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Compliance and documentation

Writing effective progress notes for family and group therapy sessions

When it comes to family therapy and group therapy, progress notes can become more complex due to the multiple parties involved.

December 21, 2023 • Updated on January 16, 2026

21 min read

Progress notes are an essential part of any therapeutic process: They serve as a record of what transpired during a session, the clinician's observations, and the client's progress toward their treatment goals. When it comes to family therapy and group therapy, progress notes can become more complex due to the multiple parties involved, the different dynamics at play, and note writing formats.

In family and group therapy, progress notes must capture the essence of interactions among participants while focusing on the identified patient. The identified patient is the individual whose insurance is being billed, and their progress is central to the documentation.

This article outlines best practices for writing progress notes on the Headway platform for family/couples and group therapy (CPT codes 90847 and 90853) using the SOAP note format and considerations for the identified patient — the person whose insurance is being billed. It also describes when to use family/couples therapy CPT codes.

For these examples, we’ll follow the SOAP note template for progress notes, which includes sections for:

  • Subjective: The client's subjective concerns, symptoms, and any information that the client provided about their condition, personal experiences, and feelings. 
  • Objective: The therapist's observations, including behaviors, interactions, and non-verbal cues.
  • Assessment: The therapist's interpretation of the session, including any diagnoses or clinical impressions and interventions.
  • Plan: The next steps and follow-up plans.

Writing progress notes for family therapy and group therapy requires a balanced approach that focuses on the identified patient while capturing the broader dynamics at play. By using the SOAP note format, therapists can create clear, concise, and meaningful documentation that reflects the therapeutic journey and provides valuable insights for ongoing treatment.

How to write a progress note for family therapy, with examples

Family therapy involves multiple family members, each with their own dynamics and contributions to the therapeutic process. When writing progress notes, focus on the identified patient while capturing the interactions and impact on the family as a whole.

Documentation for family therapy should follow the basic documentation requirements of a progress note, and meet the requirements for billing with a 90847 CPT code. 

Subjective

Begin with the identified patient's account of their feelings, thoughts, and experiences during the session. Include any statements made by other family members that are relevant to the identified patient's perspective.

Note examples:

  • "The identified patient (John) expressed feeling overwhelmed by his family's expectations. "
  • "John's sister mentioned that she has noticed him withdrawing from family activities."

Objective

Record the therapist's observations, including family dynamics, behaviors, and any notable non-verbal cues. This section should remain objective and fact-based.

Note examples:

  • "John avoided eye contact with his parents during most of the session."
  • "His mother became visibly emotional when discussing family traditions."

Assessment

In this section, interpret the events of the session and assess their impact on the identified patient, including diagnoses or clinical impressions and interventions used during the session.

Note examples:

  • "John's withdrawal appears to be linked to a fear of disappointing his parents. He noted feeling depressed for several days, anhedonic, lethargic, and sleeping more than usual.”
  • "This therapist utilized circular questioning from systemic family therapy to encourage family members to think about their shared connections. The family's willingness to discuss sensitive topics indicates a growing level of trust."

Plan

Outline the plan for future sessions.

Note examples:

  • "Next session, we will explore John’s interests and work on setting boundaries. Follow up in 1 week."
  • "Recommend family members practice active listening techniques at home. Follow up in 2 weeks."

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How to write a progress note for group therapy, with examples

Group therapy involves a collective dynamic among participants. Progress notes should focus on the identified patient's experience within the group context while recognizing the broader group dynamics. A group note should be written for each member of the group.

Documentation for group therapy should follow the basic documentation requirements of a progress note, and meet the requirements for billing with a 90853 CPT code.

Subjective

Start with the identified patient's subjective account of their experiences and interactions within the group. Include statements from other group members that relate to the identified patient. 

Note examples:

  • "The identified patient (Maria) shared that she feels more accepted in the group."
  • "Maria mentioned that she’s learning to express her emotions more openly."

Objective

Describe the therapist's observations of the group dynamics and the identified patient's behavior during the session.

Note examples:

  • "Maria actively participated in the group discussion, offering support to other members."
  • "She appeared relaxed and engaged throughout the session."

Assessment

Interpret the identified patient's progress in the context of the group. This might involve noting changes in behavior, attitude, or communication skills. This would also include any therapeutic techniques used during the group session.

Note examples:

  • "Maria's increased participation suggests improved confidence and social skills. The group’s cohesion allows for this therapist and group members to actively show unconditional positive regard."
  • "Her supportive behavior indicates growth in empathy and relational skills."

Plan

Outline the next steps for the identified patient's treatment within the group therapy context. This could include specific group activities, individual assignments, or additional sessions.

Note examples:

  • "Continue to encourage Maria to share her experiences with the group. Follow up group to meet in 1 week"
  • "Next session, focus on exploring coping strategies for social anxiety. Follow up group to meet in 2 weeks."

Use Headway’s progress note templates

While there are many options for documentation, Headway's in-product templates are designed to make note-taking fast and efficient, all while helping to take out the guesswork. 

Our documentation templates are built with the needs of in-network providers in mind. That means they’re specifically created to meet insurance requirements (and are regularly reviewed by our clinical and compliance teams to ensure that stays the case). Our AI assistant also accelerates the documentation process, allowing you to create thorough progress notes in a snap based on a quick session summary. Once they’re drafted, notes are seamlessly linked to claims to create a streamlined and accurate billing process. It’s really that simple. Plus, our templates are included at no additional cost for Headway providers.

Explore our session notes feature

90847 vs. 90837: How to distinguish between family/couples therapy and individual therapy (with an additional person present).

It can be challenging to differentiate between family/couples therapy and individual therapy with an additional person present; the latter documented with CPT codes like 90832, 90834, and 90837 depending on session duration.

The difference depends on factors like:

  • Participants
  • Nature of the interaction
  • Content of the session
  • Goals
  • Documentation

To help you know when to use the appropriate code, Headway has created a guide for weighing each factor and making a sound decision about which codes to use. 

Use the guide
A worksheet designed to help mental healthcare providers dist

This document is intended for educational purposes only. Examples are for purposes of illustration only. It is designed to facilitate compliance with payer requirements and applicable law, but please note that the applicable laws and requirements vary from payer to payer and state to state. Please check with your legal counsel or state licensing board for specific requirements.

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Family and group therapy come with unique dynamics‌ — ‌and documentation needs. Headway’s platform supports your work with tools designed for multi-client sessions, secure note-taking, and simplified scheduling and billing. With everything in one place, you can focus on fostering connections with your clients while we handle the administrative details that keep your practice running smoothly.

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This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.

© 2026 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.

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