness - and while it can be challenging, it's also treatable.

Generally, people with BPD experience intense mood swings and have trouble regulating their emotions. This can impact relationships with loved ones and lead to impulsive and sometimes destructive behaviors.

Borderline Personality Disorder Symptoms

Borderline personality disorder symptoms include:

Efforts to avoid real or imagined abandonment

A pattern of unstable relationships

Distorted and unstable self-image or sense of self

Impulsive and often dangerous behaviors (e.g., substance abuse, unsafe sex, reckless driving)

Self-harming or suicidal behavior

Chronic feelings of emptiness

Intense and highly changeable moods

Inappropriate bursts of anger or problems controlling anger

Dissociation - feeling like you're disconnected from your thoughts or sense of identity

Not everyone with BPD will experience all of these symptoms, but some people will experience many of them over time. These symptoms usually appear during adolescence or early adulthood, although early symptoms may occur during childhood.

Co-Occurring Disorders

One reason BPD is difficult to diagnose is because the condition is often accompanied by other mental illnesses, such as depression, anxiety or substance abuse. During a mental health assessment, be sure to discuss all your symptoms and concerns.

What Does Borderline Personality Disorder Treatment Look Like?

With treatment, people who have BPD can live healthy, productive, and fulfilling lives. When you seek treatment, you may be prescribed therapy, medication or, likely, both.

There's no one medication that is specifically made to treat BPD, but medication can often help relieve symptoms and treat other co-occurring illnesses, like depression. People with BPD may benefit from antidepressants or mood stabilizers to help with extreme mood swings.

Medication is usually prescribed in conjunction with psychotherapy, sometimes called talk therapy. Specifically, Cognitive Behavioral Therapy (CBT) helps people with BPD challenge their core beliefs and negative patterns of thinking. CBT can help you learn new ways to interact with others while teaching you skills to manage your emotions.

If you're experiencing severe symptoms, especially if you are a threat to yourself or others, you may be recommended for inpatient mental health treatment. When you no longer require constant medical monitoring, you may step down to outpatient mental health treatment. Or, if you are not in crisis, you may start your treatment as an outpatient.

At our Dallas, TX-area facilities, both inpatient and outpatient services typically offer individual, group, and family therapy, along with medication management. Other opportunities may include holistic therapies, like yoga or music therapy, as well as mindfulness training and wellness education.

How Do I Get Help for Borderline Personality Disorder?

It's important to receive the correct diagnosis for borderline personality disorder as people with BPD are often misdiagnosed due to overlapping symptoms with other illnesses. To get help at our facility, you can schedule a no-obligation assessment by calling or chatting with us anytime, day or night. We also offer walk-in appointments.

Your assessment will help our team understand your history with BPD and identify all of the symptoms you're experiencing, as well as any other physical or emotional concerns you have. We'll then work with you to create a comprehensive treatment plan to meet your needs.

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Borderline Personality Disorder Treatment in Dallas, TX

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Borderline personality disorder (BPD) is a complex condition that impacts how a person thinks, feels, and behaves. People who live with BPD often have difficulty maintaining stable relationships, and several symptoms can be dangerous. While some are similar to other mental illnesses, the combination of BPD symptoms can feel overwhelming.

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This severe mental disorder can result in hallucinations, delusions, and extremely disordered thinking and behavior that interfere with daily living.

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The Eating Disorders Program at Texas Children's Hospital was established in 1986. The program provides interdisciplinary inpatient (including 24 hour on-call coverage) and outpatient care for adolescent and young adults with eating disorders. The program also trains the future doctors and psychologists in clinical management of eating disorders.

To support and manage the health of patients, we provide outpatient and inpatient treatment, as determined by medical severity. Our health care professionals are committed to an interdisciplinary team approach with a focus on the healthy development of the patient.

Our team of professionals in the Eating Disorders Program treat the following eating disorders:

Anorexia nervosa

Bulimia nervosa

Binge Eating Disorders or Compulsive Overeating

Unspecified Feeding or Eating Disorders

Other Specified Feeding or Eating disorder

Avoidant Restrictive Food Intake Disorder

Interdisciplinary clinical care involves development and participation in a medical and behavioral evidence-based approach to care. The team consists of 5 board certified Adolescent Medicine physicians, each with three years of fellowship training in the inpatient and outpatient management of eating disorders, clinical psychologists, dieticians, nurses, patient-care extenders, physical therapists, hospital school, child life therapists, hospital chaplain, social work and child adolescent psychiatry consultants.

The Eating Disorder Program at Texas Children's Hospital is a member of the national consortium National Eating Disorder Quality Improvement Collaborative (NEDQIC).

Services

Our health care professionals are committed to an interdisciplinary team approach with a focus on the healthy development of the patient. Interdisciplinary clinical care involves development and participation in a medical and behavioral evidence-based approach to care. Our team meets regularly to coordinate care for our adolescents. Our close collaboration helps each adolescent get the most individualized and comprehensive plan.

Outpatient Treatment

We offer a full team of professionals to help address all aspects of health living. Outpatient Treatment includes:

Medical visits that occur as often as determined necessary by the physician.

Dietitian support is available for individualized intervention of meal planning and nutritional balance.

Individual and family therapists provide psychological and behavioral intervention to address eating concerns, body image and self-esteem concerns, as well as other presenting difficulties with depression or anxiety. In addition, therapists may assist with family communication, helping the family to establish a healthy support system, and education to parents and family members about eating disorders.

Inpatient Treatment

Our inpatient treatment of eating disorder is a medical hospitalization to treat severe malnutrition and medical complications of eating disorders. This program includes:

Daily monitoring from medical professionals and dietitians.

Individual & family provided by team of Psychologists focusing on psychological well-being and transition from hospital to home.

Group therapy is offered three times per week and focuses on coping strategies, distress tolerance, mindfulness, and psychoeducation.

Individual therapy is 2-3 times per week, Family therapy once a week, and Group therapy is 3 times per week.

Hospital school (Monday through Friday)

Monitored physical activity (stretching, strength training and cardiovascular exercise) within our Wellness Center (once medically stable)

Child Life Therapists, including music therapy 2x/week

Hospital Chaplain

Our Team

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The Eating Disorders Program at Texas Children's Hospital was established in 1986. The program provides interdisciplinary inpatient (including 24 hour on-call coverage) and outpatient care for adolescent and young adults with eating disorders. The program also trains the future doctors and psychologists in clinical management of eating disorders.

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One's experience with mental illness is greatly affected by one's unique cultural views and background. Cultural differences can influence whether or not mental illness is properly diagnosed and/or treated. There are many barriers that diverse communities face when seeking healthcare in general. Some of these barriers include: higher levels of stigma, misinformation about mental health and language that may discourage people from seeking help. A person's beliefs, norms, values and language affect how the perceive and experience mental health conditions. The experiences with mental illness are greatly affected by different cultural views.

To effectively serve diverse populations, the community and mental health professionals need to understand, respect and value all of the different cultural differences and perspectives towards mental health. Increasing and applying cultural competence is important when serving diverse communities.

ADAA is committed to providing anxiety, depression and related disorder resources and current research for the Black, Latinx, Asian-American, LGBTQ+, and low income communities.

ADAA's Special Interest Group (SIG) on Multicultural Advances encourages collaboration, communication, education, research, mentoring, and networking focused on multicultural issues within anxiety, depression, and related disorders. Click here to learn more about this SIG.

ADAA's 2019 Annual Conference for mental health experts focused on transcending cultural, racial, and socioeconomic barriers and optimizing treatment success.

Black Community

Although anyone can develop a mental health problem, the Black community sometimes experience more severe forms of mental health conditions due to unmet needs and other barriers. According to the Health and Human Services Office of Minority Health, Black Americans are 20% more likely to experience serious mental health problems than the general population. Black youth who are exposed to violence are at a greater risk for PTSD by over 25%. Read more.

Common mental health disorders among Latinos are generalized anxiety disorder, major depression, posttraumatic stress disorder (PTSD) and alcoholism. While Latino communities display a similar susceptibility to mental illness as that of the general population, they experience health disparities that affect the way they receive mental health care, such as the access and quality of treatment. Read more.

Asian-Americans

Asian-Americans report fewer mental health conditions than their white counterparts. However, they are more likely to consider and attempt suicide. There are several barriers to this population seeking help from mental health professionals, including language barriers, stigma, and lack of awareness of resources and mental health services. Read more.

Mental illness affects all communities, including the lesbian, bisexual, transgender, queer and questioning (LGBTQ+) community. LGBTQ+ individuals are three times as likely to experience a mental health disorder in comparison to individuals that identify as straight. Read more.

At a personal level, poverty leads to physiologic responses to stress such as high blood pressure and high cortisol levels. With prolonged exposure to poverty, these responses turn into disruptions in brain functioning, which ultimately lead to both long-term physical and mental health consequences. On a family level, poverty causes stressors such as insecurity in food, housing, income, and more. Read more.

ADAA Resources

Trending Articles

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One's experience with mental illness is greatly affected by one's unique cultural views and background. Cultural differences can influence whether or not mental illness is properly diagnosed and/or treated. There are many barriers that diverse communities face when seeking healthcare in general.

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The DFW Center for OCD and Anxiety provides specialized treatment for children, teens, and adults suffering from Obsessive-Compulsive Disorder and related Anxiety and Stress Disorders. Treatment includes a comprehensive assessment and diagnosis, psychoeducation, symptom management, empirically-supported therapy, exposure and response prevention, and relapse prevention.

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Children who have obsessive-compulsive disorder (OCD) are plagued with unwanted thoughts, images or impulses that are difficult to suppress, causing them great stress and worry. These are called obsessions. To alleviate the anxiety caused by their obsessive thoughts, they perform repetitive, ritualized actions called compulsions. A child with OCD might need to line things up, touch things in a certain order when leaving the room or wash his hands repeatedly.

Obsessions Common in Kids With OCD

Contamination: Kids with this obsession are sometimes called "germaphobes." In schools, this plays out with kids worrying about other kids sneezing and coughing, touching things that might be dirty or getting sick in many different ways. This is the most common obsession seen in children.

Magical thinking: This is a kind of superstition, like "step on a crack, break your mother's back," taken to extremes. For example, kids might worry that their thoughts can cause someone to get hurt, or get sick. A child might think, "Unless my things are lined up in a certain way, mom will get in a car accident."

Catastrophizing: Some kids easily jump to the conclusion that something terrible has happened. For example, if her parents are five minutes late picking her up, a girl who is catastrophizing might tell herself that they've decided to abandon her.

Scrupulosity: This is when kids have obsessive worries about offending God or being blasphemous in some way.

What ifs: Kids may be plagued by a lot of different kinds of thoughts about bad things they could do. "What if I hurt someone? What if I stab someone? What if I kill someone?"

The "just right feeling": When OCD first develops, from about 6 to 9 years of age, kids may not know why they are doing something, but just that they need to do it until they get what we call the "just right feeling." So: "I'll line these things up until it just kind of feels right, and then I'll stop." And then over time - in the 9- to 12-year-old range - it evolves into magical thinking and becomes more superstitious in nature.

Behaviors You Might See in Students With OCD

Frequent requests to go to the bathroom: This could be to wash hands, if someone near the child was coughing or sneezing, or if she touched something that she perceives as contaminated. She could be washing items-pens, pencils, backpacks, books. It could also be an excuse to get out the classroom and just be away from everyone, and have some respite.

Constant reassurance-seeking: This takes the form of repetitive questions. "Are you sure that's the answer? Could you tell me again? Did you hear what I said?" Checking doors, windows, lockers, desks. Over and over and over again.

Getting stuck on tasks: Sometimes kids with OCD will need to finish something to completion, or understand it to completion, before they're able to move on. So if a child is working out what he did wrong on a math test, and the teacher says, "Now let's open the textbook and start a new chapter," he's not going to be able to shift gears.

Retracing: If a child leaves the classroom and worries that she left a pencil behind, she'll go back into the classroom and go to her desk and check. If she had a bad thought as she went through the doorway, she might have to "fix it" by going back through the doorway again saying a good word. If she had a bad thought when she went down a flight of stairs on the way to class, she might need to go back up that same stairway at the end of the period, even if it means being late to her next class.

Obsessive erasing: A child could be erasing a lot because the letters have to look perfect. Or he could have used a word that disturbs him. For example, if he has a fear of vomiting and he's written the word vomit, he might not be able to stand seeing that word, so he erases it. Kids start having erasers worn down to the metal. Teachers start to see holes in the paper. Words will be drawn over on the back of the page. A lot of different areas of writing become problematic.

Behaviors Often Confused With Another Disorder

Some behaviors associated with OCD are easy to confuse with ADHD, learning problems or being oppositional.

Distraction: If a child is busy thinking that if she doesn't turn the pen cap and count to four the right way then her mom is going to get sick, she's not going to be paying attention in class. And if her teacher calls on her to answer a question, her distraction might look like ADHD, but it isn't.

Slowness on exams, papers and tasks: Sometimes when kids take a long time, they're struggling with the perfectionism of needing to do things the right way. This could look like learning problems, or inattention, but it isn't.

Avoidance: Teachers might see a child who doesn't want to sit on the floor, or pick things up that touched the floor, or get his hands dirty in art class. He may avoid a lot of playground activities - kids with germ fears will view the playground the way some adults view the subway: it's gross. Why touch anything there?

Tapping and touching symmetrically: If a child sits down at her desk and she accidentally kicks the chair of the kid next to her with her right foot, she's going to have to then kick it with her left foot. That might look like somebody who's being oppositional, or somebody who's got too much energy, but actually it's OCD.

Complaints of anxiety and fatigue: There's one interesting theory that kids with OCD are smarter than other kids. And if you consider how much thinking they're doing, they're really using their brain more frequently than a lot of other kids are. But when that's coupled with a lot of anxiety, you can have a lot of fatigue. So it's common for kids with OCD to want to come home and take a nap after school.

How to Help Students With OCD

For children struggling with OCD, functioning in school can be complicated and very difficult. Here are some things you can do to help them, and the class as a whole, focus on learning:

Seating arrangement: If the school has noisy hallways, you might not want to have a child with OCD sit by the door. You might have her sit in the front, where she's less able to hear the noise and can stay more focused on her work. On the other hand, a child who has very observable symptoms, and doesn't want other kids to see her fidgeting with her hands, rocking or getting up a lot, might be better off closer to the door, toward the back of the room.

Extended time for tests and papers: If writing is a problem for a child who needs to find the perfect way to say something, he's going to need more time to finish those essay questions or papers.

Laptops for writing: If writing and rewriting/erasing is really problematic for a child, consider letting her use a laptop for taking notes, and having all assignments be typed instead of handwritten.

Private testing rooms: Research is quite clear that kids with OCD do better, are less overwhelmed and are more in control of their thoughts and their reactions if they're in a quiet place away from the other kids.

Skip reading out loud: Kids who feel they need to read perfectly may have to go back and reread sentences or whole paragraphs over and over to make sure they've got them right. So reading becomes a very laborious task, and reading in front of the class can become a nightmare. So if we know doing this is a problem for children, we can spare them.

Books on tape: If kids get so hung up reading that it takes forever, listening to the books can be a solution.

Break homework into chunks: If looking at a whole page of math makes kids feel overwhelmed and anxious - think of the potential for mistakes! - the problems can be broken up over four pages. It helps kids stay focused on doing the problems instead of worrying.

How to Minimize Behavioral Problems

Plan an escape route: Try working out a communication system so that if the student feels symptoms coming on, she can signal to you and leave the classroom, or go to a protected place in the classroom, without interrupting the class. It can prevent an embarrassing and disruptive blowup of symptoms in the classroom, and the other kids picking on or bullying her about it.

Be aware of triggering events: It's very important for teachers to know what kind of things might trigger the symptoms. Fatigue is a huge piece of OCD, and it can be exacerbated by medication. So it's important to know that if a child is drowsy in class, and maybe he's putting his head down, it's not because he's being oppositional or disrespectful, but because he's overwhelmed with fatigue.

Advance notice: Irritability and frustration are two of the longer-lasting things that kids with OCD are feeling on a daily basis. Changes in schedule can be very disruptive for a child with OCD, so it can be helpful for teachers to give advance notice of things. Kids who know what to expect are less likely to be thrown by the change.

Children with OCD are often teased and bullied because of their symptoms. Kids feel very uncomfortable about their rituals, knowing that they're being watched. It can be helpful to educate the whole class about what's going on, especially if a child is going to be in the same school for a number of years, and it can inspire a surprising amount of support from other children.

Peer understanding program: A peer understanding program includes a presentation in the classroom that explains (with the child participating) what OCD is. The child might say, "Listen, I have OCD. It's an anxiety disorder. It makes me think that my hands are dirty and I have to wash my hands a lot, so if you see me getting up and going to the sink to wash my hands, that's why." Psychologists can role-play with the teacher and child ahead of time, to anticipate questions his classmates might ask, and how to answer them.

A buddy system: A buddy is like a peer coach who sits next to the child and prompts him to keep up with note taking and staying on task. It can be great for the buddy, to foster a sense of confidence and pride and to be able to help someone in need, and great for fostering friendship.

This guide was last reviewed or updated on September 7, 2021.

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Lo sentimos, la página que usted busca no se ha podido encontrar. Puede intentar su búsqueda de nuevo o visitar la lista de temas populares. Children who have obsessive-compulsive disorder (OCD) are plagued with unwanted thoughts, images or impulses that are difficult to suppress, causing them great stress and worry.

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Home - ADDA - Attention Deficit Disorder Association

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Empowering adults with adhd to live their best lives A Different Brain Requires a Different Approach Whether you're newly diagnosed, wondering if you have ADHD, or simply ready to take charge of your life - we're here to help. Have ...

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Module 5-Dysfunctional Behaviors EDG 6327

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How do doctors or therapists track what is happening with a patient or client from one visit to the next?

How do these professionals communicate this information with other professionals also working with the patient or client?

Years ago, this type of communication was not easy. It often meant that a client had to remember from visit to visit what they said to one doctor and then to another.

Now, medical professionals use SOAP notes for this purpose. This type of note-taking system offers one clear advantage: consistent, clear information about each patient during each visit to a provider. When the providers are part of the same group, this information can be easily shared.

Before you read on, we thought you might like to download our three Positive Psychology Exercises for free. These science-based exercises explore fundamental aspects of positive psychology, including strengths, values, and self-compassion, and will give you the tools to enhance the wellbeing of your clients, students, or employees.

What Are SOAP Notes?

Professionals in the medical and psychological fields often use SOAP notes while working with patients or clients. They are an easy-to-understand process of capturing the critical points during an interaction. Coaches also can make use of SOAP notes, with some adaptations.

SOAP notes are structured and ordered so that only vital and pertinent information is included. Initially developed by Larry Weed 50 years ago, these notes provide a " framework for evaluating information [and a] cognitive framework for clinical reasoning " (Gossman, Lew, & Ghassemzadeh, 2020).

SOAP notes are primarily the realm of medical professionals; however, as you continue reading, you will see examples of how you might adapt them for use in a coaching session.

To begin, the acronym SOAP stands for the following components:

Subjective

During the first part of the interaction, the client or patient explains their chief complaint (CC). There might be more than one, so it is the professional's role to listen and ask clarifying questions. These questions help to write the subjective and objective portions of the notes accurately.

The descriptor 'subjective' comes from the client's perspective regarding their experiences and feelings. It might also include the view of others who are close to the client.

An example of a subjective note could be, " Client has headaches. Client expressed concern about inability to stay focused and achieve goals."

Another useful acronym for capturing subjective information is OLDCARTS (Gossman et al., 2020).

Onset: When did the CC begin?

Location: Where is the CC located?

Duration: How long has the CC been going on for?

Characterization: How does the patient describe the CC?

Alleviating and aggravating factors: What makes the CC better? Worse?

Radiation: Does the CC move or stay in one location?

Temporal factor: Is the CC worse (or better) at a certain time of the day?

Severity: Using a scale of 1 to 10, 1 being the least severe, 10 being the most severe, how does the patient rate the CC?

Think back to when you have had an appointment with a doctor. How many of these questions did your doctor ask? Chances are, they asked all of them. These questions are part of the initial intake of information and help the doctor or therapist assess, diagnose, and create a treatment plan.

A coach can easily adapt this method to their sessions and exclude whatever does not apply.

For example, a life coach may not need to know or ask about location unless the client indicates that every time they are in a particular spot, they notice X. Here, the idea is shifted from a location in the body to a location in the environment.

Objective

The professional only includes information that is tangible in this section. In a clinical setting, this might be details about:

Vital signs

Physical exam findings

Laboratory data

Imaging results

Other diagnostic data

Recognition and review of the documentation of other clinicians

Some clinical examples include, " Patients heart rate is X." " Upon examination of the patient's eyes, it was found that they are unable to read lines X and X."

In a coaching situation, a coach might include some of this information, but it depends on why the client is seeking assistance from the coach and the type of coaching. For instance, a health or fitness coach might want to note diagnostic details like vital signs before, during, and after exercise.

Most coaches do not talk in terms of symptoms or signs, but if you happen to do so, then it is important to understand the distinction between them.

Symptoms are what the person tells you is going on physically, psychologically, and emotionally. They are the client's subjective opinion and should be included in the "S" part of your notes.

Signs are objective information related to the symptoms the client expressed and are included in the "O" section of your notes.

Using the example from earlier, a coach might determine that the "S" is the client expressing concern over an inability to complete tasks and achieve a larger goal. The "O" is their observation that the client has no time-keeping devices.

After further discussion, the coach may discover that the client does not plan their day with any structured tool. They use sticky notes as reminders. Each of these small details might relate to the CC: an inability to stay focused and complete goals.

On the other hand, a medical doctor would assess the headache issue and test the person's eyesight, especially if the patient does not already wear glasses.

The doctor might also explore whether the patient has attention deficit-hyperactivity disorder because the CC mentions "an inability to focus and achieve goals."

Assessment

In this section, the professional combines what they know from both the subjective and objective information. Here, the therapist or doctor identifies the primary problem, along with any contributing factors.

They also analyze the interaction between problems, as well as any changes. When finished, the clinician has a diagnosis of the problem, a differential diagnosis (other possible explanations), discussion, and a plan.

Coaches do not "diagnose" in the traditional sense. Their role is generally one of assisting a client in seeing what they typically already know, but with greater clarity and, perhaps, renewed purpose.

Plan

A plan is where the rubber meets the road. Working with the client or patient, the clinician creates a plan going forward. The plan might include additional testing, medications, and the implementation of various activities (e.g., counseling, therapy, dietary and exercise changes, meditation.)

In a coaching relationship, the coach works with the client to create realistic goals, including incremental steps. This plan includes check-in points and deadlines for each smaller goal and the larger one. The coach might assign homework just as a therapist would. Often the homework offers opportunities for self-reflection. It also provides practice and acquisition of a new skill.

There are other considerations and inclusions used in the medical field. Gossman et al. (2020) also point out several limitations regarding the use of SOAP notes, including:

The order places the less essential details at the top. It forces the clinician to lose time scanning for necessary information during subsequent visits.

There is no section addressing how conditions change over time.

There also is no assessment area for how the plan is working.

Why Are SOAP Notes Important?

Cynthia Moreno Tuohy, executive director of the Association for Addiction Professionals, has highlighted the importance of quality SOAP notes for more than 40 years.

At the 2016 NCRG Conference on Gambling and Addiction, she covered SOAP notes and the elements of good documentation.

According to Tuohy (2016), good documentation includes:

Use of direct quotes from the patient or client

A distinction between facts, observations, hard data, and opinions

Information written in present tense, as appropriate

Internal consistency

Relevant information with appropriate details

Notes that are organized, concise, and reflect the application of professional knowledge

SOAP notes offer concrete, clear language and avoid the use of professional jargon. They include descriptions using the five senses, as appropriate. They also avoid value-heavy terms. Impressions made by the clinician are labeled as such and based on observable data. Written documentation is about gathering the facts, not evaluating them.

Documentation protects the medical and therapeutic professionals while also helping the client. Clear notes communicate all necessary information about the patient or client to all of the people involved in the person's care. SOAP notes facilitate the coordination and continuity of care.

Writing Your SOAP Notes

The primary thing to keep in mind is that SOAP notes are meant to be detailed, but not lengthy. They are a clear and concise record of each interaction with the patient or client.

Following the format is essential, but it is possible to reorder it so that the assessment and plan appear at the top (APSO). Doing this makes it much easier to locate the information you might need during future meetings or appointments.

The following video by Jessica Nishikawa provides additional information regarding why SOAP notes are used, by whom, and how.

2 SOAP Note Examples

Your client Tom Peters met with you this morning. Your notes are as follows:

S: " They don't appreciate how hard I'm working."
O: Client did not sit down when he entered. Client is pacing with his hands clenched. Client sat and is fidgeting. Client is crumpling a sheet of paper.
A: Needs ideas for better communicating with their boss; Needs ideas for stress management.
P: Practice conflict resolution scenarios; Practice body scan technique; Go for a walk during lunch every day for one week.

Your client Rosy Storme met with you this afternoon.

S: " I'm tired of being overlooked for promotions. I just don't know how to make them see what I can do."
O: Client is sitting in a chair, slumped forward, and burying her face in her hands.
A: Needs ideas for better communicating her ideas with her boss; Needs ideas for how to ask for more responsibility; Needs ideas for tracking her contributions.
P: Practice asking for what you want scenarios; Volunteer for roles within the company that are unrelated to current job; Brainstorm solutions to problems employer faces.

3 Useful Templates

Numerous websites offer free SOAP templates. Most are designed for use in the medical professions, including client-centered therapy and counseling. Here are three templates you can use for a medical visit, therapy, or coaching session.

1. SOAP note for medical practitioners (Care Cloud, n.d.):

2. SOAP note for counseling sessions (PDF)

3. SOAP note for coaching sessions (PDF)

A Take-Home Message

Whether you are in the medical, therapy, counseling, or coaching profession, SOAP notes are an excellent way to document interactions with patients or clients. SOAP notes are easy to use and designed to communicate the most relevant information about the individual. They can also provide documentation of progress.

For clinical professionals, SOAP notes offer a clear, concise picture of where the client is at the time of each session. They contribute to the continuity of care and are a tool for risk management and malpractice protection. For the client, they provide documentation of their problem, diagnosis, treatment options, and plans.

What is your experience using SOAP notes? How have you applied them to your coaching practice?

We hope you enjoyed reading this article. Don't forget to download our three Positive Psychology Exercises for free.

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What are SOAP Notes in Counseling? (+ Examples)

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How do doctors or therapists track what is happening with a patient or client from one visit to the next? How do these professionals communicate this information with other professionals also working with the patient or client? Years ago, this type of communication was not easy.

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Bipolar and Depressive Disorders Resource Guide

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Bipolar and Depressive Disorders Resource Guide

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Anxiety Disorders Infographic: Test Anxiety and OCD

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Anxiety Disorders Infographic: Test Anxiety and OCD

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Child Mind Institute | Transforming Children’s Lives.

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The Child Mind Institute is an independent nonprofit dedicated to transforming the lives of children struggling with mental health and learning disorders.

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Finding the motivation to make positive lifestyle changes can be hard for anyone. For teenagers, it can be especially difficult when parents are the ones telling them to do it. But if they've fallen into unhealthy habits like vaping or alcohol abuse, change can be beneficial. Motivational interviewing is a form of therapy that creates a safe, non-judgmental environment for teens to establish their own goals and values and see how changing unhealthy behaviors can benefit them in the long run.

This series of articles comes from the Child Mind Institute, with most available in English and Spanish. Why might teens be resistant to therapy and how can parents and others to help them get the treatment they need? The articles explain how motivational interviewing can help teens gain the self-confidence to make important behavioral changes. To read more about motivational interviewing, and to connect with the articles in both English and Spanish, please visit CPIR's abstract.

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Center for Parent Information and Resources | Your Central Hub for Parent Centers Serving Families of Children With Disabilities

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Finding the motivation to make positive lifestyle changes can be hard for anyone. For teenagers, it can be especially difficult when parents are the ones telling them to do it. But if they've fallen into unhealthy habits like vaping or alcohol abuse, change can be beneficial.

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Mental Health Professionals Role in Schools

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Mental Health Professionals Role in Schools

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National Institute of Mental Health (NIMH) - Transforming the understanding and treatment of mental illnesses

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The Division of Intramural Research Programs (IRP) is the internal research division of the NIMH. Over 40 research groups conduct basic neuroscience research and clinical investigations of mental illnesses, brain function, and behavior at the NIH campus in Bethesda, Maryland. Learn more about research conducted at NIMH.