Documentation is one of the most time-consuming parts of mental health practice. Progress notes after every session. Treatment plan updates on schedule. Psychoeducation handouts tailored to each client's needs. All competing for the limited time between sessions.
AI can reduce that documentation burden, giving you more time for clinical work. But mental health documentation carries unique considerations. The language in a therapy note reflects clinical judgment. Treatment plans require individualized assessment. And client confidentiality is a legal and ethical obligation.
This guide provides prompt templates designed for therapists, counselors, psychologists, and psychiatric providers. Every template is built around the principle that AI handles structural and linguistic work while the clinician retains full responsibility for clinical content.
Warning
AI is a documentation and writing tool, not a clinical tool. It does not have therapeutic judgment, cannot assess client risk, and cannot replace the clinical decision-making of a licensed mental health professional. Every AI-generated document must be reviewed by the responsible clinician before it becomes part of the clinical record.
Confidentiality: Non-Negotiable Ground Rules
What Never Goes Into a Public AI Tool
- Client names, initials, or dates of birth
- Specific identifying details (employer, school, family member names)
- Verbatim client statements that could identify the individual
- Diagnosis codes paired with any identifying information
- Details of abuse, trauma, or legal situations that are case-specific
- Information covered by state-specific confidentiality protections
The Workflow
- Draft the prompt using de-identified, generalized clinical language.
- Generate the AI output — a template or structural draft.
- Transfer to your secure system (EHR, practice management software).
- Add client-specific clinical details within your HIPAA-compliant platform.
- Review the complete note as the responsible clinician.
The AI never sees real client data. Your final documentation reflects your own clinical assessment.
Session Documentation Prompts
Progress Note Template (DAP Format)
You are a clinical documentation specialist for mental health
practice. Generate a DAP progress note template.
Session context:
- Treatment modality: {{modality}} (e.g., individual, couples,
group therapy)
- Presenting issues: {{general_presenting_issues}} (e.g., anxiety,
depression, trauma, relationship difficulties)
- Therapeutic approach: {{approach}} (e.g., CBT, DBT, EMDR,
psychodynamic)
Generate a progress note:
**Data (D):**
- Client presentation (affect, mood, appearance, engagement)
- Topics addressed in session
- Interventions used and client response
- Relevant client-reported information
- Risk assessment summary (SI, HI, self-harm — include screening
result if applicable)
**Assessment (A):**
- Clinical impression of current functioning
- Progress toward treatment goals (improved, stable, declined)
- Therapeutic alliance observations
- Diagnostic considerations
- Clinical reasoning for current approach
**Plan (P):**
- Continuation or modification of interventions
- Between-session assignments or recommendations
- Referrals or coordination of care (if applicable)
- Next session date and planned focus
- Treatment plan changes
Use professional clinical language. Leave [specific detail]
brackets where clinician inserts session-specific information.
Target 250-400 words for the completed note.
Progress Note Template (BIRP Format)
You are a clinical documentation specialist. Generate a BIRP
format progress note template.
Session type: {{session_type}}
Primary focus: {{clinical_focus}}
Treatment approach: {{therapeutic_approach}}
**Behavior (B):** Observable behaviors during session —
appearance, affect, communication patterns, engagement level,
reported behaviors since last session. [Placeholders for specific
observations]
**Intervention (I):** Clinical interventions used — therapeutic
techniques, psychoeducation topics, skills taught or practiced,
risk assessment conducted. [Placeholders for specific
interventions]
**Response (R):** Client's response to interventions —
understanding, emotional responses, skill acquisition, resistance
or barriers, shifts in perspective. [Placeholders for specific
responses]
**Plan (P):** Forward-looking plan — next session focus,
between-session recommendations, treatment plan review timeline,
safety plan updates if applicable.
Professional clinical terminology. Target 200-350 words. Include
a risk assessment line in every note.
Group Therapy Session Note
You are a clinical documentation specialist for group therapy.
Create a group therapy progress note template.
Group type: {{group_type}} (e.g., process, skills-based, support)
Group topic: {{topic}}
Session number: {{session_number}} in {{total_sessions}} series
**Section 1: Group Process Note**
- Session topic and objectives
- Activities or exercises conducted
- Group dynamics (cohesion, participation, conflict, support)
- Themes that emerged
- Facilitator interventions and rationale
- Group progress toward goals
[Target: 150-250 words]
**Section 2: Individual Participant Note Template**
(To be completed separately for each member)
- Attendance and punctuality
- Level of participation
- Individual contributions to discussion
- Demonstrated skill use
- Treatment goal relevance
- Plan for individual follow-up if needed
[Target: 75-125 words per participant]
Treatment Plan Prompts
Initial Treatment Plan Framework
You are a mental health treatment planning specialist. Generate a
treatment plan framework for outpatient mental health treatment.
Primary presenting concern: {{presenting_concern}}
Diagnostic category: {{diagnostic_category}}
Client's stated goals: {{client_goals}}
Clinician's priority areas: {{priority_areas}}
Assessed risk level: {{risk_level}}
Structure:
**Problem 1: {{primary_problem_area}}**
Long-term goal: [Observable, measurable outcome]
Short-term objective 1:
- Specific, measurable behavior or skill
- Target timeframe
- How progress will be measured
- Baseline: [placeholder for current functioning]
Short-term objective 2: [Same structure]
Interventions:
- Specific therapeutic interventions
- Frequency and modality
- Evidence base for the approach
**Problem 2: {{secondary_problem_area}}**
[Same structure]
**Risk Management:**
- Current risk level and basis
- Safety plan status
- Crisis resources provided
- Risk reassessment schedule
**Review Schedule:**
- Review date, modification criteria, discharge criteria
Write goals using SMART criteria. Use language consistent with
insurance documentation requirements. Leave [brackets] where
clinician-specific content must be added.
Treatment Plan Review and Update
You are a treatment planning specialist. Generate a treatment
plan review template.
Time since last review: {{timeframe}}
Primary treatment focus: {{treatment_focus}}
General progress trajectory: {{trajectory}} (improving, stable,
declined, mixed)
**Progress Summary:** For each existing goal:
- Goal statement (from current plan)
- Baseline vs. current functioning
- Progress rating: [Met / Partially Met / Not Met / Regressed]
- Evidence supporting the rating
- Barriers to progress if applicable
**Revised Goals:** For met goals: document achievement, decide
if goal closes or advances. For unmet goals: continue / modify /
discontinue with rationale. For new goals: problem statement,
long-term goal, SMART objectives, planned interventions.
**Updated Risk Assessment:** Current level vs. last review,
safety plan changes.
**Plan:** Session frequency, anticipated remaining duration,
referrals, next review date.
**Client Participation:** Document plan was reviewed with client,
client input, signature line.
Psychoeducation Material Prompts
Condition-Specific Handout
You are a mental health educator creating a client-facing handout
about {{condition_or_topic}} (e.g., generalized anxiety, panic
attacks, depression, PTSD, grief).
Reading level: 8th grade. Audience: therapy clients.
Sections:
1. **What is {{condition}}?** Plain, non-stigmatizing language.
Normalize the experience without minimizing it.
2. **What does it feel like?** Common experiences — physical
sensations, thought patterns, behavioral changes. Use "you
might notice..." framing.
3. **Why does it happen?** Accessible explanation of contributing
factors. Emphasize this is not a personal failing.
4. **How is it treated?** Overview of evidence-based approaches.
Mention medication is sometimes part of treatment without
recommending specifics.
5. **What can I do right now?** 3-5 practical, evidence-informed
coping strategies for between sessions.
6. **When to reach out for help** — Include the 988 Suicide and
Crisis Lifeline and Crisis Text Line (text HOME to 741741).
Tone: warm, validating, empowering. Total: 500-700 words.
Coping Skill Instruction Sheet
You are a therapist educator creating a step-by-step instruction
sheet for a specific coping skill.
Skill: {{skill_name}} (e.g., diaphragmatic breathing, progressive
muscle relaxation, grounding 5-4-3-2-1, thought records)
Therapeutic approach: {{approach}} (e.g., CBT, DBT, ACT)
1. **What this skill does** — When and why to use it. Frame in
client's experience: "When you notice {{trigger}}, this helps
you {{benefit}}."
2. **Step-by-step instructions** — Numbered, 1-2 sentences each.
Second person ("Notice your feet on the floor...").
3. **Practice tips** — When to practice, how often, common
challenges, how to know it is working.
4. **Quick reference version** — 3-5 step condensed version for
phone or index card.
Tone: encouraging, practical. Total: 300-500 words.
Psychoeducation for Family Members
You are a family therapist creating an educational resource for
family members of someone experiencing {{condition_or_situation}}.
Reading level: 8th grade
1. **Understanding what your family member is going through** —
Compassionate explanation. Correct common misconceptions.
2. **How to be supportive** — 5-7 specific, actionable ways.
Include examples of helpful language.
3. **What to avoid** — 3-5 well-intentioned but unhelpful
behaviors. Frame without blame.
4. **Taking care of yourself** — Acknowledge the stress. 3-4
self-care strategies. Normalize seeking their own support.
5. **When to seek additional help** — Warning signs needing
professional intervention. Include 988 Lifeline.
Tone: compassionate, validating, practical. Total: 500-700 words.
Practical Workflow Integration
Where AI Fits in Mental Health Documentation
- Before the session: Generate a note template based on planned session focus.
- During the session: Focus entirely on the client. Do not interact with AI.
- After the session: Open the template in your secure system. Fill in session-specific details from your own notes. Review and modify everything.
Choosing the Right Level of AI Assistance
High value: Treatment plan structure, psychoeducation handouts, discharge summary formatting, coping skill instruction sheets. Standardized enough for useful first drafts.
Moderate value: Progress note templates, referral letters. Useful for format, but clinical content must be entirely yours.
Low value: Risk assessments, crisis documentation, clinical formulations. These require real-time clinical judgment.
What AI Cannot Do in Mental Health Practice
- AI cannot conduct therapy. It cannot form a therapeutic alliance, read nonverbal cues, or hold space for difficult emotions.
- AI cannot assess risk. Suicidality and crisis assessment require real-time clinical evaluation by a trained professional.
- AI cannot make diagnoses. Diagnostic impressions require comprehensive assessment and professional judgment.
- AI cannot replace supervision. Clinical supervision involves case conceptualization and countertransference processing that are fundamentally interpersonal.
These are not limitations to work around. They are boundaries that define responsible use.
Getting Started
- Start with psychoeducation handouts. Lowest-risk, highest-value use case.
- Try a progress note template. Compare the time spent to your usual process.
- Build a library of reviewed templates. SurePrompts' Template Builder can help organize and iterate on templates.
- Check with your licensing board and employer. AI use in clinical documentation may be subject to state regulations or employer policies.
For additional healthcare templates, see our healthcare documentation guide and the medical writing prompts guide. For general prompt techniques, our guide to writing AI prompts covers the fundamentals.
Keep Reading
- AI Prompts for Healthcare — Clinical documentation, patient education, and research summarization templates
- Medical Writing with AI — Research papers, CME content, and patient material prompts
- Healthcare AI Prompts: Complete Toolkit — Comprehensive healthcare prompt collection