Organized Assignment Prompt:

Scenario:
Imagine you are a front-line worker at BAC group home for youth who have substance abuse issues.

Task:
You must invent all the necessary details (including times, dates, and all other relevant information) to complete this progress note.

Instructions:

Conduct (imagine) an interview with a resident about their progress in an anger management program.
Note that the resident hates the program and would prefer to start one-on-one counseling.
Use realistic, detailed information such as names, ages, dates, times, setting, behaviors, and the resident’s statements and attitudes.
The progress note should reflect the youth’s feelings, your professional observations, and your recommendations as a worker.

Assignment Description:

This assignment asks you to practice your documentation skills as a front-line worker in a group home setting for youth with substance abuse problems. Your task is to create a realistic progress note based on a fictional interview with a resident about their experience in an anger management program.

The resident is resistant to the group anger management program and expresses a preference for individual counseling instead. You will need to invent all the contextual and behavioral details, such as the resident's age, background, the date and time of the session, and any specific comments made by the resident.

Your progress note should be clear, objective, and professionally written. It must include:

A brief summary of the session,
Direct quotes or paraphrased statements from the resident,
Your observations about the resident's behavior and attitude,
Assessment of their progress in the program,
Any recommendations or next steps you, as the worker, would suggest.

This exercise helps build your clinical writing skills and your ability to capture meaningful information in youth counseling settings, especially when dealing with resistance and the need for personalized approaches.

The answer

Resident Name: Jane Doe

Staff Member: Shawn Beck

Case #: 000000001

Program: BAC Group Home Counseling Room

Date of Service: 09/11/22

Unit: 123

SubUnit: 1234

Server ID: 0011

Service Time: :60

Travel Time: :40

Documentation Time: :19

Participants: Jane Doe, Clinician and Social Worker and a JD family: Brother

Intervention:(what was done as related to Engagement, Assessment/Evaluation, Plan Development/Revision, Referral/Follow up Activities, Transition) Clinician provided JD with a Pathways to Well-Being Child and Family Teaming Standards document, briefly reviewed the standards, and discussed with team the purpose of the meeting. Clinician facilitated the creation of group agreements and an agenda for the meeting as a means of supporting the client and family. Clinician then facilitated a discussion about client’s strengths. Clinician reminded team of agreements throughout the meeting, validated the feelings of client, and support Client in

having a voice in the process. Clinician reviewed with the family their strengths, needs, and goals, including a recent shared family experience where JD had a successful visit with one another.

Response/Observed Behavior(s): (what are the high risk behaviors that meet medical necessity; response to intervention; how did behaviors/mood change) JD and thebrother were receptive to meeting and engaged in services participating actively in creation of the agreements, discussion around strengths, and assessment of services. Client and sibling struggled with taking turns talking and arguing with one another, but were able to redirect with prompting from clinician and encouragement to use appropriate coping strategies while waiting for their turns to speak. All contributed to identifying client strengths, which included: caring, assertive, expressive, funny, strong academically, and willingness to do what it takes to get back

Progress Note

Resident Name: Micheal Jean
Staff Member: Shawn Beck
Case #: 01
Program: BAC Group Home Counseling Room
Date of Service: 03/28/25

Time: 2:00 PM – 2:30 PM
Documentation Time: :30
Participants: Micheal Jean, Clinician, and Case Manager

Intervention:

(What was done in relation to referral/follow-up activities, engagement, assessment/evaluation, plan development/revision, and transition)

Michael Jean and the clinician met to discuss his participation issues and evaluate his progress in the anger management program.

An outline of the program's goals and coping mechanisms intended to support emotional control was given to Michael.

He did, however, voice his displeasure with the program, saying that he would rather receive one-on-one counseling because the group environment does not suit his needs.

The therapist acknowledged Michael's emotions and promoted candid conversation about different approaches to dealing with his anger management issues.

Following a quick review of self-regulation skills, Michael was urged to pinpoint his own triggers and coping mechanisms.

To discuss the prospect of adding individual counseling to group sessions, the case manager was brought into the discussion.

While his desire for one-on-one counseling is being considered, Michael consented to keep going to sessions.

Response/Observed Behavior(s):

(Which high-risk behaviors are medically necessary; how did the intervention affect the behavior or mood?)

At first, Michael was uncooperative and disinterested, avoiding eye contact and crossing his arms.

His voice was irritated, and he voiced doubts about the program's efficacy.

He got increasingly interested in talking about his own experiences with rage and his preference for individual treatment as the session went on.

Although Michael said that he finds it difficult to regulate his emotions under pressure, he stated that he would be open to working on improving himself if given a new strategy.

Even though he was adamant about not liking group sessions, he was open to picking up coping mechanisms and promised to go till other options were considered.

When talking about past disputes in the group context, he showed some aggravation, but with encouragement, he was able to refocus.

His strengths identified during the session include self-awareness, willingness to communicate his needs, and openness to exploring solutions.

Plan & Next Steps:

Check in with the case manager to see if Michael can benefit from individual counseling.
While reviewing his request, encourage him to continue attending group anger management sessions.
Keep an eye on Michael's participation in future sessions to gauge his development and emotional control.
Arrange a follow-up consultation to discuss any modifications to Michael's treatment plan and to reevaluate his concerns.

Staff Signature:

Shawn Beck
BAC Group Home Staff