Quill generated this note with AI from the summary that was provided. The therapist can then copy-and-paste the note into their current EHR platform.
Data:
Client attended a 45-minute session at the clinic. She reported feelings of uncertainty about her future and discussed her recent diagnosis of generalized anxiety disorder. Client stated that she often worries about potential occurrences and feels persistently on edge. She directly stated, "I just can’t seem to stop my mind from racing all the time." Interventions included discussion on understanding anxiety, identifying triggers, and the introduction of cognitive-behavioral techniques to challenge negative thoughts. The therapist provided education on each topic, and the client was actively engaged, asking questions about the techniques.
Assessment:
Client appears to be in the early stages of addressing her generalized anxiety disorder, with a clear expression of her symptoms and concerns. She demonstrated a developing understanding of anxiety triggers and the impact of her thoughts. Client’s engagement and questions indicate a positive response to the cognitive-behavioral interventions.
Plan:
Client is assigned homework to maintain a thought diary, tracking situations that increase anxiety levels. The goal is for the client to become more aware of her triggers and thought patterns. The next session is scheduled for two weeks from today, during which we will review the thought diary and continue exploring anxiety-management strategies.
Client attended a 45-minute session today at the clinic. She discussed her recent diagnosis of generalized anxiety disorder and her feelings of uncertainty about the future. Ummm, she said she often worries about things that might happen and feels like she’s always on edge. She said, "I just can’t seem to stop my mind from racing all the time." We talked about understanding anxiety and identifying triggers. We introduced cognitive-behavioral techniques to challenge negative thoughts. Client’s homework is to keep a thought diary and note situations that trigger her anxiety. She was engaged and asked questions about the techniques. Our next session is in two weeks.
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