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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.

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.
  4. 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.
  5. 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 — the group appears in the appointment's client search. 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)​

Open the session and use its attendance panel. Mark each member:

  • 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 who attended just this session.
  • Re-add a roster member you'd removed from this session.
  • Remove a member from this session (they stay on the group).

After the session time passes, undocumented 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 panel:

  • Set a group default fee per member, and override it for an individual member on a given session.
  • Invoice & collect each member separately — each charge lands on that member's own account, guarantor, and AutoPay.

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").
  2. 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.
  3. For each attending member, add their Individual Response — how that specific client participated and responded.
  4. Save — this creates a separate note on each attending member's own chart, then sign each one from your Notes to Sign queue like any other note.

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 confirms attendance first.

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​

Click the pencil icon by the group's name to edit it:

  • Members — add or remove clients. Removing a member keeps their individual record and billing history intact.
  • Group Type is locked for a group — 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 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 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.