Client Identification Report Sample

SUBJECTIVE/STATUS: The therapist met with the client for an individual session. The therapist greeted the client and reviewed the main goals that the client identified it last session. The therapist checked-in with the client and asked the client about her mood and she reported that she feels good today as she felt so since morning. The client reported that during the breakfast and the lunch, she was not able to eat all her food and asked to change the lunch with the replacement one because it was full of fats as she reported and she does not want to gain weight. The client reported that she started to feel that it is more about who am I in general, not what is my body shape or my weight. The client stated, "I was comparing my body shape to my friends who are beautiful and thin, but now I realized that everyone has his or her body shape. The client shared that she has to watch her food as well as she stated, "The more …show more content…
The client appeared happy because she was enjoying the group sessions and the school work. The client seemed to be more comfortable and cooperative aeb making good eye contact and engaged with the therapist in a conversation about expectations in relation to her eating disorder. The client denied having thoughts of suicide or homicide in session.

ASSESSMENT/INTERVENTION: The therapist greeted the client and reviewed the main goal of the client. The therapist checked-in with the client and asked the client to share about her appetite approach towards the food and the food restriction. The therapist affirmed the client's emotion and accepting the client's feeling at the moment by allowing herself to feel so without guilt. The therapist provided a safe atmosphere for the client to share thoughts, feelings, and to ask questions. The therapist assessed for suicidal/homicidal ideation, and client reported none. The therapist asked the client open ended questions.