The Counselor's STEPs for Progress Notes: A Guide to Clinical Language and Documentation

Dr. Rhonda Sutton's second edition of the straightforward guide to progress notes includes additional examples, information, documentation, and clinical language that expands on the utility and readability of the first book. Additional case studies provide examples of how to use the STEPs to format notes. New chapters include information on clinical language and documentation. This book covers everything about progress notes, from how to write them, to how to store them, and even what to do when someone requests to them. In addition, clinical terms and abbreviations are included as well as suggestions for other clinical documentation such as termination letters, privacy statements, and professional disclosure statements. Suited for all types of mental health clinicians, this book will help therapists improve upon their progress notes and other forms of clinical documentation.

Dr. Rhonda Sutton is a licensed professional counselor, a licensed counselor supervisor and a national certified counselor with over 25 years of experience in the counseling and mental health fields. Dr. Sutton managers her private counseling and consultation practice in North Carolina, and also serves as an adjunct professor in the Counselor Education Program at North Carolina State University. As a supervisor for counselors-in-training, Dr. Sutton finds many of her supervisees wanting guidance for taking progress notes. Seeing the need, Dr. Sutton developed STEPnotes(TM) to give counselors and counselors-in-training an efficient, systematic way to conceptualize their therapy sessions. In addition, Dr. Sutton is an advocate for those who work in mental health, and she strives to educate and promote the professional nature of therapeutic work.