CCPT Session Note

Session Information

Child's First Name / Initials

Session #

Date

Start Time

End Time

Session Length (min)

DSM Diagnosis / Code

Others Present

Subjective — Emotions Expressed S

Check all emotions the child communicated through play, body language, or verbally.

😊 Happy / Positive

💪 Confident

😢 Sad / Discouraged

😕 Confused / Uncertain

😠 Angry / Frustrated

🔍 Curious / Focused

😨 Afraid / Anxious

Overall Intensity 3

Quality:

Objective — Play Observed O

Check toys/materials used. Describe notable play sequences briefly below.

Play Type

Relating Style to Therapist

Brief Description of Play Sequences

Significant Verbalizations (use quotes if exact)

Therapist Interventions Used

Directive Activity Used (if applicable)

Assessment — Themes & Clinical Impression A

Check primary play themes observed. Add your brief clinical impression below.

Clinical Impression / Case Conceptualization Notes

Progress Toward Treatment Goals

Risk / Safety Notes (suicidality, self-harm, abuse disclosures)

Plan P

Next Appointment Date

Session Frequency

Homework / Recommendations for Parent

Plans / Goals for Next Session

Collateral Contacts / Referrals Needed

Therapist Name & Credentials

Play Therapy Session Note