The Ultimate Therapy Progress Notes Cheat Sheet (DAP & SOAP Formats)

Good documentation is a skill you can shortcut with the right phrases. This cheat sheet gives you a side-by-side of the two most popular mental health formats, SOAP and DAP, followed by a bank of copy-ready clinical phrases you can drop into any note today. Bookmark it, print it, keep it by your keyboard.

Start your free 7-day trial → (no credit card required)

SOAP vs DAP at a glance

SOAP	DAP	What goes here
Subjective	Data	What the client reports, mood, symptoms, stressors, their words.
Objective	Data	What you observe/measure, affect, mental status, scores.
Assessment	Assessment	Your clinical interpretation, progress, diagnosis, risk.
Plan	Plan	Interventions, homework, referrals, next session.

DAP simply folds SOAP's Subjective and Objective into one "Data" section. Use SOAP when coordinating with medical providers; use DAP for leaner psychotherapy notes. See the full breakdown in SOAP vs DAP vs BIRP.

Phrase bank: Subjective / Data

"Client reported…", "Client described…", "Client identified…", "Client endorsed…"
"Since the last session, client noted…"
"Client's stated goal for today was…"
Quote sparingly and purposefully: In client's words: "…"

Phrase bank: Objective

Appearance/behavior: "well-groomed," "arrived on time," "restless," "guarded," "engaged readily."
Affect/mood: "affect congruent with content," "constricted affect," "euthymic," "tearful when discussing…"
Mental status: "oriented x4," "linear and goal-directed thought process," "no evidence of psychosis," "speech normal in rate and volume."
Measures & risk: "PHQ-9 = __," "GAD-7 = __," "Denied suicidal and homicidal ideation."

Phrase bank: Assessment

Progress: "Client demonstrates partial response to…," "Client is progressing toward Goal #__…," "Symptoms remain consistent with…"
Clinical reasoning: "Presentation is consistent with [diagnosis, ICD-10]…," "Cognitive distortions around __ remain active…"
Risk change: "No change in risk profile," "Risk elevated due to…; safety plan reviewed."

Phrase bank: Plan

"Continue weekly [modality] targeting…"
"Assigned homework: … to be reviewed next session."
"Coordinate with prescriber regarding…"
"Next session on __/__; reassess [measure] in __ weeks."

Language that documents medical necessity

Payers and auditors want to see why continued care is needed. Weave these into your Assessment and Plan:

"Continued treatment is medically necessary to reduce [symptom] and prevent [functional impairment]."
"Without intervention, client is at risk of [relapse / hospitalization / decompensation]."
"Client's [avoidance / distortion / symptom] directly impairs [work / relationships / daily functioning]."

Three fast rules

Be specific, not generic. "Practiced coping skills" is weak; "led interoceptive exposure, SUDS dropped 8→4" is strong.
Individualize every note. Copy-pasted sessions are the fastest way to fail an audit.
Always screen and document risk, even a negative screen belongs in the note.

Skip the blank page entirely

NotedTherapy drafts a complete SOAP or DAP note from your session in your own clinical voice, already using the kind of specific, medical-necessity language above, so you review and sign instead of writing from scratch. No audio is stored. Ready to reclaim hours every week?

Start your free 7-day trial →, no credit card, first note in about a minute.