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GROUP SESSION
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TYPE OF GROUP SESSION
• • •
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Facilitator(s)
• • •
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Topics Discussed
• • •
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Topics Discussed
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LENGTH OF SESSION
• • •
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ELECTRONIC SIGNED FIELD
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signed by pin#
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ADDITIONAL GROUP SESSIONS
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TYPE OF GROUP SESSION
• • •
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Facilitator(s)
• • •
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Facilitated by
• • •
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Facilitated by
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Topics Discussed
• • •
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Length of Session
• • •
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INDIVIDUAL SESSION
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Length of Session
• • •
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TYPE OF INDIVIDUAL
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Time Start
• • •
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Time End
• • •
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Time Started
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Time Finished
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ADDITIONAL INDIVIDUAL SESSION
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Behavior Ratings
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Seemed interested in the group
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Seemed to benefit from the session
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Understood session topics
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Participated in session topics
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Initiated positive interactions (if a group session)
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Showed listening skills / empathy
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Treatment Considerations Being Addressed
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Treatment considerations being addressed
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Treatment Goals being met
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Individual Contributions This Session
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Additional Peer Group:
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Time Start
• • •
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Time End
• • •
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Type of Session
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Topics Discussed
• • •
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Topics Discussed
• • •
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The topics discussed
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Facilitated by
• • •
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Facilitated by
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Length of Session
• • •
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Time Started
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Time Finished
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Behavior Ratings
|
|
|
Seemed interested in the group
|
Seemed to benefit from the session
|
|
Understood session topics
|
Participated in session topics
|
|
Initiated positive interactions (if a group session)
|
Showed listening skills / empathy
|
|
Treatment Considerations Being Addressed
|
Treatment considerations being addressed
|
|
Treatment Goals being met
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Individual Contributions This Session
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ELECTRONIC SIGNED FIELD
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signed by pin#
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