Psychotherapy notes are like your personal diary — for your clinical brain.

They give you a private, judgment-free space to jot down insights, connect dots, and reflect on the therapeutic process without the rigid structure of formal documentation breathing down your neck.

Unlike progress notes (which are basically legal documents in scrubs), these notes let you think out loud. They help you:

• Remember those “aha!” moments between sessions
• Spot subtle patterns that build up over time
• Fine-tune your approach like the thoughtful therapist you are

And yes, we’ve got a free psychotherapy note template. Then we'll unpack these notes matter and how to make them work for you.

What is a psychotherapy note?

Psychotherapy notes are a clinician’s personal observations and analyses during therapy sessions. 

Think of them as your internal monologue during sessions, minus the background noise and awkward silences.

Psychotherapy notes are:

• Private: For your eyes only. Not part of the official medical record.
• Reflective: They capture your impressions, emotional reactions, hunches, and maybe that odd feeling you got during the client’s story about their cat.
• Flexible: There’s no required format, just your thoughts flowing in a way that makes sense to you.

Why bother? Because our brains aren’t filing cabinets. If you want to remember that tiny detail from week 3 that suddenly makes sense in week 9, you’ll want these notes around. 

Free psychotherapy note template

When your thoughts are moving fast between sessions, structure is your safety net. Our psychotherapy note template helps you stay grounded — without slowing you down.

That’s why we created a psychotherapy note template to make life easier for you. 

‎📌 Download free psychotherapy note template 

Breaking down our psychotherapy note template 

Our template is thoughtfully designed for both patients and providers. 

Here’s what each section includes:

• Patient details: Identifiers like client code or initials and the therapist's name. You can also add session details like date, time, and number. 
• Free-form reflections and observations: Your unfiltered thoughts and impressions from the session.
• Emotional and behavioral observations: The patient’s body language and mood shifts.
• Therapist's internal reactions and countertransference: Your instincts and reactions. This component focuses on self-awareness.
• Key themes or insights: Were there any crucial discussion points that steered your conversation? Discuss any patterns, narratives, or metaphors that reveal a patient’s underlying emotions.
• Emerging patterns or progression over time: Monitor recurring themes or evolving dynamics across several sessions. This way, you can map the patient’s behavior over time and identify broader clinical patterns.
• Hypotheses, clinical intuition, or next steps: Document your interpretations, potential shifts in approach, or technique adjustments. This is a forward-thinking section to plan future interventions.
• Additional notes:Any other relevant mental health information or other patient information that doesn't fit into the above categories but seems clinically significant.

When you have specific boxes to record your thoughts psychotherapy notes flow. These elements will come together to give you a more informed clinical perspective when you re-read.

Psychotherapy notes vs. Progress notes

Progress notes are a part of every patient’s official medical record. They objectively cover patient information like:

• Chief complaint and symptoms
• Diagnoses
• Treatment plans

Psychotherapy notes are offline. They capture a health care provider's personal thoughts, impressions, and hypotheses.

They’re not a part of the medical records and are protected under HIPAA.

Here’s a preview of how psychotherapy notes compare against progress notes:

Why are psychotherapy notes treated differently?

The process of psychotherapy is quite intimate. A clinician’s notes might contain sensitive patient information. 

Psychotherapy notes emphasize the need for privacy in mental health treatment to protect confidential details. 

Besides, patients often share deeply personal experiences in a therapy session. 

Clinicians need space to process complex emotions and document their own observations without compromising patient privacy or stressing about external reviews. That’s where psychotherapy notes come in handy. 

And finally, psychotherapy notes have an additional layer of legal protection with more than usual steps to access these documents. This protects the patient and provider’s privacy in case of lawsuits.

Psychotherapy notes guidelines

Even though psychotherapy notes aren’t a part of mental health records, clinicians still have to follow a few crucial guidelines when preparing these notes. Let’s break them down.

Physically separate your notes

Keep psychotherapy notes physically away from other paperwork. 

Whether it's pen and paper or a digital file, store these notes separately from all other progress notes. 

This is a legal requirement under HIPAA for maintaining special protections. 

Use professional language

While these are private notes, maintain professional language to avoid any judgmental or problematic statements. 

These notes can be audited in the future in case of legal proceedings. Meet professionalism standards and maintain a patient’s privacy.

Cover relevant insights 

Psychotherapy notes focus on your personal reflections and hypotheses about a patient. You can also use this space to discuss your therapeutic process. 

They don't require medical information about session timing, medication, treatment plans, and more. Maintain clear boundaries between the two types of notes (official and private) to avoid any overlap.

Plan retention policies 

As a best practice, a healthcare provider should eventually delete psychotherapy notes. 

You can destroy these notes once they're outdated and no longer serve a clinical purpose.

Remember to be consistent with your retention policy so you don't delete any notes for an ongoing patient.

A new approach: Sharing psychotherapy notes with patients

Mental health clinicians are asking:What if patients could see what we see?

Research suggests that sharing psychotherapy notes could build trust and deepen engagement—if done with care.

Patients have easy access to progress notes. But psychotherapy notes have traditionally remained for your eyes only.

So, why is this shift happening, and what does it mean for the future of mental healthcare? Let’s find out. 

How is the landscape evolving toward patient autonomy 

A research study evaluated the prospect of sharing psychotherapy notes with patients to maximize transpinarency in a healthcare setting. 

This study advocates for patient autonomy, which means that patients have a complete understanding of their care. While clinicians agree that sharing these notes can lead to some degree of confusion, many believe that this exercise can empower patients to make health-related decisions. 

The study notes:

“By signaling trust in the patient as a “grown-up” care partner, and by facilitating greater time to reflect on disclosures, open notes may strengthen patients' sense of agency and can conceivably play a role in improving outcomes.”

A key argument in favor of sharing these notes is the chance to gain patients’ trust and involve them more deeply in the care delivery process.

Let’s understand how this process can harm or benefit both parties involved. 

Key challenges with sharing psychotherapy notes

Shared psychotherapy notes with patients have their barriers. How can you be candid?

This might lead to an endless list of psychotherapy notes: one for personal use and another for sharing.

Your thoughts can also be confusing when patients don’t have enough context. This step can potentially disrupt the therapy session by creating distress or doubt among patients.

Benefits of sharing psychotherapy notes with patients

In short: transparency strengthens relationships.

Patients can gain a clear insight into their therapist’s perspective and clinical thought process. It can strengthen trust between the two parties.

Besides, access to these notes would also make patients feel more invested in the process. They’ll have a tangible understanding of their emotions, patterns, and behaviors. This is equally important for maintaining continuity between sessions where patients can review discussions from the previous one.

And lastly, sharing these notes allows patients to pinpoint any misunderstandings or incorrect interpretations. They can offer more context to clear the air around any subject.

The future of note-sharing 

So where does that leave us?

Therapy is built on trust. But trust doesn’t mean giving up your clinical space.

The future won’t be all or nothing. It will be nuanced —because care is nuanced.

Clinicians need room to think clearly and candidly. Patients want to feel seen and trusted. Both can be true.

What’s next isn’t about choosing sides. It’s about creating tools and practices that protect what’s personal, while making space for connection when it matters most.

Documentation should support your thinking—not reshape it.

P.S. Freed's AI scribe helps make that balance possible, without adding to your workload. Try for free.

Disclaimer: This article is for informational purposes only and does not constitute legal or clinical advice. Clinicians should follow applicable laws, regulations, and institutional policies when creating or sharing psychotherapy notes.