Systemic and family therapy session note: template, structure and example

A systemic session note is the written record of a family, couple or individual therapy session conducted from a systemic perspective. It does more than summarise what each person said. It describes what happens between people, the therapist's hypotheses about the role the problem plays in the family, and what was proposed for the next steps.

This template is for psychologists and family therapists who see families, couples or individuals with a systemic lens. Write the note right after the session, while the exchanges are still clear. It then helps you prepare the next session, track how your hypotheses evolve and present the case in supervision.

What a systemic session note is for

In family therapy, several voices speak in the same hour. Without a note, it is hard to remember who said what to whom, which alliance appeared, or which question shifted the conversation. The note keeps these elements and lets you compare sessions over time.

It also avoids a trap. Families often come for one member, the identified patient. A note focused only on that person ends up confirming that the problem lies within them. A systemic note puts the symptom back into the context of relationships.

When to use it

• After every family or couple session, including when part of the family did not attend.
• After an individual session conducted with a systemic lens.

The framework

The French code of ethics for psychologists (updated in 2021) puts professional confidentiality at the centre of practice. It covers everything the psychologist learns through their work, what they are told as well as what they see, hear or understand (article 7). In family therapy, this applies to each family member.

• What one person shares alone does not go into the joint note. If a parent talks to you privately, record it separately and do not bring it up in front of the others without their agreement.
• Exchanges with other professionals are limited to what is strictly necessary for the purpose of the work, and the people concerned are informed beforehand where possible (article 8).
• Minors. The psychologist seeks the authorisation of the legal guardians, in line with the rules on parental authority (article 11).
• Notes and data are filed and archived in a way that protects people's privacy (article 23).

Everyone has a right to access the data that concerns them (article 15 of the GDPR, as explained by the French data protection authority, CNIL). When your notes are added to a patient's record in a French healthcare facility, article L1111-7 of the Public Health Code applies. Information gathered from third parties who are not involved in the patient's care, or that concerns those third parties, cannot then be disclosed. In every case, write as if each family member could read what concerns them.

The structure, section by section

1. Session details

Date, session number, length, in person or video, co-therapist if any.

2. Who attended and who did not

List who came, with each person's age and relationship. Also note who was missing and why. Repeated absence is clinical information.

3. Request and reason for referral

Who is asking for what, and for whom. The parent's request, the teenager's and the referrer's are often different. Write them separately, in each person's own words.

4. Genogram and updates

The genogram is a diagram of the family across several generations (births, unions, separations, deaths, significant events). It is built at the start of therapy. In the note, record only what has changed or come to light.

5. What happened in the session

The topics discussed and above all the interaction sequences. Who speaks to whom, who interrupts whom, who stays silent, who defends whom. One or two sentences quoted word for word are worth more than a long summary.

6. Systemic hypotheses

A hypothesis describes how the problem fits into relationships, and what purpose it may serve in the family's balance. The Milan team made hypothesising, circularity and neutrality three guidelines for conducting a session (Selvini Palazzoli et al., 1980). Phrase your hypotheses tentatively, and note which ones the session strengthened or weakened.

7. Therapist interventions

Circular questions (asking one person how they see the relationship between two others), reframing (offering another reading of a behaviour), tasks or rituals. Record how each person responded.

8. Resources and change

What is going better, moments when the problem does not appear, the family's strengths.

9. Safety concerns

Violence, risk-taking, a child's situation that worries you. If a situation could harm someone's integrity, the code asks you to assess carefully what to do, seeking advice if needed (article 17). Record what you observed and what you decided.

10. Next steps

Task proposed between sessions, who is invited to the next session, date, planned contacts with other professionals.

Filled-in example

Fictional family. All names and details are invented.

Session details. Third session, 75 minutes, in person. One therapist.

Attended. Mrs M., 42, mother. Mr M., 45, father. Lucas, 15. Absent, Léa, 11, staying with her maternal grandmother according to the parents, "so as not to bother her with all this".

Request. The parents are seeking help because Lucas has been missing school since the start of term. Lucas says he comes "because they make me" and mostly wants people "to stop talking to me about grades". The school nurse suggested the consultation.

Genogram updates. Mrs M.'s father died a year ago. This had not been mentioned in the first two sessions.

Session content. The session opens on the absences. Mrs M. speaks for Lucas several times. Mr M. stays in the background, then addresses Lucas more firmly. Lucas answers his mother, never his father. When the therapist asks Lucas how he sees his parents discussing his grades, he says that "since grandpa, mum is worried all the time". Silence. Mrs M. cries briefly, Mr M. puts his hand on her shoulder.

Hypotheses. Lucas's absences may keep his mother busy and present at a time when she is going through a grief little shared within the family. The father's withdrawal may leave the mother alone with her worry. Hypothesis strengthened by this session. A couple conflict in the foreground seems less supported today.

Interventions. Circular questions about how each person experienced the death. Reframing the absences as a way for Lucas to stay close to home.

Resources. A spontaneous moment of support between the parents. Lucas attended school three days the previous week.

Safety. No sign of danger reported or observed.

Next steps. The parents are invited to take some time together during the week to talk about the grandfather, without Lucas. Léa invited to the next session, with the parents' agreement. Next session in three weeks.

Common mistakes

• Writing a note that only talks about the identified patient, as in individual therapy.
• Presenting a hypothesis as an established fact, for example "the mother overprotects her son".
• Taking sides in the wording, praising one member and discrediting another.
• Including in the joint note something one person shared privately.
• Forgetting to note who was absent and why.
• Noting a task between sessions without noting, next time, what the family did with it.

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, or add written notes. Delta then generates the session report (short summary, detailed summary, topics for the next session), taking into account your profession and approach, including systemic therapy, and updates the patient record with a summary of the therapy and the goals being tracked. Data is hosted in France with an HDS-certified provider, the patient's name and identifying details are pseudonymised before the AI, no audio file is kept and data is never used to train a model. Learn more about Delta.

Read also

• First session intake, template and structure
• Session note with a child or adolescent
• Note-taking software for psychologists
• All clinical document templates

Sources

• French code of ethics for psychologists, 2021 update (articles 7, 8, 11, 17 and 23)
• Selvini Palazzoli M., Boscolo L., Cecchin G., Prata G. Hypothesizing, circularity, neutrality. Family Process, 1980
• CNIL, the right of access to your data (in French)
• Service-public.fr, access to medical records (in French)