Not only can writing notes be more simple, it can also be interactive and fun when you use some of these techniques. Share your notes together and compare and contrast. Either have someone describe a session, enact a mock session or watch a video (the Gloria videos are great and readily available on YouTube) and then spend five to 10 minutes having everyone write a note for the session. Every time I have therapists do this exercise in a training they find it extremely helpful. Bring up a session in your next consultation group and write a note together as a group.Choose a respected colleague and give one another tips as well as constructive feedback on what could be improved. This suggestion is an excellent way to get feedback and also resolve anxiety around whether or not your notes are good enough. Meet with a colleague or supervisor to do a mutual chart review.You could potentially do this action for each section in your template. Then put five to 10 common phrases into a checkbox and include one or two lines underneath to capture any other information. Instead, use your own notes to pull out the things you write over and over across sessions and clients. I never recommend copying checkboxes from a pre-made template or from another therapist because they are likely to have a different style than you. This step is a more long-term plan for shortening notes but can be very effective when done thoughtfully. Review six to 12 months of notes and identify common interventions to create check boxes.This can easily be done in about 30-60 minutes. And since youre already doing a review, I also recommend you identify things that may be missing or need improvement. Take note of those so you can avoid them in the future. Youll likely notice themes of things that stand out as nonessential. Choose one client file and read through six months of notes. Do a review of your notes and identify what was nonessential and could be taken out.Less time than that and youre likely not reflecting enough on the clinical content. Realistically, you should plan to spend five to 10 minutes writing notes for a 45-minute session. If youre already at 10 minutes or less then you may be just fine. If you werent able to finish one case note in that timeframe, identify where your time is spent so you can begin shortening that timeframe. Set a timer for 10 minutes and then begin writing your note.Unless something extraordinary happened in your session, two to three sentences in each section of the template should provide an excellent clinical note. I recommend DAP (Data, Assessment, Plan) because it is simple but covers all the clinical bases.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |