Introducing HEART—
A Relational Approach to Therapy Notes
HEART is a flexible documentation framework designed to honor both clinical nuance and ethical care. Built for relational and process-based therapies like ACT, CFT, and IFS, it centers client experience, therapist presence, and the unfolding of change—not just interventions or compliance.
Unlike traditional formats like SOAP, which prioritize standardized structure for billing or auditing, HEART reframes documentation as a relational and reflective practice. It treats note-taking not as a detached record, but as an extension of the therapeutic process itself.
Rooted in principles aligned with feminist ethics, HEART values voice, context, and collaboration. It invites clinicians to slow down, track meaning, and document not just what happened, but what mattered.
It honors the artistry of therapy—messy, human, and full of meaning—by offering a format that is narrative-rich and bullet-flexible, bending to the work rather than forcing the work to fit a mold.
What is HEART?
HEART is built around five core elements:
H: Human Connection – How the client presented, rapport dynamics, emotional tone, and interpersonal engagement.
E: Exploration & Themes – What topics came up naturally or were addressed. The content of the session.
A: Approach & Interventions – What the therapist did, why it was done, and what clinical models/interventions were used.
R: Response & Progress – How the client responded to the approach, including any insight, resistance, emotional reactions, or behavioral shifts.
T: Trajectory & Plan – Next steps, treatment goals, planned areas of focus, or questions to revisit.
Want to Go Deeper?
Explore how HEART works in practice:
🔍 Breakdown by Section
A detailed look at each part section of a HEART note, showing what to include and how it compares to traditional formats—so you can document what mattered, not just what happened.
🪶 Full vs. Lite Notes
Need to catch up on notes but don’t want to lose the heart of the session? HEART comes in two formats—Full and Lite—so you can choose the level of depth that fits your time and therapeutic style.
Curious about how HEART notes compare with other formats, like SOAP and DAP? Check out this page for side-by-side examples of different formats.
Check back soon for more guides!