How to Ease the Overwhelm of Getting Behind on Notes
Let’s be honest with each other for a moment - how behind on notes are you right now?
Days?
Weeks?
Months?
Maybe it’s too painful to think about or you’re not even sure anymore. If notes weren’t already difficult enough to keep up with, this year has made it nearly impossible to get notes done on time or at all! I have had so many therapists reach out to me privately to share that their notes have gotten to an overwhelming place, that they fear they can never catch up.
I completely understand as there was a period that I was months behind on progress notes myself due to a really stressful caseload. During that time I was too ashamed to tell anyone because I felt like a “bad” therapist and I now realize that I’m far from alone in that experience.
Why is the note writing process so difficult?
You’re Already Overwhelmed
The most common reason is that you’re probably OVERWHELMED, just getting through sessions while working from home and balancing everything else this year has brought is stressful. Most folks don’t realize that being a therapist is so much more than sitting in sessions, it comes with a considerable amount of admin work, especially if you take insurance or work for an agency.
Reliving the Sessions Is Difficult
Sensitive Therapists are incredibly perceptive, empathetic, and intuitive by nature or as I like to call it, spongy! You are noticing and absorbing so many layers in each session. As my own therapist once said, although the work of a therapist looks passive, you are actually using every part of yourself. Writing notes can feel like reliving all those emotions again so no wonder you feel RESISTANCE!
Notes Aren’t Heart-Centered
Finding the energy to take a very heart-centered experience like sitting with clients in their vulnerable emotions and then translating it into clinical jargon that will pass insurance audits or stand up in court can feel impossible. How do you translate all those feelings into the right words?
To quote fellow HST Liz Gray, “My client had difficulty finding words to describe their experience, and I’m having trouble finding words to describe the session. How am I supposed to condense an hour-long session into a few sentences and checkboxes? It’s difficult on a practical level and more importantly, feels like I’m invalidating my client’s experiences.”
Not Enough Time
Being more perceptive means needing to pause and reflect before completing a note. You probably have heard me mention this before and the reason it’s so important is that there is pressure to do everything quick and immediate, but that’s not how a Highly Sensitive brain is wired.
The standard for note writing tends to be to squeeze it in the ten minutes between sessions. To be honest, that is my worst nightmare! I need much more time to decompress and prepare for my next session. Rarely do I complete notes between sessions, instead batching them together at the end of the day when I can take my time to think and reflect.
5 Ways to Transform Your Note Aversion
Let Go of Perfectionism
As the saying goes, "done is better than perfect". Highly Sensitive folks have a strong tendency towards perfectionism which can sabotage our productivity and contentment, especially in the notes department. This approach will help you get your notes done in less time.
Keep It Brief
Although we want to capture all the important details from the session, it is in the client’s best interest to stay generalized and not go into too many specifics. Therefore, we can take the pressure off ourselves to write a lengthy note. To support this process, try implementing a limit on how much time you spend writing each note.
Don’t Reinvent the Wheel
Many therapists tend to have a specific area of focus and a set of favorite tools, meaning we often use the same handful of interventions with clients. Instead of creating every note from scratch, create a checklist of common interventions and templates for common note types such as intake, assessment, termination, etc. You can keep your templates in a Google Doc or create a custom note in your EHR system.
Create a Routine
Besides the common benefits of a daily routine, Highly Sensitive People use considerable brain power to make decisions because we are wired to pause and reflect before acting. Therefore, it takes us longer to make decisions, complete simple tasks, and transition between activities. Creating a routine around note writing takes away the need to analyze the decision to write notes. Is this a good time? How long will it take me? Once I started writing notes at the same time every day, it became much more effortless.
On Your Own Terms
Having nervous systems that are very susceptible to the effects of overstimulation when under time pressure, it is best for us to complete notes when we have time to settle into the activity. For instance, setting aside an hour at the beginning or end of the day to write notes may feel much more supportive than rushing to finish notes between sessions.
However, if you prefer to write notes immediately after sessions, consider extending time between sessions to allow for self-care activities. Find what approach works best for you, even if that looks different than what your colleagues are doing.
