Psychodynamic session note: template, structure and example

A psychodynamic session note is the document in which the clinician records what the patient brought to the session, the themes that recur, what is happening in the relationship with the therapist and the working hypotheses that are emerging. It follows the logic of psychoanalytic therapies, which attend to the meaning of what is said, repeated or left unsaid.

It is designed for psychologists, psychiatrists and psychotherapists working in a psychodynamic or psychoanalytic approach, in private practice or in institutions. It helps track work that is often long and notice what changes from one session to the next.

What a psychodynamic session note is for

In psychoanalytically oriented work, meaning builds up over time. A dream or a recurring theme gains depth when you can link it to what was said weeks earlier. The note keeps these threads. It lets you find when a theme first appeared, how it changed, and what was happening in the therapeutic relationship at the time.

It also tracks the frame. Missed sessions, lateness, requests to change times or difficulties with payment often carry meaning in this approach. Recording them lets you return to them at the right moment.

When to use it

For psychodynamic psychotherapy sessions, usually face to face once or twice a week, and for psychoanalysis. The first consultations, where you assess the request and the indication, call for a broader template, close to an intake.

The rules

In France, the code of ethics for psychologists (2021 version) requires professional secrecy (article 7), which covers what is confided and also what is seen, heard or understood. Article 23 refers to personal notes and asks psychologists to collect, file and archive them in a way that protects privacy and confidentiality. Article 8 limits exchanges between professionals, supervision included, to strictly necessary information, and asks that the people concerned be told where possible.

The line between personal notes and the record matters a great deal in this approach, but it protects less than people think. In a French healthcare facility, anything placed in the file falls under the right of access in article L1111-7 of the Public Health Code. In private practice, the GDPR gives everyone a right of access to the data that concerns them. In Belgium, the Commission of Psychologists points out that since 4 March 2024, patients can consult their entire file, personal notes included, except data about third parties. In Switzerland, the FSP code also gives patients the right to consult their file.

In practice, keep what belongs to your inner reflection for supervision, and only put in the note what you could explain to the patient. Information about third parties (parents, partner, children) is limited to what sheds light on the work.

The template, section by section

Header

Date, session number, length, setting (face to face or couch, weekly frequency). Add any event concerning the frame, such as lateness, a missed session, a request for change or a payment issue.

What the patient brings

The themes raised, in the order they came, with a few of the patient's words when they are telling. Dreams, briefly summarised, and the associations the patient makes. Things forgotten, slips of the tongue or silences that marked the session. Order matters, because the sequence of themes often says as much as the themes themselves.

Affect and presence in session

What you observed of the patient's emotional state and way of speaking. Laughing while describing a painful event, speaking faster on one subject, finding it hard to start the session. Describe without interpreting.

Therapeutic relationship

What is happening with you, known as transference. Does the patient attribute an expectation, a reproach or kindness to you? Are they repeating with you a way of relating they describe elsewhere? Also note, briefly and plainly, your own reactions when they shed light on the session (countertransference), bearing in mind that the note may be read.

Clinician's interventions

What you said and what the patient did with it. A clarification, a link between two themes, an interpretation. The patient's reaction (agreement, silence, rejection, a new memory) is clinical information in itself.

Working hypotheses

Your provisional understanding, written tentatively or introduced with "hypothesis". What conflict seems to be at work? What repetition is emerging? They will be confirmed or dropped over the sessions.

Progress and points of concern

What changes over time in symptoms, in the patient's life and in their relationship to the therapy. The risk assessment if one was carried out, with the patient's answer.

Completed example

Fictional patient. Ms B., 38, teacher, has been in therapy for seven months for a feeling of exhaustion and romantic relationships she describes as "always the same". One session a week, face to face.

Header. 8 October, session 27, 45 minutes. Arrived ten minutes late, for the second time this month. She apologises at length.

What the patient brings. Starts with an argument with a colleague who criticised her for leaving a file unfinished. "I can never say no, and then people hold it against me." Then talks about her mother, who called to ask her to look after her nephews during the holidays, which she agreed to. Describes a dream from the week, she is in a station and misses a train because she is helping someone carry their bags. Associates this with always "missing something" for others. Long silence at the end of the session.

Affect and presence. Light tone at first, laughing while recounting the argument. Lower voice when speaking of her mother. Tears while telling the dream, which she quickly wipes away, saying "it's nothing".

Therapeutic relationship. Very insistent apologies for being late, as if expecting a reproach. At the end she asks whether she "talked too much". Hypothesis of a fear of disappointing that is also being replayed in session.

Interventions. Link made between the dream and the week's situations, both marked by helping others at the expense of what she wants. She stays silent, then recalls a childhood memory of looking after her younger brother while her mother was away.

Working hypotheses. A long-standing role as "the one who helps" that may protect her from a fear of rejection. The lateness might say something about how hard she finds it to take a place for herself, here included. To revisit if this is confirmed.

Progress and concerns. She speaks more freely about her anger than at the start of therapy. Fatigue still present, sleep adequate. No suicidal thoughts at the last check in session 24. Next session on 15 October.

Common mistakes

• Writing a hypothesis as a fact. "She repeats her relationship with her mother" becomes "hypothesis of a repetition of the relationship with her mother".
• Confusing the record with personal reflection. Your inner work on the session belongs in supervision, not in the file.
• Using opaque jargon. An unexplained theoretical term makes the note unreadable for a colleague from another approach and for the patient.
• Forgetting the frame. Lateness, missed sessions and money issues are part of the clinical material in this approach.
• Never recording the risk assessment. Even in meaning-focused work, the patient's state must be traceable.

Save time with Delta

Delta is the clinical assistant for mental health and allied health professionals. During the session, Delta transcribes what is said. You can also dictate your observations after the session, which suits many psychoanalytically oriented clinicians, and add written notes. Delta then generates the session report (short summary, detailed summary, topics for the next session) taking your approach into account, the psychodynamic approach included, and updates the patient record with a summary of the therapy and the goals being tracked. Data is hosted in France by an HDS-certified provider, the patient's name and identifying details are pseudonymised before reaching the AI, no audio file is kept and data is never used to train a model. Learn more about Delta.

Further reading

• DAP note template and example
• Systemic and family therapy session note
• End-of-therapy summary template
• All our clinical document templates

Sources

• French Code of Ethics for Psychologists, 2021 revision
• Psycom, brochure on psychoanalytic therapies (in French)
• CNIL, how to answer a subject access request (in French)
• Belgian Commission of Psychologists, ethics newsletter on the patient file, April 2025 (in French)