When I Was a Therapist...

I frequently find myself using a phrase that is somewhat disturbing. What’s more, I’ve decided recently that this phrase is also totally inaccurate. This unassuming yet powerful phrase is: “When I was a therapist…”

I spent a few years providing therapy (e.g. being a typical therapist) and then about three years providing vocational and learning disability assessments through a private company. While my assessment gig wasn’t providing therapy, it was still clearly clinical (and unique enough to get me the occasional impressed eye-brow raise from other therapists). I continued practicing my interview skills on a daily basis and quite frankly, learned how to write reports “like a boss” and in very little time.

However, for quite a few reasons, I needed to find something more stable and full-time. I wasn’t interested in providing long-term therapy again because I prefer the short-term and very focused work. I finally came across a position in quality improvement and thought, “I think I’d like that.” Paperwork had never been difficult for me and I was quite practiced at it, especially in my recent position providing assessment on a daily basis. 

I applied, got the job and it was a great fit! I loved working with other therapists by training them on the county-required paperwork. The documentation requirements for the LA County Department of Mental Health are infamous among mental health professionals here in Southern California and it’s certainly a reason many therapists get out of community mental health as soon as possible. 

However, I found that I could give people great tips on how to capture the data they needed. I was good at interpreting the clinical focus of the paperwork and emphasized this when talking to the therapists I was training. This helped them make a connection to the paperwork and see the real purpose for it. I firmly believe in sharing as much information as possible and that people (especially educated people in a stressful position) are more likely to do well on a task if they understand the purpose behind it. 

So what does this have to do with my saying the phrase, “When I was a therapist…?” While I obviously needed the clinical skill to do my job in quality improvement/quality assurance, I was selling myself short and sending the wrong message to the people I was training. My main goal of training is to show therapists the connection between the clinical work and the paperwork. However, by using that phrase I was essentially saying that I was now a paper-pusher and that meant I could not also be a therapist.

How wrong I was! Do I currently see clients in therapy or for assessment? No, I don’t. I no longer take crisis phone calls and write progress notes. However, I do open my DSM to check diagnoses multiple times a week. I do consult with staff on “tricky” situations and how to bill (or not bill) for their time. I evaluate treatment plans and notice when there are discrepancies in the plan and the actual treatment. I read more progress notes than you can imagine and evaluate whether or not the therapist is providing the appropriate level of treatment.

My work is very clinical and requires not just an MA or PhD in psychology but also practical experience in the field from which to base decisions on. I am a psychologist, a therapist, an assessor, a supervisor, a trainer and I continue to help people on a daily basis. I don’t do this by processing trauma with clients but by helping my fellow therapists make sense of the administrative requirements of their job. I process with them so they can figure out what paperwork is needed, and in turn do the work they love and help their clients. 

I absolutely love helping therapists figure out the messy situations and how documentation plays a role in the treatment they provide. So, sign up here for my newsletter (and free paperwork crash course) and get monthly tips from me or leave me a comment below with a documentation question you have so I can help support you. Happy writing, everyone!