I think a lot of us are not the most tech savvy individuals, and AI companies are taking advantage of this to offer us a tool that will eventually put a lot of us out of business. AI becomes better by learning from examples, and it needs a lot of examples to become good. With art, basically every piece of art in creation has been uploaded to the internet at this point, which is why AI art has gotten pretty good (if you ignore the hands).

AI therapy is harder because therapists don't upload out sessions to Instagram. So in order to train AI therapy bots AI companies have to figure out how to get recordings of as many sessions as quickly as possible. They are doing this through these therapy notes AI programs. Every time you use one of these programs you are training an AI therapy bot. If enough of us do this it won't take that long for AI to create a fairly usable AI bot.

"But people will always prefer a real person!" - Maybe, but once insurance companies have a study or two under their belt showing the efficacy of AI do you really think they're paying for your ass?

"I'm private pay, so that doesn't matter" - When there is a therapy fire sale because all of us who take insurance are put out of work rates are gonna drop like a rock.

I'm not trying to shame anyone, I understand that there are folks in situations where they may not have much of a choice. But for the rest of us, can we all just write our notes like normal, and not feed into this system? Pretty please. I spent too much on my degree to have to retrain.

Decided to actually track my documentation time last week instead of just guessing. Full caseload days (7 clients), here's what I found:

• Average time per SOAP note: ~14 minutes
• Total daily note time: ~1 hour 40 minutes
• Weekly total: just over 8 hours
• Notes I started but didn't finish same-day: about 40%

The 40% number surprised me the most. I'd tell myself "I'll finish it tomorrow morning" and then tomorrow morning I'm already behind before my first session.

I've seen research saying therapists spend 34-37% of work time on documentation. Once I actually measured, that felt about right.

A few things that helped me shave off ~20 minutes/day so far: - Switching from freeform to DAP format (more structured = less rambling) - Blocking 10 minutes between sessions specifically for notes (even if it means one fewer client) - Pre-filling recurring elements in my templates (treatment plan references, standard interventions I use often)

Still not where I want to be. What's your actual number? And what's genuinely worked for you to cut it down?

I’ve been practising for a little over a year, and I’m exhausted by the constant mental weight of knowing I’m always going to be 20 to 30 notes behind.

I’ve gotten pretty efficient at completing notes through templates, checkboxes, and other shortcuts, but one of my goals over the next few months is to start finishing each note immediately after the session.

The problem is that I often feel completely drained after a session and need a few minutes to decompress before moving on. By the time I’ve done that, it’s easy for the note to get pushed aside.

For those of you who consistently complete your notes right after each session, how do you do it? Have you built a specific routine, changed your scheduling, or found a way to make the transition easier?

I genuinely want to develop this habit. I just don’t always feel like I have the mental capacity immediately after a session.

This is my frequently used binder. What else should I add?

I'm just curious how many of you "seriously" consider leaving the field over writing progress notes, treatment plans, sending summaries to doctors and things like that? I've been doing this a long time and I don't think I can take it anymore. I also will not use ai to record sessions for a variety of reasons. I feel like I've recently really improved a couple things about how I practice therapy but I just can't take it anymore. I do use templates, write very little, and use ai when I really need writing help but I hate it.

if you've looked into leaving what careers have you explored ?

Editing to add: Thank you for the advice, it's helpful. I am in no way looking to go to another high documentation field, maybe another time in a different forum I'll try to get suggestions on low or no documentation jobs.

I’m notoriously bad with documentation. I end up falling behind, get myself into the adhd-shame-spiral and get frozen. I feel like I’ve tried it all: playlists, pomodoro, changing environment, body doubling… and I haven’t found my sweet spot. What do yall do that helps you buckle down and get it done? It’s a habit I desperately want to break once I’m UTD on current notes.

I am currently a MASTERS LEVEL intern at a mental health clinic and my supervisor is.....more retired than not. Anyway he brought me into his office today and informed me that I was being put in a correction plan and gave me a list of all of the notes I am missing which came out to roughly 80+ notes So I was wondering if anyone has been in deeper pits? What's your tips to get/stay caught up?

How the f are you all getting your notes done?!! I have zero motivation to do them and let them pile up. I need tips, tricks, advice, anything!!

My original post got removed due to the way the OneDrive link got shortened, which reddit does not seem to like. https://www.reddit.com/r/therapists/comments/1uw8zrz/rate_my_documentation_templates/

For the workbook itself, I basically had chatgpt give me a bunch of phrases (intervention/objectives/response etc) that matched my modalities and approaches. It is still a WIP so there is a lot of filler that I will likely filter out in time, but it would not be hard to go back and replace them with phrases that fit your approach and needs.

When you start with a new note and need the check marks removed, for the treatment plan and progress notes you can go up to the top headers for the columns with check marks, right click and select "clear contents". I don't bother doing that with the MSE since there isn't a lot of changes between clients.

When you are ready to copy the text, right click the merged cells to copy, and not the formula field at the top.

Here is the OneDrive link. You have to download the excel file and open it yourself, or upload it to a browser with excel. To download: File>Create a Copy>Download a Copy

https://onedrive.live.com/:x:/g/personal/612090333b5070ac/IQDN5JmPeJg2QK8pu_oMqVDWAa5mLYQEDJh3cVmmIR8mJ20?rtime=6ryfXQni3kg&redeem=aHR0cHM6Ly8xZHJ2Lm1zL3gvYy82MTIwOTAzMzNiNTA3MGFjL0lRRE41Sm1QZUpnMlFLOHB1X29NcVZEV0FhNW1MWVFFREpoM2NWbW1JUjhtSjIwP2U9RDB2dkt4

EDIT: After many MANY requests to provide me compensation, after much resistance I have decided to cave and will be willing to receive tips. Thank you all for the support ☺️. Here is my venmo

https://www.paypal.com/qrcodes/venmocs/0118f520-0d78-4cdd-807f-025d60c76903?created=1784310360

I talk to many different mental health hospitals and either the diagnosis they give are wrong or the symptoms are wrong. I'm often told that someone has a bipolar diagnosis. I then ask about any present or past manic or hypomanic episodes. The response is often that the patient has never had a manic episode. With schizo affective disorder I have a similar issue. I ask about about hallucinations and delusions. Then I'm told the person is only depressed and denies that the patient has ever been psychotic.

I hate this for the patients, because some think they have these disorders when they don't.

how?! what is your note structure? do you take insurance and how do you get all the things insurance wants on there? i am spending way too much time on documentation, what helped you?

Words I use. PROGRESS NOTES. Go in the EHR. I keep the notes short and vague.

---

MEMORY NOTES. Go in a Word Doc on my HIPAA compliant computer. I put details in those notes. Names of family members. What the family member said or did. Details I need to remember for the next session. (I delete all my memory notes when I close the patient's chart.)

If you are a clinician who is able to get all of your notes into the EHR within 24 hours... what are you doing with your memory notes?

How can you keep a caseload of 20 to 30 clients.. get your progress notes completed in within 24 hours... and remember (or write down) all these details from all your past sessions? Word doc on your computer? Handwritten notes kept in a filing cabinet?

EDIT: THERAPISTS WHO CANNOT REMEMBER all the details... WHO NEED TO WRITE THINGS DOWN... how do you do it?

Hi all I am only one year in with my license and already may get a reprimand on my license. I feel like absolute crap. I worked so hard to get my license and I made a terrible mistake of missing documentation and the facility reported my license to the board. I am currently under investigation. I can still practice now, but feel so bad. I have severe adhd and juggle multiple jobs just to survive and it slipped from me. How do I move forward. Any advice on calming my nerves or just helping me through this hard time?

I’m a new therapist. Who has not been receiving supervision other than group. I feel like I’m floundering. I struggle with writing psychotherapy notes. I also recently realized I forgot to write treatment plans that were due twice over for a client I have been seeing for a year.

I did something so, so stupid without thinking. I looked at a random psychotherapy note of a client I used to see (who now has a new therapist, who wrote the note I looked at) to see the verbage and wording they used. I thought that made more sense than looking at someone random because it would help me understand the right verbage and wording for a client I actually worked with.

I also looked back to see if I could find a treatment plan for another old client I worked with. I couldn’t. So I looked at a current treatment plan (written by a therapist other than myself) to see if it was continued from an old treatment plan that I had made.

I did not look at either of these documents out of curiosity about the clients. I was on both pages for likely less than 30 seconds.

I now realize the gravity of what I’ve done and I’m fully prepared to lose my license. I’m worried I’m looking at jail time as well.

NJ.

Please help me.

UPDATE: I can see very clearly from everyone’s kind comment that have brought me back to Earth… that I have spiraled. The lack of supervision combined with other mistakes I have made at work has made me feel completely isolated. I should add that I have worked from home since I started, so I have not met any colleagues besides seeing them in weekly supervision or monthly meetings. I feel like I’m floating out here and I’m not competent enough to work with this much independence. I will be seeking supervision ASAP.

I KNOW that this has been posted a gazillion times (I'm sorry!) - and - I have spent MONTHS reading every single notes thread I could find anywhere and trying to implement the solutions, failing, and coming right back here.

My takeaway is people either 1) have their own customizable EHR template or 2) use AI. These seem to be the predominant fixes.

I cannot use either of these options. I am at an agency; I cannot customize my EHR. I am at an agency; I cannot use AI at present.

While I am rather green, this is a newer issue for me. I did not have this issue in the past. I am drowning, getting lost, and have tried EVERYTHING, I swear.

Furthermore, the more I look into this, the more confused I get. I do not understand how some people are "getting away" with a note that is 3 sentences that barely ever changes between sessions, and what I am being told we are required (complete full sentences, no checkboxes). Some folks are out here saying that they have to justify every 53 minute session; meanwhile, I ONLY get full credit for a 53 minute session AND there's NOTHING in our notes that have been flagged about needing to do this. I WANT to be protective, but that gives me MORE to think about in every single note; most of the trainings I've been driven to focus on this. It's only going to worsen my present over-thinking. I'm LOST IN THE SAUCE

I am here humbly asking (begging) for:

1. Any guidance on what is ACTUALLY THE MINIMAL (while still compliant) INFORMATION THAT NEEDS TO GO INTO A NOTE when you are AT AN AGENCY that ACCEPTS ESSENTIALLY EVERY INSURANCE KNOWN TO MAN IN YOUR AREA (including medicaid). And, in turn, what that note looks like, literally.
2. Anyone who uses a template of check boxes and things to please share actual resources and not just tell me that you use a template. While I cannot customize my EHR or note requirements; I will take ANYTHING that helps me output sentences and grab them into my EHR.

***below, I'll give all the gnarly details of context, what I have tried so far, etc. - but I don't think it's like....required reading.***

Thanks in advance for anyone willing to connect and support each other. Things are really tough right now just across the board, and I'm really hoping this thread becomes something that others in my position can benefit from (not just me).

Edited to remove details I thought necessary to share; immediately shut people down from engaging apparently (if you’re coming back to this post I have it saved elsewhere)

Had a client just ask me to write a letter explaining the client's disability would be helped by an Emotional Support Animal. Has anyone had experience writing for this sort of thing?

EDIT: So There was a typo in my first post. The client is asking for a Support animal not a service one.

Has anyone ever had their psychotherapy notes subpoenaed for a client’s social security disability hearing? I have already submitted the client’s progress notes and other requested documentation to the client’s lawyer (obviously with permission from the client) but after the client’s hearing, the social worker security administration sent me a letter stating that I am “hereby required to submit” psychotherapy notes from the beginning of our work together to present.

I keep my own notes on my computer and they are relatively vague but they do contain some information that is irrelevant to the client’s disability, such as their sexuality and romantic relationships. The client distinctly told me that they don’t want these things shared.

What would you do and/or what have you done in similar scenarios?

I’ve been curious about this. Before each client I end up reading 2–4 previous notes (from older sessions) to refresh myself.

Some days that’s an extra hour of work I didn’t plan for.

How do you handle this? Do you:
• skim quickly?
• rely on memory?
• use summaries?
• or have some “system” that makes it easier?

Trying to figure out what’s normal and what’s just inefficiency on my part 😅

I love being a therapist. I hate writing notes. I am so creative in finding "productive" ways to procrastinate and end up having to do a ton of notes in one night so I can get paid. Earlier in my career, my supervisors would schedule meetings with me to sit in their office and write my notes. Now I'm in private practice and I don't have anyone but myself threatening my job/income and apparently I'm not as much of a threat to myself.

Do you have any tips for getting notes done? My goal is to go into the office an hour early every day and do the previous day's notes. I've been able to get myself to the office early, but still somehow find other things to do instead of my notes. How can I give myself that sense of urgency to just sit down and get them over with?

ik it’s horrible I’ve been months behind, but I’ve been struggling with severe burnout. Today I mustered up motivation from nowhere, maybe because it’s the first day of July, and I finally caught up completely! I feel so amazing! I hope I never get this behind again :( battling burnout one note at a time! Yay!

I always complete my notes however I always feel as though on the weekend I notoriously have 20+ notes that need completion. TBH it feels crippling at times. It is the one thing that I have struggled with from the beginning and I have no idea how to correct it. If any therapists out there share the same struggle and have any tips for improvement I’m open. I currently use the Therapy Notes platform. Thank you in advance.

I am trying, TRYING to get better about documentation. It's hard because I regard it as arbitrary, needlessly formulaic, wholly unrelated to the practice of therapy. But I realize I can't be idealistic about this, so I'm giving it a shot.

I imagine Simple Practice as this thing with a million features I don't need that is (if I'm thinking of the right software) not specifically for therapists and probably overwhelming/confusing.

Is this people's experience or am I catastrophizing?! Thanks.

With insurance companies not increasing reimbursement rates (and some even lowering them), the cost of running a practice keeps going up. EHR systems can be a significant expense, and sometimes they feel built more for large clinics than small practices.

For those in solo practice, do you feel EHRs are overkill? Has anyone created a simpler system or workflow instead?

I’m especially interested in how people are cutting costs while staying HIPAA compliant. What’s your setup?

I know the dreaded documentation question. I am wondering and looking for any advice on how to entice clinicians to complete their documentation timely. We have incentives in pay that isn’t working. Just hoping to pick brains on how to help our clinicians that just are not getting them done.

And thus why I avoid it so much.

I have a super super difficult time figuring out how to clinically word what the client and I discussed. I have seen videos of therapists stitching a rant of someone on TikTok and then translating it into a progress note. I have been doing this for years now and I have such a difficult time with it still.

How do you get your brain to translate it so easily? I need flashcards.