Let me tell you a story, the story of the typical therapist who comes to me saying they are behind in notes and desperate for help...
We'll call our imaginary therapist Dorothy. Dorothy has been licensed for about two years and started her own private practice shortly after getting licensed. Before that she had a supervisor who would check in with her about clinical things and periodically about paperwork- just making sure it was done.
But now that Dorothy is the Owner of Oz Counseling she has a lot of other things on her mind besides client care and documentation... she attends networking events regularly with the hopes of growing her connections, makes sure to answer phone calls from potential clients, does her bookkeeping (as regularly as she can), decorates her office, works on her website ("that new picture will hopefully make a difference this time") and does about a hundred other things that take up time!
Ultimately, being a good therapist is what's most important to Dorothy. She's good at it and her practice is slowly growing as a result. But all the demands on her time have impacted one thing pretty significantly. She is getting behind in her notes.
Dorothy would never just NOT write notes so she does what lots of other therapists do but never talk about- she jots down quick notes to herself between or during sessions.
These are just little notes on a steno pad but they remind her what was talked about in the session. Then she can go back and write the full note when she has time... tomorrow... or this weekend... or next week...
The pattern continues until Dorothy has about six months of notes on her steno pad and none in her client files. Now the task of writing those notes feels very overwhelming. She feels a sense of guilt and regret when continuing to take her quick notes on the steno pad.
But what other option does she have? She's so behind at this point. Better to have something than nothing, right? At least when she's able to finally sit down and write those notes it will go pretty smoothly because she has a backup.
Fast forward another month and Dorothy takes a day off seeing clients to start catching up on her notes. She looks at the stack and a huge sense of dread washes over her. This will take sooooo long!
But she is brave and dives in anyway... and is devastated to find her brief notes she's been counting on aren't quite as clear six months later. She spends most of the time trying to connect the dots and make sense of what she wrote. After two hours she has barely made a dent in the workload and bursts into tears.
How could this happen? She was so sure she'd been making good notes for herself! Now she is scared. What if Tin Man requests his records next week? It would take days to get his notes ready. And Cowardly Lion is such a volatile client. What if something happens and someone wants to see his record?
She freaks out for a bit but then she goes to the all powerful internet to find some help. She types in "How to catch up on therapy notes" and finds... me!
Yes, I'm able to help her catch up (and that part is really important) but how do we know the pattern won't happen again? What was it that led Dorothy down this road?
Like my reference there? ;)
After working with dozens of therapists who struggle with getting documentation done on time I've discovered that time management with paperwork is largely dependent on the emotional connection the therapist has to the paperwork.
It's interesting to me that almost every therapist I've helped to catch up on months of notes has taken these quick notes religiously. So they are writing notes (not ethically sufficient to be considered in the client record but still notes), but think they're not.
That leads me to believe this whole note writing thing is largely a mental game.
Then I hear stories of counselors being berated by supervisors for poor documentation... but not being told what good documentation looks like. And I hear therapists say they never received any training in writing notes. They've just been winging it most of their career and assume it's okay.
Put all that together with the fact that most of us have insecurities around running our practice, feel guilty charging people for our time, and often burn ourselves out caring not only for clients but also for everyone else in our life.
Yeah... recipe for disaster.
So how do we fix it? By doing what we would tell our clients to do. We look at the cause of this issue with writing notes... then we create a plan of action and learn tools to make things work.
And we forgive ourselves for prior mistakes. We focus on loving ourselves, healing the relationship and changing our behavior for the better.
Last year I created a training video to help therapists with this task of catching up on notes. I only offered it to those who were signed up for my email list but now I want to share it with you, because I think this is really important and I know this will help.
But promise me that you'll spend some time (even just 10 minutes) thinking about why you're behind on your notes before going to the action plan. Because if you don't take that time you'll just end up bookmarking the action plan to use every 6-9 months.
I'd rather you create a whole new relationship with your documentation so that it's not something you're avoiding or dreading.
Now do something that will truly change your life by taking that time and then let us know in the comments below. What keeps you from getting your notes done?
Then click here to watch the free video (and ignore the registration deadline at the end of the video).
Like the tips in this blog post? This blog is part of the compiled tips in the ebook Workflow Therapy: Time Management and Simple Systems for Counselors.