In my work with therapists there is one overarching theme I see that has a detrimental impact on their documentation, but also their well-being. And that theme is feeling shame.
Shame about getting behind in writing notes. Shame about not knowing what a treatment plan is supposed to include. Shame about not knowing whether or not they're putting the right amount of information in their notes.
Brene Brown writes that "Shame creates feelings of fear, blame and disconnection." That's exactly what I see. Therapists who feel this shame are often fearful of others (especially other professionals) seeing their documentation. The thought of a subpoena or records request is terrifying.
Many counselors will beat themselves up for not knowing all these principles, regardless of the fact that they were never given adequate education/training on the subject. And that leads to a vicious cycle where counselors who feel inadequate then avoid training new therapists about documentation and so on.
That leads us to the disconnection piece. We're all in these offices, isolated and fearful. The last thing most therapists want to do is broadcast that they have no clue what they're doing when it comes to paperwork. So they search the internet for answers or avoid it all completely, never doing the most important step in this situation which is to seek out consultation and training.
But I understand the step of reaching out may be very difficult when caught in the middle of that shame sh*t storm! So I've got some steps for initiating a practice of forgiveness and acceptance first. If you can do this on your own then it may be easier to reach out to a colleague for support.
Forgive yourself for messing up
Yup, we all mess up. Thankfully, we're not surgeons and our mistakes aren't likely to kill anyone but they can sure feel awful just the same. But would you talk to a first year graduate student and tell them you never expect them to mess up after graduation? Of course not! That's ridiculous.
So own your mistakes. They often provide invaluable lessons that you'll carry with you for years to come. I'll be the first to admit I hate making mistakes but they still happen. And while I may have a little freak out moment initially, they've always provided me with great information on how I can improve something.
You know what else? Mistakes usually help me create more community. When I reach out to colleagues for support the response is overwhelming and I end up feeling much more connected than I had before.
Forgive yourself for feeling like you don't know what you're doing
Even after you've been licensed for years there is waaaaaaay too much information out there to know it all. And if there's a topic about which you never received specific training (ahem, documentation!) then of course you'll feel like you don't know what you're doing!
So let's just get fight that point right now with some truth: If you don't know, that's okay. This is an opportunity to learn. In our mental health field things are constantly changing and improving. In order to stay up on things we must continue to learn.
If no one ever told you how to write notes or what to include in a treatment plan, sign up for my free Private Practice Paperwork Crash Course. It's meant to give you an overview of all aspects of documentation so you can have a better foundation.
Forgive yourself for getting behind in notes
This is the most common experience of shame that therapists talk about with me. Whether it's two weeks, two months or a year of notes, getting behind is extremely stressful. What increases the stress is the feeling of not knowing how to catch up and feeling embarrassed to reach out for help.
It's like you're drowning, you know you're drowning, and there are people nearby who can help. But you're scared to yell out to those people because you're not sure if they'll give you a hand or react in disgust and push you down further.
This speaks to a few things. First, the importance of having trusted colleagues in your corner so you can reach out for help with confidence. Second, the importance of identifying the problem early so you can address it before things get too out of hand.
But the piece of this metaphor that's missing is the shared experience. Because there are typically many other therapists drowning with you, but you think they are easily treading water. The shame of drowning in paperwork keeps us from sharing this information.
I'm here to tell you that it's rare to speak with a counselor who hasn't fallen behind in notes at least once or twice. And it's actually pretty common for therapists to get stuck in a cycle of getting behind in notes by a couple weeks, catching up, falling behind again, etc.
Let me say that again, it's common for therapists to fall behind in their documentation.
While this obviously isn't the ideal, I think it really helps to know that you're not alone. If you're brave enough to reach out for help you'll likely find someone else who shares your experience. So I would really encourage you to reach out if this is a struggle for you.
You can also check out this blog post on How to Catch Up on Paperwork if you need some practical tips for getting started.
Let me know in the comments... are any of these areas in your life you need to forgive? Have you had an experience of overcoming shame around documentation? I encourage you to be brave and fight fear with action! We're all here to support you.