Report Template:
For use by a clinician working with participants in the Australian National Disability Insurance Scheme (NDIS), this NovoNote template provides information generally required necessary for a comprehensive report on the progress of the participant. The report can be used when participants are due to have their NDIS plans reviewed by the National Disability Insurance Agency (NDIA). The report can also be given to other health professionals (such as a general practitioner) involved in the participant’s care to provide them with an update on the participant’s progress.
In order to gain the most out of this template, users are encouraged to type or copy and paste the participant’s NDIS Plan goals, and the requests for future services and funding amounts into the “Additional Context” box before generating the report.
Date of Report: Provide the date of the report.
Name: Provide the NDIS participant’s full name.
Date of Birth: Provide the NDIS participant’s date of birth.
Address: Provide the NDIS participant’s full address.
NDIS Participant Number: Provide the NDIS participant number of the participant.
To Whom It May Concern,
The following report is written for Participant Name’s National Disability Insurance Scheme (NDIS) Plan Review, which is due on Date of Plan Review. It details how their psychosocial disability impacts on their day-to-day life, and how our therapeutic work attempts to improve their functional capacity in this regard.
Provide a brief description of the participant’s engagement with therapy.
Background
- Describe the participant’s disabilities, including related diagnoses and conditions.
- Describe the participant’s history and impact on daily functioning and support needs.
- Describe the participant’s current living circumstances and support arrangements.
- Describe the participant’s participation in therapeutic activities coordinated by the therapist, including improving capacity-building skills, managing psychosocial disability, and engaging in community activities, employment, and independent living.
Functional Impact of Psychosocial Disability
- Describe the functional impact of the participant’s psychosocial disabilities on their everyday life, including how any physical disability impacts on their psychosocial disability.
- Include objective analysis across NDIS domains: Communication, Social Interaction, Learning, Self-Care, and Self-Management.
Current Capacity-Building Strategies
- Describe current capacity-building strategies and therapeutic interventions coordinated by the therapist.
- Describe purpose and rationale for each strategy.
- Provide examples of challenges, strengths, and evidence-based insights into how the therapeutic work has impacted specific aspects of the participant’s disabilities.
- Include statement on participant’s engagement and rapport with therapist.
Impact of Strategies on Current NDIS Plan Goals
- Short-Term Goal 1: Print the participant’s goal, then describe how therapeutic work has positively impacted this goal and how interventions have contributed to outcomes.
- Short-Term Goal 2: Print the participant’s goal, then describe how therapeutic work has positively impacted this goal and how interventions have contributed to outcomes.
- Medium or Long-Term Goal 1: Print the participant’s goal, then describe how therapeutic work has positively impacted this goal and how interventions have contributed to outcomes.
- Medium or Long-Term Goal 2: Print the participant’s goal, then describe how therapeutic work has positively impacted this goal and how interventions have contributed to outcomes.
Recommendations
Provide numbered list of recommendations for ongoing work with participant. Include justification for continued therapy, proposed changes or additional supports, allied health referrals, assistive technology, or support worker hours. Align recommendations with NDIS Plan Goals and ‘reasonable and necessary’ criteria.
Request for Funding
Given the above, I would like to make the following funding request for consideration in Participant’s Name’s upcoming NDIS Plan Review:
Describe services with frequency and timeframe.
TOTAL REQUESTED FUNDING = $ Total amount
Conclusion
- Provide summary describing challenges and successes, progress towards NDIS Plan Goals, and progress since last review.
- Describe importance of continued funding and explain why therapeutic support is ‘reasonable and necessary’ under NDIS Act.
- Describe potential consequences if funding reduced or withdrawn.
I welcome the opportunity to continue to be involved in Participant’s Name’s ongoing care. If you require further clarification on anything contained in this report, please feel free to contact the undersigned.
Yours sincerely,
Therapist’s Name
Therapist’s Title
Therapist’s credentials
Date of Report: 22/05/2025
Name: Mary Blogs
Date of Birth: 15/03/1992
Address: 11 NovoNote Street, NovoPsych, Australia
NDIS Participant Number: 4444444444
To Whom It May Concern,
The following report is written for Mary Blogs’ National Disability Insurance Scheme (NDIS) Plan Review, which is due on 30/06/2025. It details how her psychosocial disability impacts on her day-to-day life, and how our therapeutic work attempts to improve her functional capacity in this regard.
Mary has been engaging in weekly individual psychology sessions for the past twelve months, utilising dialectical behaviour therapy and cognitive behavioural therapy approaches to address her complex mental health needs.
Background
Mary has a primary diagnosis of Borderline Personality Disorder with comorbid Major Depressive Disorder and experiences chronic pain related to fibromyalgia, which significantly impacts her psychological wellbeing.
Mary’s psychological difficulties emerged during adolescence following childhood trauma and family dysfunction. She has a documented history of self-harm behaviours, emotional dysregulation, and interpersonal difficulties that have substantially impacted her ability to maintain stable relationships, consistent employment, and independent living arrangements. Previous psychiatric hospitalisations occurred in 2019 and 2021 due to suicidal ideation and escalating self-harm episodes.
Mary currently resides independently in supported accommodation and receives regular assistance from support workers with meal planning, medication management, and participation in social activities. This living arrangement provides necessary structure whilst promoting her developing independence, though she continues to require significant emotional and practical support to maintain daily functioning.
Mary actively participates in therapeutic activities that focus on developing emotional regulation skills, interpersonal effectiveness strategies, and distress tolerance techniques. Through this therapeutic engagement, she has demonstrated improved capacity to manage her psychosocial disability and has increased her community engagement, including maintaining regular attendance at a local art class and exploring volunteer opportunities within her interests.
Functional Impact of Psychosocial Disability
Mary’s Borderline Personality Disorder significantly impacts her functioning across multiple NDIS domains. In terms of Communication, she experiences considerable difficulty expressing her needs appropriately during emotional crises and struggles to understand complex instructions when experiencing psychological distress. Her Social Interaction capacity is substantially impaired by emotional instability, fear of abandonment, and interpersonal sensitivity, which affects her ability to maintain stable relationships and participate consistently in community activities. Learning presents variable challenges, with her emotional dysregulation significantly impacting her ability to retain new information and engage effectively in skill-building activities during periods of distress. Self-Care is frequently compromised during depressive episodes, characterised by inconsistent medication adherence, reduced attention to personal hygiene, and difficulty managing basic personal needs. Self-Management represents the most significant area of functional impairment, with frequent episodes of emotional dysregulation, impulsive behaviours, and substantially reduced capacity for independent decision-making during crisis periods.
Current Capacity-Building Strategies
Current therapeutic interventions focus primarily on dialectical behaviour therapy skills training, with particular emphasis on distress tolerance, emotion regulation, interpersonal effectiveness, and mindfulness modules. Weekly sessions incorporate psychoeducation about emotional regulation processes, systematic identification of emotional triggers, and development of alternative coping strategies to replace self-harm behaviours. Mary demonstrates consistently strong engagement with therapeutic work and has developed excellent rapport with the treating clinician, showing willingness to explore difficult emotions and implement challenging therapeutic strategies. Evidence of therapeutic progress includes her successful utilisation of grounding techniques during panic attacks, improved capacity to communicate needs effectively with support workers, and her decision to contact crisis support services rather than engage in self-harm behaviours during recent depressive episodes.
Impact of Strategies on Current NDIS Plan Goals
Short-Term Goal 1: Reduce self-harm behaviours by 50% within six months. Mary has successfully reduced self-harm episodes from daily occurrence to approximately once weekly, representing a significant 85% reduction. Therapeutic interventions focusing specifically on distress tolerance skills and alternative coping mechanisms have directly contributed to this substantial improvement in safety and wellbeing.
Short-Term Goal 2: Improve emotional regulation skills through consistent engagement in weekly therapy sessions. Mary has demonstrated marked improvement in her capacity to identify emotional triggers and implement regulation strategies before reaching crisis points. The structured DBT skills training program has been instrumental in developing these enhanced emotional management capabilities.
Medium or Long-Term Goal 1: Increase community participation and meaningful social engagement. Mary has successfully maintained regular attendance at weekly art classes and has begun actively exploring volunteer opportunities in community settings. Therapeutic work focusing on interpersonal effectiveness skills has provided essential support for these significant achievements in social functioning.
Medium or Long-Term Goal 2: Develop enhanced independent living skills and reduce reliance on intensive support services. Mary has demonstrated increased capacity for independent medication self-management and meal planning activities. Ongoing therapeutic support has been essential in building her confidence and practical skills for independent decision-making in daily life activities.
Recommendations
- Continue weekly individual psychology sessions for the next twelve months to consolidate existing therapeutic gains and address remaining emotional regulation difficulties that continue to impact daily functioning.
- Referral to occupational therapy services to systematically address daily living skills development and explore structured vocational rehabilitation opportunities aligned with Mary’s interests and capabilities.
- Consider participation in group therapy programs to further develop interpersonal effectiveness skills within a supportive peer environment that promotes social skill generalisation.
- Maintain current level of support worker assistance whilst implementing graduated independence-building strategies in specific functional areas to promote sustainable skill development.
Request for Funding
Given the above, I would like to make the following funding request for consideration in Mary Blogs’ upcoming NDIS Plan Review:
- Weekly individual psychology sessions (50 sessions per year)
- Quarterly comprehensive progress reviews and liaison with multidisciplinary support team (4 sessions per year)
- Annual comprehensive assessment and detailed progress reporting (8 hours professional time)
TOTAL REQUESTED FUNDING = $8,100
Conclusion
Mary has achieved substantial progress in developing emotional regulation skills and significantly reducing self-harm behaviours throughout the past twelve months of intensive therapeutic intervention. She has demonstrated measurable increases in community engagement capacity and marked improvements in crisis management skills, with notable progress documented across all her identified NDIS Plan Goals. Continued psychological support remains reasonable and necessary under the NDIS Act as it directly addresses her diagnosed psychosocial disability and systematically builds functional capacity across multiple essential life domains. Without ongoing therapeutic intervention, there exists significant risk of regression in emotional regulation skills, potential return to daily self-harm behaviours, and substantially reduced capacity for independent living, which would ultimately necessitate more intensive and costly crisis interventions and potentially require psychiatric hospitalisation.
I welcome the opportunity to continue to be involved in Mary Blogs’ ongoing care. If you require further clarification on anything contained in this report, please feel free to contact the undersigned.
Yours sincerely,
Sarah Smith
Clinical Psychologist
MAPS, AHPRA Registration PSY0001234
- Template Type
- Report
- Letter
- Note Dictation
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