Scriber — AI Medical Scribe for Behavioral Health Clinicians

Standard templates (SOAP, DAP, BIRP) work for most behavioral health practices, but if you specialize in EMDR, Gottman couples therapy, substance abuse treatment, or another niche, your notes probably don't fit the standard structure.

Custom templates let you tell Scriber how to organize your session notes so the AI generates text that already matches your workflow. Instead of spending 5 minutes editing a generic SOAP note into an EMDR note, the AI generates an EMDR note in the first place.

How Custom Templates Work

A custom template is a set of instructions you give Scriber:

What sections your note should have (Presenting Problem, Intervention, Outcome, Homework, etc.)
What kind of content goes in each section (clinical reasoning, specific assessment tool results, patient homework, etc.)
Optional: your practice name, required fields, or special instructions

Once you create a template, Scriber uses it as the blueprint for note generation. When you generate a note, the AI sees your template and formats the output accordingly.

When to Create a Custom Template

You create a custom template if:

Your specialty has a non-standard documentation format (EMDR, trauma-informed, IFS, DBT)
Your EHR requires specific sections (SimplePractice, TherapyNotes, Valant can all have different layouts)
Your supervision or licensing board expects a specific structure
Your insurance requires certain content (risk assessment for suicide, substance abuse markers, etc.)
You want your clinical voice standardized across all clinicians in your practice

You don't need a custom template if:

You see diverse diagnoses and modalities (use standard SOAP)
You're just starting (learn standard templates first, then customize)
Your template needs are changing weekly (stabilize your format first)

Building a Custom Template: Step-by-Step

Step 1: Document your ideal note structure.

Open a Word doc and write out what your ideal note looks like. For example, if you do EMDR:

Presenting Problem:
Current disturbance level (SUD): X/10
Intervention:
Bilateral stimulation used: [left-right eye movement, tapping, audio]
Rounds of processing: [number of rounds completed]
Insight or shift noted: [what the patient reported]
Outcome:
SUD at end: X/10
Progress toward target: [yes/no/partial]
Plan:
Next session focus: [target to be processed]
Between-session homework: [if any]

This is your template structure.

Step 2: Map your sections to clinical information.

For each section, note what clinical information Scriber should extract from the transcript and include:

Presenting Problem: What the patient said at the start (symptoms, disturbance level)
Intervention: What you did (technique, duration, response)
Outcome: What changed (SUD rating, patient report of relief)
Plan: What comes next (next target, homework)

Step 3: Add special instructions.

If certain terms are critical, include examples. For EMDR:

"When the patient reports a number for subjective disturbance (e.g., 'my anxiety is at an 8'), capture that number as the SUD. If the patient doesn't give a number, estimate based on their description and note that it's estimated."

Step 4: Create the template in Scriber.

Go to Scriber's template settings, click "Create custom template," paste your structure and instructions, and save it. Name it "EMDR" or whatever your specialty is.

Step 5: Test with real sessions.

Generate your first 3 notes using the custom template. Review them carefully:

Does the structure match your template?
Does the content make sense clinically?
Did Scriber capture the information you need?
What needs tweaking?

After 3 test notes, you'll see what works and what needs refinement.

Custom Templates by Specialty

Here are common specialty-specific structures:

EMDR (Eye Movement Desensitization and Reprocessing)

Session #: [session number in processing]
Target memory/issue: [identified target]
Baseline SUD: [starting disturbance level]
Bilateral stimulation method: [eye movement, tapping, audio]
Processing observations: [patient response, shifts noted, abreaction if any]
Bilateral stimulation rounds: [number of BLS cycles]
Outcome SUD: [ending disturbance level]
Positive cognition installed: [yes/no/partial, what cognition]
Homework: [between-session work if any]
Notes for next session: [what to target next, preparation]

Key instruction: "Capture the SUD (Subjective Units of Distress) at the beginning and end of the session. If the patient reports an exact number, include it. If not, estimate based on their description."

Gottman Couples Therapy

Couple names: [names of both partners]
Session focus: [which couple issue, which Gottman principle]
Each partner's perspective on the issue: [Partner A's view, Partner B's view]
Intervention used: [which Gottman exercise or technique]
Partner responses: [how each partner responded; any breakthroughs]
Emotional regulation: [any instances of stonewalling, defensiveness, criticism, contempt; how addressed]
Positive regard observed: [moments of connection, repair, or softening]
Homework assigned: [what each partner will do between sessions]
Therapist notes: [your clinical observations; areas of progress]

Key instruction: "Always separate Partner A's and Partner B's perspectives. If you use the couple's actual names, use them consistently. Note any Four Horsemen of the Apocalypse (criticism, contempt, defensiveness, stonewalling) and how they were addressed."

Substance Abuse/Addiction (Cognitive-Behavioral or Motivational Interviewing)

Substance focus: [alcohol, opioids, cocaine, cannabis, etc.]
Current use status: [abstinent, relapse, continuation, reduction attempted]
Days abstinent (if applicable): [X days]
Triggers identified this session: [what triggered use or cravings]
Coping strategies addressed: [which strategies discussed or reinforced]
Motivation/readiness assessment: [stages of change: pre-contemplation, contemplation, preparation, action, maintenance]
Craving level (if reported): [X/10]
Support system status: [involvement of family, peer support, NA/AA, treatment]
Medical/psychiatric considerations: [withdrawal symptoms, co-occurring mental health, medication status]
Relapse prevention plan: [specific steps for high-risk situations]
Plan for next session: [focus areas]

Key instruction: "If the patient is in recovery or relapse, be clear about the timeline. Document coping skills discussed, not just those the patient implemented. Track motivation level changes across sessions."

Trauma-Informed Care (Any Modality)

Trauma history referenced: [yes/no; which trauma briefly]
Grounding/safety check: [yes/no; method used]
Window of tolerance: [patient appeared dysregulated/regulated/oscillating]
Intervention: [what you did to support regulation or processing]
Patient's response: [how they responded; any dissociation, flooding, or stabilization]
Somatic awareness: [if noted; body sensations, trauma responses]
Safety plan reviewed: [yes/no; any updates needed]
Therapist attunement: [your observations about your own responses and presence]
Pacing: [slow and stabilizing/gradual processing/patient-led]
Homework: [grounding practice, journaling, movement, other]

Key instruction: "Note any signs of dysregulation (hyperarousal, dissociation, numbness) and how they were addressed. Document whether you moved toward or away from trauma material based on the patient's capacity."

Specialty-Specific Details to Capture

For assessment-heavy practices:

Add a section for assessment tools used (PHQ-9, GAD-7, PCL-5, etc.) and scores
Include baseline vs. current scores to track progress
Document any new diagnoses or diagnostic clarifications

For medication management (NPs/PAs):

Add medication review section (current meds, side effects, compliance)
Include lab results if relevant (lipid panel, glucose, weight monitoring)
Document any medication changes and rationale

For school-based counseling:

Add parent/guardian contact attempts and outcomes
Include academic performance data if relevant
Document coordination with teachers or school staff

For group therapy:

Add participant attendance (who was present)
Include individual participant progress notes (how each person engaged, what they worked on)
Document group dynamics (cohesion, conflicts, support)

Testing Your Custom Template

After you create a template, run 3–5 test sessions before committing to it.

Test 1: A straightforward session (clear problem, clear intervention, clear outcome)

Check: Does the template capture the core content?

Test 2: A complex session (multiple issues, uncertain progress)

Check: Does the template stay organized even when the session is messy?

Test 3: A session with special elements (risk assessment, medication change, referral)

Check: Does the template handle outliers or special cases?

If the template struggles with any test, refine it.

Common Template Mistakes to Avoid

Mistake 1: Too many sections.

If your template has more than 8–10 sections, it's probably too detailed. The AI spends more time generating filler content. Keep sections focused.

Mistake 2: Vague section names.

"Observations" is too vague. "Patient's mood, affect, and behavioral observations during session" is clearer.

Mistake 3: Requiring specific numbers or codes.

Don't require the AI to generate CPT codes, ICD codes, or specific diagnostic criteria unless those are explicitly stated in the session. Let the AI capture content; you can add codes after review.

Mistake 4: Mixing clinical content with administrative content.

Your template should capture clinical information (what happened in the session). Administrative info (billing, next appointment, referrals) goes elsewhere.

Sharing Templates Across Your Practice

If you're in a group practice, create one shared set of templates (one per specialty or modality). All clinicians use the same template for their specialty.

Document the template in a procedure manual: "All EMDR clinicians use the EMDR custom template. Here's how to select it, and here's what to do if the AI note needs edits."

This ensures consistency across clinicians and reduces training time for new hires.

When to Revise Your Template

After 20 notes with your custom template, review it:

Are you making the same edits repeatedly? (Your template is missing something)
Are there sections you never use? (Remove them)
Does the structure still match your clinical thinking? (Revise if your practice has evolved)

Most templates stabilize after 30–50 notes. You don't need to revise constantly; treat it as a living document that evolves once or twice a year.

Customizing Templates for Your Niche | Scriber Wiki