Warm welcome & feelings check
A greeting ritual and a simple feelings-face scale to open session.
Use when: Default opener for most sessions with young children — builds the predictable routine that play therapy rapport depends on.·3-5 min
Clinician tool
Session check-ins — by age & style
Ready-to-use openers for young children, adolescents, adults, and older adults — mood/scaling checks, since-we-last-met recaps, agenda-setting, and safety screens, each with a suggested flow. Browse and adapt on screen, or print one straight from its card without opening it first.
AI-assisted — clinician review required.Prompts, checklists, and any suggested language here are a scaffold, not clinical advice. Confirm accuracy, apply your professional judgment, and follow your agency's policies and NH statute before anything enters the record.
These are structured starting points, not scripts — adapt wording, pacing, and depth to the client in front of you, your modality, and your agency's policies.
Concrete, sensory-first openers with a fixed routine and simple feelings language — built around the structure and choice-giving that child-centered play therapy relies on.
Caregiver bridge + child recap
A brief caregiver hand-off note, then a simple child-led recap of the week.
Use when: Best when a caregiver drops the child off — gives you collateral context before the child's own account, without making the child perform for the adult in the room.·5 min (about 2 with the caregiver, 3 with the child)
Body & feelings scan
A simple body-outline check-in that starts regulation before the work begins.
Use when: Good opener when a child arrives dysregulated — from the car ride, from school, from a hard transition — and needs to settle before anything else can happen.·3-4 min
Meridian Mental Health
Session check-in guide — Young children (ages ~3-6)
For clinical use — retain with the record
Warm welcome & feelings check
A greeting ritual and a simple feelings-face scale to open session.
Client name
Date of birth
Aug 20, 2026Date administered
Clinician
Meridian does not collect client-identifying information on screen — complete this section by hand.
Use when: Default opener for most sessions with young children — builds the predictable routine that play therapy rapport depends on.
Suggested time: 3-5 min
1. Greeting ritual
Use the same greeting every time — a hello song, a handshake, or a check-in chair — so the child learns what to expect before anything else happens.
2. Feelings check
"Which face matches how you're feeling right now?" Point to a 5-face scale (very sad to very happy) and let the child point, or offer a color instead of a word.
3. One happy, one hard
"Tell me one happy thing and one hard thing from your week." Accept single words, a drawing, or a gesture — this isn't a full narrative.
4. Today's plan, in kid words
"Today we're going to ___." Name the plan in one short sentence, and where possible offer two choices (which activity first) to build predictability and a sense of control.
5. Movement or sensory reset
A 60-second grounding activity — pinwheel breathing, a stretch, or squeezing a fidget — to settle the body before starting.
Clinical grounding
Adapted from child-centered play therapy's emphasis on structure, predictability, and choice-giving (Landreth). Keep language concrete and avoid abstract emotion words the child hasn't yet learned.
Structured start-of-session opener — Meridian clinician toolkit.
This form is a scoring aid, not a diagnosis. A score alone never establishes or rules out a clinical diagnosis — interpret alongside clinical judgment. Printed Aug 20, 2026 from Meridian Mental Health.
Meridian Mental Health
Session check-in guide — Young children (ages ~3-6)
For clinical use — retain with the record
Caregiver bridge + child recap
A brief caregiver hand-off note, then a simple child-led recap of the week.
Client name
Date of birth
Aug 20, 2026Date administered
Clinician
Meridian does not collect client-identifying information on screen — complete this section by hand.
Use when: Best when a caregiver drops the child off — gives you collateral context before the child's own account, without making the child perform for the adult in the room.
Suggested time: 5 min (about 2 with the caregiver, 3 with the child)
1. 60-second caregiver hand-off
Ask the caregiver privately, away from the child: "Anything I should know before we start today?" — sleep, behavior changes, incidents, medication, upcoming stressors.
2. Welcome the child in
Greet the child on their own terms — don't relay the caregiver's report back to them unless it's clinically necessary.
3. Simple recap
"Tell me one happy thing and one hard thing." Use a feelings chart or a drawing prompt if the child is nonverbal or overwhelmed.
4. Safety screen — through observation and caregiver report
Rather than a direct self-report question, screen for risk through the caregiver's report and your own observation this session: sleep or appetite changes, withdrawal, aggression, statements about not wanting to be here or not wanting to be alive, self-injury. Flag anything positive for a full assessment.
5. Preview today
Name the plan in one short, concrete sentence.
Clinical grounding
Direct self-report safety questions ("are you thinking about killing yourself") are generally not developmentally appropriate for young children — risk is more reliably screened through caregiver report and behavioral observation. Flagging the age cutoff and phrasing for your confirmation, Chris, since it should match your population and training.
Structured start-of-session opener — Meridian clinician toolkit.
This form is a scoring aid, not a diagnosis. A score alone never establishes or rules out a clinical diagnosis — interpret alongside clinical judgment. Printed Aug 20, 2026 from Meridian Mental Health.
Meridian Mental Health
Session check-in guide — Young children (ages ~3-6)
For clinical use — retain with the record
Body & feelings scan
A simple body-outline check-in that starts regulation before the work begins.
Client name
Date of birth
Aug 20, 2026Date administered
Clinician
Meridian does not collect client-identifying information on screen — complete this section by hand.
Use when: Good opener when a child arrives dysregulated — from the car ride, from school, from a hard transition — and needs to settle before anything else can happen.
Suggested time: 3-4 min
1. Find the feeling
Show a simple body outline. "Where do you feel [mad / sad / scared / happy] in your body today?" Let the child point or color it in.
2. Name it simply
Offer three or four concrete feeling words with faces or colors attached — avoid asking the child to generate a feeling word unprompted.
3. Ground together
Do one sensory grounding activity together: blow bubbles, smell a scented item, squeeze a ball, or name five things you can see.
4. Bridge to today
"Now that our bodies feel a little calmer, today we're going to ___."
Clinical grounding
Body-mapping is a standard trauma-informed opener for young children who don't yet have language for internal states.
Structured start-of-session opener — Meridian clinician toolkit.
This form is a scoring aid, not a diagnosis. A score alone never establishes or rules out a clinical diagnosis — interpret alongside clinical judgment. Printed Aug 20, 2026 from Meridian Mental Health.
Meridian Mental Health
Session check-in guide — Adolescents (ages ~13-17)
For clinical use — retain with the record
Mood scaling + since-we-last-met
A 1-10 mood check paired with a quick sweep of sleep, school, peers, and substance use.
Client name
Date of birth
Aug 20, 2026Date administered
Clinician
Meridian does not collect client-identifying information on screen — complete this section by hand.
Use when: Default opener for most teen sessions — fast, low-pressure, and keeps you current on functioning without it feeling like an interrogation.
Suggested time: 5 min
1. Mood scaling
"On a scale of 1-10, where's your mood been since we last talked?" Ask for the number and one word for why.
2. Quick sweep
"Since we last met — how's sleep, school or work, friends, and family been?" Keep it conversational, not a checklist read aloud.
3. Substance use check
"Any alcohol, vaping, or other substance use since we last talked?" Ask it the same way every session so it doesn't feel like a gotcha.
4. Safety screen
"Any thoughts of hurting yourself, or of not wanting to be here, since we last met?" Ask directly and matter-of-factly — a flat, non-alarmed tone increases honest disclosure.
5. Confidentiality reminder, as needed
If something new and sensitive comes up, briefly restate the limits of confidentiality before they say more, so they can choose what to share knowingly.
Clinical grounding
Scaling questions plus direct safety language are standard in adolescent CBT/DBT opening structure.
Structured start-of-session opener — Meridian clinician toolkit.
This form is a scoring aid, not a diagnosis. A score alone never establishes or rules out a clinical diagnosis — interpret alongside clinical judgment. Printed Aug 20, 2026 from Meridian Mental Health.
Meridian Mental Health
Session check-in guide — Adolescents (ages ~13-17)
For clinical use — retain with the record
Collaborative agenda-setting
A CBT-style bridge-and-agenda opener that puts the teen's priorities first.
Client name
Date of birth
Aug 20, 2026Date administered
Clinician
Meridian does not collect client-identifying information on screen — complete this section by hand.
Use when: Best for structured, skills-based work (CBT/DBT) where session content is planned together rather than clinician-driven.
Suggested time: 5-7 min
1. Bridge from last time
"What's stuck with you from our last session?"
2. Homework or practice review
"Did you get a chance to try [the between-session task]? What happened?" Normalize partial or no completion — the point is the data, not compliance.
3. Teen sets the agenda first
"What do you want to make sure we talk about today?" Write it down before adding your own items.
4. Clinician adds items
Add anything you're tracking — safety, a skill to practice, a theme from last time — and prioritize together.
5. Time check
Name how the time will roughly split so the teen knows what to expect.
Clinical grounding
Autonomy-supportive agenda-setting — letting the client name priorities first — is associated with a stronger adolescent therapeutic alliance.
Structured start-of-session opener — Meridian clinician toolkit.
This form is a scoring aid, not a diagnosis. A score alone never establishes or rules out a clinical diagnosis — interpret alongside clinical judgment. Printed Aug 20, 2026 from Meridian Mental Health.
Meridian Mental Health
Session check-in guide — Adolescents (ages ~13-17)
For clinical use — retain with the record
Engagement / rupture-repair check-in
An opener for when rapport feels strained or the teen seems checked out.
Client name
Date of birth
Aug 20, 2026Date administered
Clinician
Meridian does not collect client-identifying information on screen — complete this section by hand.
Use when: Use when you notice disengagement, short answers, missed sessions, or a shift in how the teen is showing up — not as a weekly default.
Suggested time: 5-10 min
1. Name what you're noticing, non-blaming
"I've noticed things have felt a little different between us the last couple sessions — I wanted to check in about that."
2. Open the floor
"How's therapy been feeling for you lately? Anything you'd change?" Genuinely invite criticism.
3. Normalize disagreement
Make explicit that they're allowed to disagree with you or push back on the plan — this isn't a test.
4. Offer choice
"What would make today feel more useful to you?" Let them pick the focus or format — talk, activity, shorter session.
5. Reconnect to purpose
Briefly restate why they're in therapy in their own words, and check that it still fits.
Clinical grounding
Rupture-repair sequences — noticing, naming non-defensively, inviting the client's perspective, adjusting — draw on alliance-rupture repair research (Safran & Muran) and matter especially for adolescents, who disengage quickly from perceived loss of control.
Structured start-of-session opener — Meridian clinician toolkit.
This form is a scoring aid, not a diagnosis. A score alone never establishes or rules out a clinical diagnosis — interpret alongside clinical judgment. Printed Aug 20, 2026 from Meridian Mental Health.
Meridian Mental Health
Session check-in guide — Adults (ages 18+)
For clinical use — retain with the record
Mood/functioning check + since-we-last-met
The standard CBT-style opener: a mood rating, a functioning sweep, and a bridge from last session.
Client name
Date of birth
Aug 20, 2026Date administered
Clinician
Meridian does not collect client-identifying information on screen — complete this section by hand.
Use when: Default opener for most adult sessions, especially structured or skills-based work.
Suggested time: 5 min
1. Mood/symptom rating
"On a scale of 1-10, how's your mood or anxiety been since we last met?"
2. Functioning sweep
Quick check on sleep, appetite, work or role functioning, and substance use since last session.
3. Medication check, if applicable
"Any changes in how you're taking your medication, or new side effects?"
4. Safety screen
"Any thoughts of suicide or self-harm since we last talked?" Ask directly, every session, in the same tone.
5. Bridge from last session
"What's stayed with you from our last conversation?"
Clinical grounding
Mirrors standard Beck-style CBT session structure — mood check, bridge, agenda, homework review, new work, summary and feedback.
Structured start-of-session opener — Meridian clinician toolkit.
This form is a scoring aid, not a diagnosis. A score alone never establishes or rules out a clinical diagnosis — interpret alongside clinical judgment. Printed Aug 20, 2026 from Meridian Mental Health.
Meridian Mental Health
Session check-in guide — Adults (ages 18+)
For clinical use — retain with the record
Collaborative agenda-setting
Structured CBT agenda-setting — client items first, then clinician items, prioritized together.
Client name
Date of birth
Aug 20, 2026Date administered
Clinician
Meridian does not collect client-identifying information on screen — complete this section by hand.
Use when: Best for skills-based or structured modalities where each session has a clear focus.
Suggested time: 5 min
1. Client's agenda items
"What do you want to make sure we cover today?" Write down one to three items.
2. Clinician's agenda items
Add anything you're tracking — a theme, a homework follow-up, a risk item — and be transparent about why.
3. Prioritize together
"Given our time, what feels most important to start with?"
4. Homework review
Briefly check on the between-session task before moving into new material.
5. Time check
State roughly how the session will be divided.
Clinical grounding
Pairs well with the mood/functioning check-in above for a full start-of-session routine.
Structured start-of-session opener — Meridian clinician toolkit.
This form is a scoring aid, not a diagnosis. A score alone never establishes or rules out a clinical diagnosis — interpret alongside clinical judgment. Printed Aug 20, 2026 from Meridian Mental Health.
Meridian Mental Health
Session check-in guide — Adults (ages 18+)
For clinical use — retain with the record
Grounding & safety-focused check-in
A centering exercise plus a direct safety screen — for higher-acuity or crisis-adjacent work.
Client name
Date of birth
Aug 20, 2026Date administered
Clinician
Meridian does not collect client-identifying information on screen — complete this section by hand.
Use when: Clients with recent crisis history, active safety planning, or presentations where regulation needs to happen before anything else.
Suggested time: 5-8 min
1. Brief grounding
60-90 seconds of a grounding exercise — 5-4-3-2-1 senses, paced breathing, or orienting to the room — before any content.
2. Direct safety screen
"Since we last met, any thoughts of suicide, self-harm, or wanting to not be here? Any plan, intent, or access to means?" Ask plainly — avoid euphemism.
3. Protective factors check
"What's been helping you stay safe, or get through the hard moments?"
4. Safety plan review, if one exists
"Has anything changed that we should update on your safety plan?"
5. Gentle transition
"Given all that, what feels most important for us to focus on today?"
Clinical grounding
Direct, plain-language safety questioning every session is standard of care for clients with recent SI or self-harm history; any positive endorsement should trigger a full risk assessment, not just this brief screen.
Structured start-of-session opener — Meridian clinician toolkit.
This form is a scoring aid, not a diagnosis. A score alone never establishes or rules out a clinical diagnosis — interpret alongside clinical judgment. Printed Aug 20, 2026 from Meridian Mental Health.
Meridian Mental Health
Session check-in guide — Adults (ages 18+)
For clinical use — retain with the record
Open / process-oriented check-in
A less-structured opener for insight-oriented or humanistic work, anchored by a consistent ritual.
Client name
Date of birth
Aug 20, 2026Date administered
Clinician
Meridian does not collect client-identifying information on screen — complete this section by hand.
Use when: Psychodynamic, humanistic, or exploratory modalities where a rigid agenda would work against the process.
Suggested time: Flexible — the ritual is brief, the content is open
1. Consistent opening ritual
Use the same brief opening question every session — "What's alive for you today?" or "Where would you like to start?" — the predictability is in the ritual, not the content.
2. Follow, don't steer
Let the client's opening set the direction; resist redirecting to your own agenda early.
3. Light safety check, woven in
If nothing else surfaces it, check in briefly and naturally: "How have you been managing, safety-wise, since we talked?"
4. Time awareness
Give a soft time check partway through so the ending doesn't feel abrupt.
Clinical grounding
Even unstructured modalities benefit from a fixed, predictable opening ritual — the consistency is what builds safety and rapport over time.
Structured start-of-session opener — Meridian clinician toolkit.
This form is a scoring aid, not a diagnosis. A score alone never establishes or rules out a clinical diagnosis — interpret alongside clinical judgment. Printed Aug 20, 2026 from Meridian Mental Health.
Meridian Mental Health
Session check-in guide — Older adults (ages 65+)
For clinical use — retain with the record
Orientation & rapport check-in
A cognitively accessible opener with a plain-language mood scale and a health/medication sweep.
Client name
Date of birth
Aug 20, 2026Date administered
Clinician
Meridian does not collect client-identifying information on screen — complete this section by hand.
Use when: Default opener, and especially useful with clients managing cognitive change, sensory loss, or multiple medical comorbidities.
Suggested time: 5-7 min
1. Warm, unhurried greeting
Allow extra time for settling in — coats, hearing aids, mobility aids. Don't rush the transition into session.
2. Orientation, as needed
For clients with cognitive changes, a brief, respectful orientation to the purpose of today's visit can reduce anxiety — not a formal exam, just a grounding sentence: "We're meeting today to check in on how things have been going."
3. Plain-language mood check
"How have you been feeling, overall, since we last talked — better, worse, or about the same?" Avoid 1-10 scales unless the client already uses and prefers them.
4. Health & medication sweep
"Any changes in your health, appointments, or medications since we last met?" Polypharmacy and medical comorbidity are common in this population and can drive mood or cognitive symptoms.
5. Safety screen, respectful and direct
"Have you had any thoughts of not wanting to be here, or of harming yourself?" Ask plainly — avoid euphemism or hesitation, which can itself feel stigmatizing.
Clinical grounding
Balance orientation and pacing accommodations with respect for autonomy — don't assume cognitive impairment; ask or observe before adjusting the approach.
Structured start-of-session opener — Meridian clinician toolkit.
This form is a scoring aid, not a diagnosis. A score alone never establishes or rules out a clinical diagnosis — interpret alongside clinical judgment. Printed Aug 20, 2026 from Meridian Mental Health.
Meridian Mental Health
Session check-in guide — Older adults (ages 65+)
For clinical use — retain with the record
Since-we-last-met (autonomy-respecting)
A collaborative recap that treats the client as the expert on their own life, with a loss/grief screen.
Client name
Date of birth
Aug 20, 2026Date administered
Clinician
Meridian does not collect client-identifying information on screen — complete this section by hand.
Use when: Ongoing supportive or adjustment-focused work, especially where independence, caregiving, or loss are active themes.
Suggested time: 5 min
1. Collaborative framing
"What's been on your mind since we last talked?" — open-ended, not a checklist read at the client.
2. Independence / living-situation check
"Any changes in how things are going at home, or with the people helping you out?" Listen for shifts in independence, caregiving load, or living arrangement.
3. Loss/grief screen
"Any losses or hard anniversaries come up recently?" Bereavement and anticipatory loss are common and often under-addressed in this population.
4. Safety screen
"Any thoughts of suicide, or of not wanting to go on?" Ask directly — older adults, especially older men, carry an elevated and frequently under-detected suicide risk.
5. Client sets today's focus
"What would be most useful to spend our time on today?"
Clinical grounding
Older adults — particularly men 75+ — have among the highest suicide rates of any demographic group; a direct, unhurried safety screen every session is warranted, not only when mood appears low.
Structured start-of-session opener — Meridian clinician toolkit.
This form is a scoring aid, not a diagnosis. A score alone never establishes or rules out a clinical diagnosis — interpret alongside clinical judgment. Printed Aug 20, 2026 from Meridian Mental Health.
Meridian Mental Health
Session check-in guide — Older adults (ages 65+)
For clinical use — retain with the record
Sensory & pacing-adapted check-in
An accommodation-first opener that confirms comfort and offers format choices before starting.
Client name
Date of birth
Aug 20, 2026Date administered
Clinician
Meridian does not collect client-identifying information on screen — complete this section by hand.
Use when: Clients with hearing loss, low vision, slower processing speed, or fatigue — or any time you're unsure what accommodations help.
Suggested time: 3-5 min, plus flexible pacing throughout
1. Comfort check
"Can you hear me all right? Is the lighting and seating comfortable?" Confirm hearing aids, glasses, and physical comfort before starting content.
2. Offer format choice
"Would it help to have things written down today, or is talking through it easier?" Offer large-print notes if useful.
3. Slower-paced open question
Ask one open question and allow silence — resist filling pauses; a slower processing speed is not the same as disengagement.
4. Caregiver-collateral note, with consent
If a caregiver is involved, note what they've shared only with the client's knowledge and consent — don't let collateral information substitute for the client's own account.
5. Agenda, offered not imposed
"Is there anything in particular you'd like to make sure we get to today?"
Clinical grounding
Slowing pace and confirming sensory access are accommodations offered to the client, not assumptions made about their capacity.
Structured start-of-session opener — Meridian clinician toolkit.
This form is a scoring aid, not a diagnosis. A score alone never establishes or rules out a clinical diagnosis — interpret alongside clinical judgment. Printed Aug 20, 2026 from Meridian Mental Health.