2026 DAP note examples for therapists

[Patient name] reports steady mood improvement over the past two weeks — fewer mid-day crashes and one full day this week described as 'genuinely good.' Behavioral activation log shows 4 of 7 scheduled activities completed; the pattern of cancellation centers on Friday afternoons. PHQ-9 administered: 11 (last session 14; baseline 19). In-session work focused on activity-monitoring review and reattributing 'I'm lazy' to 'I'm depleted by Friday.' Affect noticeably brighter than session 3.

Major Depressive Disorder, recurrent, moderate (F33.1), partial response to CBT. Behavioral activation is producing measurable mood benefit. The Friday cancellation pattern suggests end-of-week depletion — worth examining as a sleep or workload signal rather than a treatment failure. Risk: low.

Continue weekly CBT with focus on behavioral activation. This week: replace one Friday afternoon scheduled activity with a deliberate rest block; add a Saturday morning low-effort pleasure activity. Reissue the activity-monitoring log. Next session [Date].

[Patient name] reports a 'mostly skillful' week with one significant lapse: Sunday evening, blended with a vulnerable emotional state and engaged in target behavior (binge eating). Diary card complete and accurate. Used Wise Mind ACCEPTS three times during the week; STOP skill once. Skills group attendance: present and contributing. In-session: chain analysis of Sunday's lapse — identified the prompting event (an unexpected text from [Provider] about insurance change) and the missing skill (radical acceptance of the news).

Borderline Personality Disorder (F60.3), in active DBT. The chain analysis identified a clear vulnerability factor (high-emotion family contact) and a workable skill gap (radical acceptance). The fact that the patient noticed the lapse, recorded it, and brought it to session is itself a target-positive behavior.

Continue weekly individual + group. Homework: radical acceptance practice — pick three small things to fully accept this week. Coach call available for Sunday evenings specifically. Continue diary card. Next session [Date].

[Patient name] arrived 5 minutes early and reports feeling 'ready to start the real work.' Reviewed the target memory list developed last session — three targets identified, with the dog-attack memory from [Date] prioritized due to highest current SUDS (8) and clearest negative cognition ('I'm not safe'). Resourcing review: safe place visualization stable, container imagery functional, calm-place body cue established. Patient demonstrated the container exercise unprompted. No dissociation triggers identified during prep.

Acute single-incident PTSD (F43.11). Phase 2 (preparation) complete; resourcing is robust enough to begin Phase 3 (assessment of the target). Patient's window of tolerance is well-established. No contraindications to beginning reprocessing.

Next session: complete Phase 3 assessment on the dog-attack target — identify the worst image, negative cognition, positive cognition, VOC, emotion, body sensation, and SUDS. If time permits, begin Phase 4 reprocessing. Self-care homework: continue safe place daily; no exposure work outside session. Next session [Date].

[Patient name] reports a hard week. A 'caretaker' part dominated for three days after a family conflict — patient described feeling 'like I disappeared' and only noticed it after the fact. Was able to step into Self during today's session and ask the caretaker what it was afraid of (rejection by [Patient name]'s mother). The caretaker shared that it has been protecting an exile that fears abandonment. Patient remained in Self for most of the dialogue; some blending occurred when the exile briefly came into view.

Generalized anxiety presentation, IFS conceptualization. The caretaker manager became visible this session — significant progress. The exile underneath is now identifiable; unburdening is not yet appropriate but on the medium-term plan. Self-leadership is developing.

Continue weekly IFS. Between sessions: gentle check-ins with the caretaker when it activates ('What are you worried about right now?'). No direct engagement with the exile outside session. Notice and journal any moments of Self-energy. Next session [Date].