How do you write a SOAP note for CBT?

Put the client’s mood report, key situations, automatic thoughts and completed homework in Subjective; your observations, measure scores and the CBT technique used in Objective; your judgment about the maintaining pattern, progress and risk in Assessment; and new homework, measures and the next session focus in Plan.

How do you document a thought record in a progress note?

Summarize the situation, the automatic thought with a belief rating, the emotion and its intensity, the key evidence reviewed, the balanced thought and the re-rating. Two or three lines are enough; the worksheet itself does not need to be copied into the note.

Where does homework go in a CBT SOAP note?

Homework completed since the last session, and what the client noticed, goes in Subjective because it is the client’s report. New homework goes in Plan. Your judgment about how homework is affecting progress goes in Assessment.

What measures are used to track progress in CBT?

Common choices are the PHQ-9 for depression (0 to 27) and the GAD-7 for anxiety (0 to 21), repeated at regular intervals and compared with intake. Behavioral counts, such as activities completed or days with low mood, are also useful.

How long should a CBT SOAP note be?

Long enough to show what was done and why: usually a short paragraph per section. Record the technique, one concrete example, the client’s response, measures and the plan; leave out the session transcript.

SOAP Notes for CBT: Example and Template

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Overview

This guide is part of our complete SOAP notes hub — format structure, a full clinical example, and all 72 diagnosis-specific templates.

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Short answer: a CBT SOAP note puts the client’s report (mood, key situations and automatic thoughts, homework completed) in Subjective; your observations, measure scores and the specific CBT technique you used in Objective; your clinical judgment about the maintaining pattern, progress toward goals and risk in Assessment; and the new homework, measures and next session focus in Plan.

CBT sessions are structured (mood check, bridge from the last session, homework review, agenda, skill work, new homework and feedback), so a good note follows that structure. Name the technique (for example a thought record, cognitive restructuring, behavioral activation or a behavioral experiment), record a short example of the thought you worked on and the more balanced alternative, and track a repeated measure such as the PHQ-9 or GAD-7 against baseline so progress is visible.

What to document in a CBT SOAP note

What to document in each SOAP section for CBT, with fictional example wording
Section	What to document	Example wording
Subjective	Mood and key situations since the last session, in the client’s words	“Low mood on 4 of 7 days; ‘I’m useless at work’ after a manager’s comment on Tuesday.”
Subjective	Homework completed and what the client noticed	“Completed 3 of 5 activity-scheduling entries; mood 3/10 before a walk, 5/10 after.”
Objective	Observations and measure scores	“Good eye contact, affect constricted, brighter when reviewing the walk. PHQ-9 14 (18 at intake).”
Objective	The CBT technique used, with a short example	“Thought record: ‘I’m useless’ (belief 85%) re-rated to 40% after reviewing evidence; balanced thought written.”
Assessment	Maintaining pattern, response to CBT and progress toward goals	“All-or-nothing thinking about work maintains low mood; responding to behavioral activation (PHQ-9 18 to 14).”
Assessment	Risk screen	“Denied suicidal thoughts and self-harm; PHQ-9 item 9 scored 0.”
Plan	New homework, measures and next session focus	“2 thought records; 4 scheduled activities; repeat PHQ-9 in 2 weeks; next: core belief about competence.”

If a client reports suicidal thoughts or scores above 0 on PHQ-9 item 9, assess and record current thoughts, plan, intent, preparatory behavior, past attempts, access to means, protective factors, your risk formulation and the safety plan. The 988 Suicide & Crisis Lifeline takes calls and texts at 988; for imminent danger, call 911 or go to the nearest emergency department.

How to Document SOAP Notes for Cognitive Behavioral Therapy

Subjective

Record the client's reported symptoms, concerns, mood, and perspective in their own words

When documenting the Subjective section in CBT, detail the client’s self-reported experiences including symptoms, emotional states, and specific situations or thoughts that trigger distress or maladaptive behaviors.

Client’s description of current mood and emotional fluctuations since the last session
Identification of recent cognitive distortions or negative automatic thoughts reported by the client
Client’s self-reported triggers or situations that elicited anxiety, depression, or other target symptoms
Description of any changes in coping strategies or behavioral responses noted by the client
Client’s insight or reflections on how thoughts, feelings, and behaviors are interconnected

Objective

Document clinical observations, affect, behavior, appearance, and measurable data

In the Objective section for CBT, document observable clinical data including therapist’s observations of client behavior, affect, and engagement, as well as specific cognitive-behavioral techniques and interventions applied during the session.

Therapist’s observations of client’s affect, body language, and level of engagement or resistance
Use and client response to cognitive restructuring exercises or thought records during session
Implementation of behavioral experiments or exposure tasks and client compliance
Application of skill-building techniques such as relaxation training, mindfulness, or problem-solving
Recording of any homework review and client’s demonstrated understanding or skill acquisition

Assessment

Provide clinical interpretation, diagnostic impressions, and progress evaluation

The Assessment section in CBT synthesizes clinical impressions based on subjective and objective data, evaluates client progress toward goals, and considers diagnostic or treatment modifications.

Clinical impression of client’s cognitive distortions and their impact on emotional and behavioral symptoms
Evaluation of client’s progress toward cognitive and behavioral goals established in prior sessions
Assessment of client’s insight and readiness for change as observed during session
Consideration of any new or evolving diagnostic factors influencing treatment planning
Reflection on client’s response to CBT interventions and identification of barriers or facilitators

Plan

Outline treatment strategy, interventions, homework, and follow-up schedule

The Plan section in CBT outlines the next steps in treatment, including homework assignments, modifications to therapeutic approach, referrals if needed, and scheduling of upcoming sessions.

Assignment of specific cognitive or behavioral homework tasks tailored to client’s current challenges
Plan to introduce or adjust CBT techniques based on client’s progress and engagement
Recommendations for referrals to other providers if comorbid conditions or additional support are identified
Scheduling of next session and discussion of session frequency or format adjustments if necessary
Outline of goals and target behaviors for upcoming sessions to maintain treatment focus