• The treatment summary will be requested before the 20th session of treatment.
• In a narrative format or letter, please address each of the 12 areas of the treatment summary.
• The treatment summary is intended to be a comprehensive report covering the client's response to treatment over time.
• It needs to reflect the client's response or lack of response to your interventions.  What are the measurable changes in sleep, depression levels, and anxiety levels, etc?
• If you have not been able to terminate by dates previously given on the RAS, please elaborate on why treatment could not be concluded successfully at those times.
• We know that sometimes clients have setbacks in their lives or remissions that cause GAF scores to drop.  We would like your report to address this change and what new or different strategies will be implemented to improve the client's conditions.  If applicable, please include more intensive treatment needs other than individual psychotherapy, such as referral for medication, hospitalization, and/or partial hospitalization program, and steps taken to obtain those services for the client.
• Treatment goals should, of course, be specific and measurable.
• Please include a realistic number of sessions and/or date when treatment will be concluded.  If you do not have an expected date or session number of completion, please explain the projection for treatment (including treatment options other than individual therapy) to maintain level of functioning possible for client.

1. Date treatment began, current frequency of treatment
2. Diagnosis
3. Symptoms being addressed
4. Past treatment history (including hospitalizations, IOP, PHP)
5. Past and current psychotropic meds
6. Suicidal/homicidal status current and past
7. Whether client has been referred for a psychiatric evaluation
8. What treatment mode is being used to address the symptoms
9. How are the symptoms tied to the treatment goals
10. How do you and the client measure progress toward the goals (ex:  Client will experience fewer than three (3) panic attacks in one day, etc.)
11. How will you and the client know when he/she is better, or when he/she no longer will need to continue counseling?
12. Name of associated psychiatrist or other MD and when that referral was made.

Return Treatment Summary Information BEFORE/BY next Request for Additional Services to:
Employee Assistance Network, inc.
Doctor's Park Suite 3-c
417 Biltmore Avenue
Asheville NC  28801
Phone 828.252.5725     Fax:  828.258.1336