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Group therapy

A group is a roster of independent clients you see together — a DBT skills group, a process group, a psychoeducation series. Unlike a couple or family, the members aren't one billing unit: each keeps their own chart, their own diagnosis, and their own bill. You schedule one session for the whole roster, mark who showed, and each attendee is billed and documented individually.

Group therapy vs. couples/family

This page is for group therapy — unrelated clients seen together, each billed on their own. If you're treating a couple or family as one unit (shared note, one bill, a primary client), that's a different setup — see Couples & Family Therapy.

In this guide, we'll cover:

Creating a group​

Groups are created from the New Client drawer:

  1. Click + → New Client and choose the Group type.
  2. Enter a Group Name — this is required, and every member sees it in their portal, so keep it generic and never include client names (e.g. "Tuesday DBT Skills Group," not "Dana & Morgan").
  3. Add each member's tab — or click Add Existing Client to search your practice and reuse someone's existing record.

The New Client form with the Group type selected, a generic group name, and Add Existing Client

  1. Set the billing type (Self-pay / Insurance). For a group this is just the default applied to any new members you create in this form — each member is billed individually, so you can change it per member later on their own Payment & Insurance tab.
  2. Click Create Group.

There's no Primary Client and no Guarantor to pick — those are couples/family unit concepts. Each group member carries their own diagnosis and their own billing.

Scheduling a group session​

Book a group session like any other appointment — in the appointment form's client search, the group appears under the Couples / Families / Groups heading. Every active member is added to the session automatically, and their names are hidden on the appointment (members can see the appointment in their portal, so the roster stays private).

The appointment's billing box shows "Per member — each attendee is billed individually" rather than a single session total.

Taking attendance (this is what makes a session billable)​

Click the session on the calendar to open it — the appointment panel has an Attendance card ("Only clients marked Show become billable for this session"). Use the dropdown next to each member's name (it reads Expected until you choose):

  • Show — attended; this is the only status that becomes billable.
  • Cancelled, Late Cancel, or No Show — not billed for the session.

From here you can also adjust the roster for this one session only, without touching the standing group:

  • Add a drop-in client — search for a client who attended just this session.
  • Add a roster member back — anyone you removed is listed under "Group members not in this session".
  • Remove a member from this session with the × at the end of their row (they stay on the group).

Once the session time has passed, a Confirm attendance & close out button appears under the roster — clicking it records the attendance on screen and bills everyone marked Show. If nobody closes the session out, members are assumed Show and flagged "(assumed)", with a Confirm attendance prompt — attest it so billing and notes reflect who was actually there.

Billing each member​

Group billing is per member and can be done at any point (before or after the session), all from the session's Attendance card:

  • Group session fee (default per member) sets the group's standard fee. A member's own account rate still wins; to change one member's fee for this session, click the pencil next to their amount.
  • Invoice & collect each member separately (it appears once a member is marked Show) — each charge lands on that member's own account, guarantor, and AutoPay. A Billing: line at the top of the card sums up how many members are uninvoiced, unpaid, and paid.

Because each member has their own account, per-member balances live on each member's billing — and on the session's attendance panel — rather than in a single group ledger.

Writing notes​

Group-therapy notes are written per member, from the session's Group Note button:

  1. Open the session and click Group Note ("Write a note per attending client").
  1. Write one shared Group Summary — the session's theme, interventions, and group dynamics, de-identified (no member names). This text is reused for every attendee.
  2. For each attending member, add their Individual Response — how that specific client participated and responded.
  3. Click Save and sign all to save and sign every member's note in one step, or Save N notes to keep them as drafts. Either way, each attending member gets a separate note on their own chart. Drafts can be signed later all at once from this page, or one at a time from Notes to Sign or the member's chart.

If a member marked Show has no Individual Response, signing warns you first and names them: their note would contain only the group summary. Choose Go back to add one, or Sign anyway. Once a note is signed, adding to it means unlocking it.

Group notes under supervision​

If you're under supervision, the button reads Save and submit all for review. Each member's note is signed by you and sent to your supervisor, exactly as when you submit a single note. While they wait, the notes show Submitted for review on this page and can't be changed here.

Your supervisor sees one entry per member note in their supervision queue. Any of those notes has an Open group session button that brings them to this page, where Co-sign all co-signs every note waiting on them in one step. To ask for changes on one member's note, they open that note and choose Request Edits as usual; it comes back to you as a draft.

Keeping members out of each other's notes is a HIPAA requirement, so the composer warns you if a member's name appears in the shared summary or in another member's section. If the session isn't marked held yet, the composer asks you to Confirm attendance & start notes first — only members marked Show get a note.

Recording and AI notes for a group session​

For a roster group, the AI scribe is deliberately switched off:

  • The session's card offers Group Note only — there is no Record, Dictate, or Type button on a group session, and a group video call has no Start Notes toggle.
  • The Group Note composer is written by hand. It does not transcribe, draft, or regenerate anything.

Why: one recording of a group session captures every member, and a single transcript can't be filed to one member's chart without carrying the others into it. Per-member notes are the compliant shape, so that's the only shape the app produces for a group.

What you can do: once you Save, each member's note is an ordinary note on that client's own chart — open it there to edit, sign, or submit it for co-sign like any other note.

This is different from couples and families, whose sessions record and generate a note exactly like a 1:1 — see Telehealth for couples & families.

Two different "Group Therapy" things

The Group Note composer above is the compliant per-member flow for a roster group. Separately, the template gallery has a generic "Group Therapy" note template you can use on an individual client's chart — it's not wired into the group session flow, so use Group Note for actual group sessions.

Managing a group​

Open the group from the Clients page and click the pencil icon by its name to edit it. The edit page has three tabs — Group Therapy Info, Clients, and Billing:

  • Members (Clients tab) — Add client brings someone onto the roster; a member's ⋮ menu removes them. Removing a member keeps their individual record and billing history intact.
  • Group Type is locked for a group — the Info tab shows a fixed Group Therapy badge ("Billed per member — the type can't change after creation"). You can't convert it to a couple or family, because that would flip the entire billing model (per-member → one unit bill) and strand the existing per-member charges.
  • Deactivate Group (Info tab) ends the group and removes it from your active lists; every member's record and all billing history are preserved.

FAQ​

Can I turn a group into a couple/family (or vice-versa)? No — the type is fixed at creation because the billing models are incompatible. Create the new unit fresh if you need to switch.

Whose insurance is billed? Each member's own — there's no shared primary client. Each attendee's session is billed under their own coverage or self-pay setting.

A client missed the session — will they be charged? Only members marked Show are billed. Mark absentees No Show, Cancelled, or Late Cancel and they're left off the session's billing.

Can I add someone who dropped in just once? Yes — add them on the session's attendance panel; it's a per-session addition and doesn't change the standing roster.

Can the AI write my group notes for me? Not today. Group sessions don't record, and the Group Note composer is manual — you write the shared summary and each member's response. AI help with the composer isn't built yet; the per-member structure itself is deliberate and will stay.

Can I record an in-person group session with the app? No. Recording is available for 1:1, couples, and family sessions only.

Can members see who else is in the group? Names are hidden on the shared appointment, and each member's note is de-identified, so members don't see each other's identities through Practice Harbor.