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Introduction

Introduction: Welcome to Write it Right Course #3 - SOAP Notes

Learning Objectives

What This Course Covers

Where This Course Fits in the Series

Meet Marcus T.

TL;DR: What a Strong SOAP Note Looks Like

Coming Up: The Subjective Section

Downloads

🔗 Download Materials

Gold Standard Template

⭐️ Gold Standard Template - SOAP Note

Module 1: The Subjective Section

FORMAT GUIDE

What Goes in the Subjective Section

What Does NOT Go in the Subjective Section

Direct Quote Conventions

Behavioral Specificity Standard

Risk Assessment

Marcus T.: Subjective Practice

Example of a Strong Response

Coming Up: The Objective Section

Module 2: The Objective Section

The S vs O Boundary

Mental Status Exam

Standardized Measures

What Does NOT Go in O

Observation vs Inference

Marcus T.: Objective Practice

Coming Up: The Interventions Section

Module 3: The Interventions Section

Rule of Thumb: How Many Interventions Per Session

Modality vs. Technique

The “Could a Friend Have Done This?” Test

Connecting Interventions to Treatment Plan Goals

Rationale for Modality and Technique

Documenting Client Response to Interventions

Documenting Psychoeducation

Documenting Skills Practice

Documenting Role-Play, Behavioral Activation, and Between-Session Planning

CPT Compliance: The I Section Justifies Your Billing Code

Marcus T.: Interventions Practice

Coming Up: The Assessment Section

Module 4: The Assessment Section

Diagnosis Statement

Clinical Formulation

Progress

Recommendation

Potential Barriers to Progress

Client Engagement and Strengths

Prognosis

Medical Necessity

Note (Disclaimer)

Risk in Assessment

What Does NOT Go in Assessment

Marcus T.: Assessment Practice

Coming Up: The Progress and Plan Section

Module 5: The Progress & Plan Section

What Goes in the Progress & Plan Section

Plan & The Golden Thread Connection

Be Specific

Coordination of Care

Marcus T.: Plan Practice

Coming Up: Administrative Completeness and Complex Scenarios

Bonus Module: Complex Scenarios for SOAP Documentation

Overview

Administrative Completeness

CPT 90837 Documentation (60-Minute Sessions)

Telehealth SOAP Notes

Family and Couples Sessions

No-Shows and Late Cancellations

Closing: What You Learned

The Complete SOAP Note

📋 Feedback & Certificate

Badge Card

Audit-ready SOAP notes that connect every session to the plan.

$ (USD)

Write SOAP progress notes that hold up under audit. This clinician-built course breaks down every section (subjective, objective, interventions, assessment, plan) and shows how each note connects back to the diagnosis and treatment plan, keeping the golden thread intact.

Write it Right: SOAP Notes | MC Clinical Documentation Course

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