Couples counseling is different from individual therapy in a lot of ways, but are the notes and paperwork any different? I've gotten this question from lots of therapists.
The short answer is no, the notes really aren't that different from individual therapy but the long answer is, it really depends on your practice. As we reviewed in a video with Rajani Venkatraman Levis, your notes can be made much more meaningful by tailoring them to your practice.
Couples therapy notes work the same way. You can use the basic principles of writing psychotherapy notes and then adjust based on your practice's needs. Here are some ways you can personalize couples therapy notes:
- Incorporate your favorite modality. In my interview with Rajani she talks about how she adjusted her notes to suit the type of therapy she does, mostly trauma work and EMDR. If you are a Gottman trained therapist, use that language. What are the key principles you review with couples? What are the common exercises you have them do at home? Write these down over the next week or two and bam! You've got your own cheat sheet (that you can now modify and add to as needed).
- Identify patterns. If you follow a similar pattern with most couples, identify the steps. Do you always cover certain topics in your first 1-2 sessions (things like confidentiality and keeping secrets)? Perhaps you have certain things you do in the first month or in the first phase of treatment. Perhaps you have exercises you assign near the end of the counseling period. Create a timeline of how couples counseling looks with you and have that handy when you write your notes. It will often make the process much easier because it prompts you to remember things you sometimes forget.
- Focus on interaction. Case notes are really all about interaction. In couples notes that's magnified because you not only have the interaction between client and therapist but between the two clients as well. I like to break down notes into focusing on two main things, therapist action and client action (or reaction). Note what you bring to the table- assignments you make, methods you teach, insights you give. And note what the couple brings to the table- the responses they give, the way they interact, the information they provide, the progress they make. Thinking of notes in this way really highlights the clinical nature of note-writing and makes it more interesting.
- Inform the couple. Couples counseling does have one big difference from individual counseling- the confidentiality piece. It's very important to inform couples of your record keeping practices from the start. In my experience, about half of therapists keep one "couples record" because they view the couple as a whole client. The other half of therapists keep separate records for each half of the couple, essentially creating two clients. Regardless of what you choose to do, make sure you explain this to the couple so they are not surprised, should they ever ask for copies of their records. And as I recommend with all policies, once you decide on a method, stick to it.
And that's it! Well, we could go on but I'll leave that for another post. What do you think? If you're a couples therapist and have more tips or insight, please add a comment below!
And if you're a little stuck because you want more of the basics on note writing, check out my free Private Practice Paperwork Crash Course. I give you two weeks of quick video training on forms, notes, treatment plans and more. And if you're looking for more in-depth help, I also offer individual consultation packages.
Either way, hope you find this helpful for making your notes easier! Happy writing.