Dealing with ADHD as a mental health therapist

If you're a mental health therapist with ADHD, progress notes are likely the bane of your existence. You're not imagining it, and you're definitely not alone.

I recorded a full video on this topic with a lot more detail and my own story woven throughout. This blog post is the quicker, reading version, so if you want the deeper dive, watch the video above. If you just want the highlights, keep scrolling!

How does ADHD impact progress notes for mental health therapists?

ADHD and progress notes are a rough combination. Task initiation, time blindness, and the mental load of switching from client to client all work against you the moment you sit down to write. This isn't a motivation problem or a character flaw. It's a brain wiring issue, and it deserves to be treated that way.

That's why the very first step isn't a system or a hack. It's self-compassion.

How to tackle a documentation backlog: self-compassion

You can't build a plan, or even start a big project, when you're stuck in your head telling yourself you'll fail before you begin. That inner narrative is exhausting, and it's also the exact thing that keeps therapists stuck.

Before you touch a single template or schedule, give yourself permission to not have this figured out yet. That's not avoidance. That's actually the starting point.

Why haven't other progress notes strategies worked for me?

If you've tried system after system and none of them stuck, that doesn't mean you're doing it wrong. It usually means you were handed a strategy built for someone else's brain.

Would you tell every client with anxiety to do the exact same thing? Probably not. You'd tailor your approach to who's in front of you. The same is true for you and your own documentation.

Getting ideas from other mental health therapists is great. Just don't assume you're missing the one big secret that will solve everything. There isn't one.

There are thousands of small solutions, kind of like hair products. There's a huge range out there for different hair types and styles. No single one works for everybody, and that's exactly how ADHD strategies for progress notes work too.

Progress note strategies worth trying

This is where I spent most of my time in the video, so let's dig in. A few areas are worth experimenting with as you figure out what actually works for you right now.

Your progress notes schedule. Schedule your progress notes separately from your other admin tasks. If you lump them in with everything else, they'll likely just... not get done. Figure out a schedule that fits your current stage of life and career, and know that this will probably change as your life changes.

Your progress notes template. A good template can save you a ton of time. My book, Stress-Free Documentation for Mental Health Therapists, includes ready-to-use templates, plus lists of sections you can adapt to build your own progress note template.

One tip though, don't waste time endlessly "improving" your template!

Create it, use it for two weeks, then make any needed adjustments and leave it alone. Schedule a check-in once a year or every six months to revisit it. Anything more frequent than that isn't going to give you a good return on your time.

Your client schedule. Make sure your schedule actually fits your life right now, not the life you had a few years ago or the one you think you should have. Kids, no kids, energy levels, morning person versus night owl, all of it shifts over time, and your schedule should shift with it.

Your caseload size and client type. If you work with clients carrying a lot of trauma, that work can be more depleting, and you may need to see fewer clients as a result.

There's no universal "right" number of clients. It's personal, and it depends on your capacity, your stage of life, and who you're working with. You might also need to adjust how many clients you see in a day or how many days a week you work.

Medication, therapy, your support system, and outsourcing. These are all worth having in your toolkit. Those of us with ADHD often need a few extra supports in place, and that's not a flaw, it's just what works.

Experimenting with these can be frustrating, especially when something that used to work stops working, or when you lose a piece of your system entirely (shout out to beloved billers who retire!).

Keep trying. Keep adjusting. And keep that self-compassion close through all of it. This is a process, not a one-time fix.

Why does my ADHD strategy need to change over time?

Because you're not the same every week, let alone every season. Different things will work at different points in time, and your energy levels shift throughout the year, and honestly, throughout the week too.

A strategy that felt great in January might completely fall apart by August, and that doesn't mean you failed. It means you're human.

How does co-working help with ADHD and progress notes?

If you've ever gotten more done in a co-working session than an entire week on your own, you already know the answer. Working alongside other people, even quietly and separately, does something for focus and accountability that white-knuckling it solo just doesn't.

That's exactly why we built the Paperwork Catch Up Group around a co-working style sprint model. Instead of asking you to maintain one steady system forever, it gives you a contained, focused period of time with other mental health therapists to actually get your progress notes done. And then you can move on to the next shiny object for a bit ;) 

The Catch Up Group is built for mental health therapists who, you guessed it, need to catch up on progress notes. If that's you, this is your sign. 

Get on the waitlist for the next Catch Up Group. Registration opens September 2nd. Go ahead and schedule that date on your calendar now, so you're set up for success before it even opens.

Join the waitlist here: https://www.qaprep.com/stress-free-notes-sprint

Where should I even start?

You don't need to implement everything on this list at once. That would just create another kind of paralysis.

Pick one thing. Just one.

Adjust your progress notes schedule, or try a new template, or block out your caseload differently. See how it goes for a couple of weeks, then decide what's next. Starting small and starting somewhere beats waiting for the perfect plan every single time.