Episode 168: What's Missing From Your Progress Notes

Summary

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Private Practice Startup Podcast: Episode 168

Title: What’s Missing From Your Progress Notes
Date: January 11, 2020
Hosts: Dr. Kate Campbell & Katie Lemieux
Guest: Barbara Griswold, LMFT

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Episode Overview

In this insightful episode, Dr. Kate Campbell and Katie Lemieux welcome Barbara Griswold, LMFT, an experienced therapist renowned for her expertise in insurance, billing, and documentation, to discuss the essential elements often missing from therapists’ progress notes. The conversation explores why effective progress notes matter, common misconceptions, compliance pitfalls, and actionable strategies to make notes thorough yet efficient. The episode combines practical instruction with many real-world examples, aiming to empower therapists to upgrade both their confidence and competence with session documentation.

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Key Discussion Points & Insights

The Prevalence of Progress Note Problems

[02:43]

• Barbara’s survey of 500 therapists revealed only 5% felt truly confident in their notes if records were ever requested:

  “5% said that they felt confident in their notes if they were ever to be requested... So if you’re one of those folks listening and you’re thinking, ‘my notes, I really don’t feel comfortable, confident,’ you are not alone.” – Barbara Griswold [02:43]

• Many therapists receive conflicting or poor advice about notes, often from supervisors or colleagues, leading to bad habits and anxiety about compliance.

• Some even defend not keeping notes at all, with 2% of survey respondents admitting to this risky practice.

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Why Progress Notes Are Often Neglected

[07:17]
Barbara identifies common reasons therapists’ notes fall short:

• Time pressure:

  “They’re a big time suck... what happens is we don’t write them and then we fall further and further and further behind.” – Barbara [07:17]

• Lack of formal training: Therapists often graduate without clear instruction on what or how to document.
• The myth of “less is more”: Some clinicians believe minimal notes protect client confidentiality, not realizing this can put both client and therapist at risk.
• Overconfidence in memory: Barbara emphasizes, “They’re not for you. They’re a medical record.” [09:03]
• Misconception about insurance:

  “The biggest myth that’s out there is ‘I don’t work with insurance, so I don’t need to keep good progress notes’ ...It has nothing to do with insurance.” – Barbara [10:29]

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Essential Elements Often Missing from Progress Notes

[14:13]
Barbara’s “most missed” components include:

• 1. Specific Symptoms and Impairment
  Document not just the topics discussed, but relevant symptoms and how client issues impair daily life (e.g., anxiety, sleep problems, job troubles).

  “If somebody’s coming in... are they having anxiety about that? Depression? Are they losing sleep? You want the impairment... is it causing financial problems, occupational problems, not functioning well at work.” – Barbara [14:17]

• 2. Session Start and Stop Times
  Increasingly essential for compliance and audits.

  “Sessions start and stop times... we didn’t usually put from 1:05 to 1:55. And that’s what we need to do from now on.” – Barbara [15:07]

  This protects both billing accuracy and safety (e.g., during critical incidents).

• 3. Therapist Interventions
  Document what you actually did in session; many notes only reflect client dialogue or issues.

  “What did you do about that? This is supposed to be a record of medical service provided.” – Barbara [17:01]

  This includes both in-session interventions and homework/next steps.

• 4. Unusual or Administrative Issues Always note atypical events like fee negotiations, boundary issues, or client requests.

  “If they ask you something, like, ‘Hey, can we do a reduced fee?’ ... I’m going to be documenting a lot of that conversation.” – Barbara [18:34]

• 5. Objective Descriptions (Not Labels) Write like a neutral reporter, avoiding pejoratives or assumptions about client motives.

  “Always say ‘write like a journalist is in the room.’... Be documentarians, be journalists, and just describe what happened, but don’t use any pejorative language.” – Barbara [24:35]

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Real-World Examples & Legal/Ethical Implications

[20:26]

• Barbara shares experiences from serving on her state Ethics Committee:
  • Abandonment complaints are common, especially surrounding abrupt or poorly documented terminations.

    “You have to handle referrals, coordination of care, but particularly endings, really carefully, and you have to document everything.” – Barbara [20:26]

  • Even billing complaints can morph into ethical investigations if proper records are lacking.

[23:29]

• Insurance documentation isn’t just for insurance! Even “private pay” or “personal growth” cases must be handled thoroughly, should records be requested.

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Mindset Shift: Reframing the Purpose of Progress Notes

[25:24]
The hosts and Barbara encourage listeners to see their notes as integral to effective care rather than mere bureaucracy.

“For me, I’m a much better clinician when I write good notes... They help you give much better care. So, it’s not stupid paperwork. If it helps me give better care, then it’s very worthwhile.” – Barbara [25:37]

Additional benefits include improved client outcomes, more robust continuity of care, and the ability to demonstrate client progress at discharge.

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Notable Quotes & Memorable Moments

• “If you didn’t document it, it didn’t happen.” – Barbara Griswold [18:17]

• “Your notes are far more important than you think they are and you should always write them as if an insurance plan is reviewing them or as if the client is reviewing them.” – Barbara [23:29]

• [Humorous highlight]:

  “I had one client come in and say, ‘Can I pay you in tomatoes instead of my copayment?’ That’s going to be documented.” – Barbara [19:11]

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Practical Resources & Takeaways

• Barbara offers a free interventions list—a practical “cheat sheet” with sample sentences covering standard modalities (CBT, DBT, EMDR, etc.)—available via the show notes. [28:39]
• Listeners are encouraged to change their relationship with documentation, using it as a tool for better clinical care, risk management, and professional growth.

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Timestamps by Topic

• 02:43 – Scope of the problem: therapists’ lack of confidence in their notes
• 07:17 – Why therapists neglect notes; common rationalizations
• 10:29 – Myths about insurance and documentation
• 14:13 – What’s actually missing: Barbara’s top five elements
• 18:34 – Documenting unusual events, administrative details
• 20:26 – Real ethics board cases: abandonment, referral/ending mishaps
• 23:29 – Write notes as if anyone could read them; neutrality in language
• 25:24 – Mindset shifts for paperwork; seeing notes as quality care tools
• 28:39 – Free interventions list and wrap-up

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Episode Takeaway

Progress notes aren’t just a regulatory burden—they’re vital records of your work, protect you and your client, and can improve both clinical outcomes and your peace of mind. Reframe your approach: document proactively, thoroughly, and objectively—because, in both clinical care and risk management, if you didn’t document it, it didn’t happen.

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Transcript

[Kate Campbell]

Welcome to the Private Practice Startup Podcast where we help ambitious private practitioners across the globe to brand themselves and grow their dream practices. We chat with successful private practitioners, business coaches and marketing experts, bringing you tons of practice building Ninja tips. Visit privatepracticestartup.com for awesome resources, attorney approved private practice paperwork, and our signature marketing E course. Here are your co hosts, Dr. Kate Campbell and Katie Lemieux. Hey there Startup Nation. Welcome back to another episode of the Private Practice Startup Podcast. We are really happy to have you guys here today and we hoped you joined us last week for the episode with Kelly Sisson where we talked about thriving, not just surviving, in private practice. So we took a step back and this was more of a personal story and personal journey, really providing hope, encouragement and inspiration. So we hope that you join us for that if you haven't already. Today our guest is Barbara Griswold, licensed marriage and family therapist. And today we're talking about a topic that you all requested because we love to poll you guys and we really appreciate you guys voting when we throw some topics out there because we want to deliver what it is that you most want. So today's topic is what's missing from your progress notes. So we're going to get into those things you all love the most. Not progress notes, but they are very important. But before we do that, I just wanted to take a quick moment to say welcome to our new guest. You are part of our Startup Nation family. We have a special gift for you and that is our A to Z cheat sheet. The essentials for building and growing your dream practice. Go over to privatepracticestartup.com, head over to the Resources tab and there you will see it hanging out there. Go ahead and enter your name and email and not only will you get the A to Z cheat sheet, but you will also get the five days of practice building emails. Because we're really here to support you along your private practice journey, wherever you are. So let's talk a little bit about Barbara. So Barbara has been interviewed by National Park Public Radio Morning Edition and her articles have appeared in the Psychotherapy Networker and the Therapist magazines. While she has a private practice therapy in San Jose, California, her true passion is leading live workshops and webinars, helping therapists understand the mysterious world of insurance and billing and teaching them how to write better progress notes. She provides consultations to therapists nationwide on essential business topics they didn't learn in grad school, including insurance, writing quick but thorough notes, and building a thriving progress practice. Welcome Barbara, thanks.

[Barbara Griswold]

I'm delighted to be here.

[Kate Campbell]

We are delighted to have you. So, yeah, progress notes, progress notes.

[Katie Lemieux]

Every therapist favorite thing.

[Kate Campbell]

How did you get such a pain?

[Barbara Griswold]

It's such a pain point for people in practice. I mean, I actually recently did a survey of 500 therapists and 5% said that they felt confident in their know notes if they were ever to be requested. That's a really low portion. And that's what, you know, that's. I think 25% said, well, maybe, you know, maybe I'm okay. So we're talking most people out there. So if you're one of those folks listening and you're thinking my notes, I really feel. Don't feel comfortable, confident, you know, you are not alone. So don't feel bad, don't feel ashamed. But this is the time where, you know, hopefully by the end of our talk today, you know, maybe you'll think about making some changes and feeling better about them.

[Kate Campbell]

So I'm just curious, like, how did you fall in love with this topic?

[Barbara Griswold]

Well, like anything in my life, the things I've fallen in love with have come completely unexpectedly, including my husband. But, you know, I opened my practice 30 years ago, I hate to admit that, and started to get involved with all the insurance plans I could possibly get involved with to build my practice. And then it started happening that people started coming to me and saying, how do you fill out this form and that form? And so then I started to become kind of the go to insurance person in my, in my building. And then got kind of known out there that, oh, you know, people kind of know, go to Barbara if you have insurance questions. And then I started. I gave my first workshop 10 years ago and no, 15 years ago, and 100 people showed up. And this was before the Internet. We didn't even do any Internet. Not, it was before the Internet, but we didn't do any Internet advertising. And there was just this amazing need for out there for insurance training. And then as I was kind of becoming giving talks all around about insurance, I started to do workshops. People were like calling me up and saying, oh, I've gotten a request for my records and I don't keep progress notes and I don't know what's supposed to be in them. And it became this. Now, oh, so many people were calling me, panicked because they're getting records requests. This is happening more and more out there. And so I decided, hey, maybe I need to kind of go off on a kind of side tangent here. After writing my book on insurance, I decided Maybe I need to talk. Tell people kind of in a preemptive way what's supposed to be in your progress notes. And that way, if you do get a request for your records, you're set, you're confident. You don't have that feeling of panic.

[Kate Campbell]

Interesting. You know, when I heard you say that people like, I don't keep progress notes like that, like, is horrifying to me.

[Barbara Griswold]

Like, yeah, 2% of people in my survey. And that doesn't sound like a lot, but it's still people out there who don't act, don't keep them. And in fact, defended it in their comments, said, yeah, and we can talk about some of the reasons why they kind of defend no notes.

[Katie Lemieux]

I was actually talking to a therapist the other day, and they said, oh, I just started running some groups, and I love it because I have all of these people coming, and I'm making more money and I don't have to write notes anymore. And I was like, wait, wait, wait, What? Where did you get the memo that you don't have to write notes? These are still clients that you're seeing for session. You got to write notes. And they were like, what? Thank goodness you told me. Apparently most times, yeah, people just don't realize.

[Barbara Griswold]

Well, a lot of people out there have gotten bad advice about notes. I hear this all the time. Like, well, my supervisor told me X or my colleague in the next office told me Y. And it's just like, oh, I just want to. No, no, don't listen to your colleague or your supervisor sometimes. Sometimes on certain issues.

[Kate Campbell]

So, yeah, there seems to be a huge missing. I mean, you know, I don't. I don't remember writing assessments in school. Treatment plans. Progress. Remember that? And then you go into work and they expect that you know how to do this. And then, you know, they just. Well, you know, most people going into community mental health, right then it's, you know, high volume of clients hurry, do the work, do the work, and they're really not checking the quality. I remember it took me about, like, two years when I was a therapist, and one of my supervisors, she had this really awesome, like, formula on how to write treatment plans. And it's something that I've followed ever since. And it was just, like, easy. But no one sat down and talked to me about how to write objectives and measure them, and I didn't know any of that.

[Barbara Griswold]

Right, right, right.

[Kate Campbell]

Yeah. So let's dive into your topic. Let's talk about some of the things that are missing in progress notes.

[Barbara Griswold]

Well, first I wanted to talk about, well, why don't we keep better notes? I mean, it kind of comes down to about five or six things that I always hear time and time again. And they're so common. First, of course, is the time issue. I mean, yes, they're a big time suck. There's no way around it. But one of the things I try to work with people is how to do quick notes that summarize a 50 or 60 minute session. It is a skill, but it's something you can build. But what happens is we don't write them and then we fall further and further and further behind. And people come to me and say, I haven't written them for the last month and now I don't know whether to write today's notes or try to remember a month ago. And then they start piling up and it becomes a huge stressor in these therapists lives. And you're already so busy and you're already dealing with a lot of stress in our personal lives and our professional lives. And the secret is, you know, keeping on top of notes is just a real stressor. So we don't write very good notes sometimes either because we're writing them so far after the session or because we're trying to speed through them so quickly. The other thing obviously is we weren't taught what to write in them. If you know what to write and how to write it quickly, then it doesn't become a pain point. Another issue is a lot of people harbor under the impression, and this is when I was taught 20, 30 years ago, the less you write, the better, right? This is a really common one that I hear in my workshops every day. I heard just this weekend that we need to protect our clients by writing lesson in their notes or not keeping notes at all. That the things we say can be used against them. And while that's very understandable, people don't understand, therapists don't understand all the ways that notes can help a client or protect you. And that's something that, you know, we can talk more about. But other client therapists are saying, my memory is great, I don't need them. Well, they're not for you. They're a medical record. They're a medical record. I mean, of course they are for you to help you remember the sessions and to do better, give better care. But you are creating a medical record for the client. I mean, how would you feel if you went into your primary healthcare provider and they didn't keep notes from one session to another? So that A year later you said, hey, I want my record. They're like, yeah, I didn't keep record of any visit you had for all the, you know, 20 times you came in here. That's unprofessional and it's illegal in most states and you know, your licensing board. And then if a client comes in and complains about you and says, hey, she didn't provide services or she didn't provide the right services or she didn't respond appropriately to my issue, you have absolutely no documentation to back up what service you provided. So the medical record has to be a record of the services you provided in each session, how you responded, was it appropriate to the client's presenting issues.

[Kate Campbell]

So yeah, only imagine you go to the bank and you deposit $5,000 and you go to the bank was like, I didn't keep that documentation. We don't have that.

[Barbara Griswold]

And the biggest myth I think that's out there is I don't work with insurance, so I don't need to keep good progress notes or I don't have to keep any progress notes. And it has nothing to do with insurance. I tell people all the time you should keep the same progress note whether your client is paying by cash check insurance. This has nothing to do with how they're paying now. Yes, insurance may have more tendency to perhaps look into your notes or you might need that information for a treatment review down the line. But there are so many other reasons why your notes could be requested. I had one client who I had two years notes that were requested for disability because my notes were so specific and had very good documentation of all his impairment and his symptoms and severity and the duration over the year. He was, was able to get permanent disability actually. And his psychiatrist had kept crappy notes, I'm sorry. And he was turned down initially due to her notes because her notes were so superficial. So you might be the difference between one of your clients getting well deserved disability or being able to get coverage through insurance for many, many more sessions that maybe all be based on your notes. So there's so many things writing on your notes, they're just. We kind of are in denial about it. We think it's just like our little private journal about our thoughts and feelings and or about what the client's working on.

[Kate Campbell]

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[Katie Lemieux]

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[Kate Campbell]

You were about to say something.

[Katie Lemieux]

I was about to say the exact same thing, that we're going to take a sponsor break. But you just said that. And I'd love to know, Barbara, what exactly needs to be in the progress notes?

[Barbara Griswold]

Yeah, sure. Do you want to go to the five things that I feel like are often miss out? Okay. I think people understand if most people cover the topics discussed. You know, they might say, you know, that they came in and they discussed this thing and this thing and this thing. They don't often get it down into what are the symptoms that are underlying those topics. So if somebody's coming in and saying that they're fighting with their boyfriend, are they having anxiety about that? Are they having depression about that? Are they losing sleep? So you want the impairment, like what is, how is that causing a problem in their life? Are they having difficulty with self care? Is it causing financial problems, is it occupational problems not functioning well at work. So these are the things that you kind of need to be collecting a little more data points on. Another kind of surprising one that's become, well, not surprising, but a new one that's kind of come into the field recently is sessions start and stop times. This has become a really big issue lately because we didn't usually capture that in the chart in terms of we might put a 50 minute session or 60 minute session, but we didn't usually put from 105 to 155. And that's what we need to do from now on because more and more there's kind of billing audits and in your progress notes, you're backing up how long exactly the session was so that it matches your amount that you're billing for. And it's a way of backing up again your records. But also just, you know, maybe a client comes 15 minutes late, you can't legally bill for a 60 minute session if they only had a 45 minute session. Right. So they want to see exactly the length of sessions. So that's a new one, kind of.

[Kate Campbell]

That's really interesting to hear that that wasn't like a big deal before. You know, one of the things when I was in management and leadership is I would always talk about critical incidences.

[Barbara Griswold]

Right.

[Kate Campbell]

It's important to know the stop and start time of any interaction with a client because God forbid a critical incident happens or they're suicidal if you don't have accurate times. And you know what I mean? So, you know, we always train on the importance of the timing being very accurate. So that's interesting that to hear that's evolved.

[Barbara Griswold]

Yeah. Actually a lot of people have software programs that just enter 45 minutes, you know, the CPT code, 45 minute session or 60 minute session. So it doesn't actually have start and stop times. And people are like, oh no, what do I do? I'm like, just write it in the progress note. And you know, when insurance plan C, sometimes your session starts at 1:05, sometimes it starts at 1:10. It's also more of a believable. Right. If every time they see you say 1:00' clock to 1:55, they're like, huh, Is that really the case or are you just writing that in? So it's, you know, the more you capture reality, obviously the more believable your chart is and other things we're talking about interventions. I can't tell you how many times I see a note that doesn't have anything about the therapist in it. So it'll be client discussed, blah, blah, blah, blah, blah. And client said this about that. And then that's the end of the note. I'll be like, well, what did you do about that? This is supposed to be a record of medical service provided. Keep coming back to that sentence. What service did you provide? And it could just be an intervention that you helped the client identify their cognitive distortions, or you recommended that they go to mindfulness based stress reduction classes, or you refer them to a medication evaluation. It can be kinds of things that you did in session or homework that you gave them, or what are they going to do before next time. But if you don't have any record of what you did, the client can later come back and complain and say she didn't do anything and you have no defense.

[Kate Campbell]

And your note says so.

[Barbara Griswold]

Right. And of course, you know, later you're on the stand saying, well, I did this and this, this. And we're like, well, if you really did that, you know, there's that old phrase, if you didn't document it, it didn't happen.

[Kate Campbell]

Right, Correct. I was just think that you thought out of my mind.

[Barbara Griswold]

It's really on you to document what happens in the session. And an offshoot of that is that whenever anything unusual happens in the session, like different than normal or when the client appears different, that's when you document that. If they ask you something that's, hey, can we do a reduced fee? Boom, I'm going to be documenting a lot of that conversation. Why does they want it? What did I say about that? What fee did we agree to? When did we agree to reevaluate? It could be administrative like that, or it could be clinical. I had one client come in and say, can I pay you in tomatoes instead of my co payment? That's going to be documented.

[Kate Campbell]

That really happened.

[Barbara Griswold]

Yes, I really love tomatoes, but I'm not going to accept you can't do those kind of things. But you have to document clients at this why did I say I wouldn't accept tomatoes? How did the client react to that? So a lot of anything that's a little unusual you want to document because you don't know how it's going to blow up later or be significant later. A lot of client therapists tell me, well, I didn't document it because I didn't think it was significant. And I think to myself, yeah, I probably over document because I've been on the state ethics committee and I saw the kind of things that People that clients brought in and complained about, their therapists about, and how often the therapist did not have proper documentation to be able to say how they handled something or just how the sessions were unwinding. And, you know, if sessions were having. If the client was having an issue, was that reflected with in any way in the documentation?

[Kate Campbell]

So you got to share with us, like, some of the top ones that you've heard. We can't step over that. We got to know.

[Barbara Griswold]

You mean like, that were brought to the Ethics committee.

[Kate Campbell]

Some of the crazy, outlandish things.

[Barbara Griswold]

You know, here's an area that people don't realize how big it is, but a couple of the cases involved abandonment. And in each case, the therapist felt like they handled an ending. You know, somebody either backed out of treatment or they felt like this person was done, or they had to leave. The therapist had to leave treatment. So from the therapist's point of view, it was handled fine. From the client's point of view, they were abandoned. And I think we don't realize how sensitive some of our clients are to abandonment and how they will interpret, misinterpret, you know, any kind of backing away. So you have to handle referrals, coordination of care, but particularly endings, really carefully, and you have to document everything. So when I refer to somebody, I document all my conversations to the client about, you know, why I'm making that referral. I document all the referrals so that. Keep a copy of the referrals in the chart. I might send an email to the client and say, here's, you know, why I'm making this referral, or, hey, you didn't come back after the last three sessions. And so we're ending. You know, I might send a letter with that. And here are some referrals just like, do extra, I would say, around endings, because you don't realize maybe how often clients will then turn around and say you abandoned them in treatment.

[Kate Campbell]

And interesting to hear that that was one of the ones, the main ones that would come to the ethics board.

[Barbara Griswold]

Well, the other here's what I think happens is they get mad at you. You're going along and you're doing well, and all of a sudden they get mad at you for something. And in this case, it was because you backed away in some manner, or they experienced you as backing away and not being there for them. And the other thing that often happens is some of the complaints involved billing. And I don't think that was really. These are things that maybe the client had gone along with improper billing Practices and they were fine with it as long as this person was treating them. And then when the therapist didn't save their marriage or they got mad at the therapist, all of a sudden they're like, well, this therapist, you know, they report to the. Did this improper billing practice or was billing. Both of our. Here's one. Was billing both of our. We were doing couples counselor and was billing counseling and was billing both of our insurance plans for the same session. So that would be like, that would be fraud. And that was fine with them as long as they were happy with you. And then as soon as they got unhappy with you, they were like, all right, where can we direct our complaint? Right.

[Kate Campbell]

So it reminds me of some of my clients. I deal with clients in affair recovery, right. And so a lot of the information comes out when the affair partner is not happy. So yeah, when you're, when you're making those, you know, agreements and things like that, as long as the relationship is going okay, it's fine. But when someone's not happy, someone else is going to hear about it for sure.

[Barbara Griswold]

So it's just so important that also that just your notes need to just so document why treatment is necessary, particularly if you do work with insurance directly. But even if you don't work with insurance directly, if you give a statement to a client to turn into their insurance, you have to remember that that opens the door for the insurance plan to review your treatment. And if you don't have like lots of documentation saying why this person is in treatment and why they need treatment, more than that, they're wanting to do personal growth work. Now, the insurance plan might not cover it and that client might drop out because they don't have coverage. So it really is in your hands. I think that's the, that's the walk away. I'm going to anticipate your question. The walk away is that your notes are far more important than you think they are and that you should always write them as if an insurance plan is reviewing them or as. Or if the client is reviewing them. You have to remember the client can at any time say, I'd like my records, please. I'm going to another. Going to another professional. And do you want to currently, if you think about that, how comfortable do you feel with your clients picking up their records and walking away with them? One of the things I tell people all the time is don't write anything that you. That is negative about your client. Like, I never use words like client became hostile or client is, you know, antagonistic or Whatever I might describe like a journalist, I always say write like a journalist is in the room. So client raised her voice, or client said she was angry at me for, you know, charging her a late fee or a miss session fee. You know, be documentarians, be journalists, and just describe what happened, but don't use any pejorative language in your. In your notes.

[Kate Campbell]

Barbara, one of the things that we find is really, like, the mindset shift about your paperwork and how you relate to your paperwork. How do you help therapists reframe their relationship with their paperwork?

[Barbara Griswold]

Yeah, that's a great question. So many people just hate this part. They hate paperwork. And they are always saying to me, you know, oh, it's just part of the job that I hate the most. And for me, I'm a much better clinician. When I write good notes, there's a couple ways that that happens. Number one, you know, if I have a client coming in and I think to myself, I kind of know what, you know, what we're going to be talking about, what they talked about last time. But I pull out my notes and they're really good from last week. I'm like, always amazed. I'm like, oh, I forgot. That's right, he was working on that. Or, oh, that's right, there's that extra piece. I forgot. Or I gave him this assignment I forgot I had given him. So maybe my memory is just really bad, but it really, when that person comes in, I'm so much more ready, and I'm so much more. It just gives me so much more, I don't know, flavor of what they're going through and reminds me about the things that we're working on. And so my treatment is actually better. That's number one. Number two is if they go away from treatment and then come back, they're always so impressed. They're always like, oh, I can't believe you remember that. Because I'll say, like, how's that thing going with your sister? Or, you know, didn't you have a wedding that you were going to with your, you know, your niece and that you were worried about and how did you get through that? And they're always like, God, you have such a good memory. And I'm like, no, I don't want to say that. But no, I don't. I actually just have really good notes. And, you know, they really help you connect with the clients and they help you give much better care. So it's not stupid paperwork. If it helps me give better care, then it's very Worthwhile.

[Kate Campbell]

And I couldn't agree more with you because there's times, like, if I don't see a client, like every week, I definitely forget. So every other week. And I just quickly look at my notes and I was like, oh, yeah, I did forget. I assigned that to them. But it also helps provide better care because you're helping hold them accountable to what they may have said that they were going to do or what they were going to agree to do. And also, too, one of the things that I like about knowing some documentation is, you know, when clients are getting ready to transition or discharge or graduate, I like to walk them through the journey. Right. And I like to highlight where they were and the progress they've made. And a lot of times they're like, much more astounded. Like, wow, that's right. We really did do that. So it's a great opportunity to utilize that as well, to really help them see their own progress and many other things. So we really appreciate you being here today talking about progress notes because this is, yes, it's a love hate relationship for most people or more hate hate, I guess, hopefully with some of Barbara's suggestions and tips, you guys can apply these things to your notes. And we really invite you just to begin to change your relationship with your notes. And that's really important. And Barbara, you have a giveaway for our audience today. What is that?

[Barbara Griswold]

Yeah, a lot of times I hear from a therapist, well, you tell me I need to write interventions, but I don't know how to write that. What does that look like? What's an intervention? So I put together a list of sentences that, here are some interventions. And it has all kinds, dbt, cbt, emdr, all kinds of different interventions that are kind of spelled out in the whole sentence. And so it's an interventions list that I hope you find helpful to say, oh, that's the kind of thing I'm supposed to be writing.

[Kate Campbell]

Nice.

[Barbara Griswold]

Yeah.

[Kate Campbell]

That's amazing. And you can find the link to that at our show on our show notes page. That information will be right there. So, Startup Nation, we hope you guys join us next week as we talk to Julia Harris. And we're going to be talking about what to track. So more about documentation to have a successful private practice. So Julie's actually an accountant and the owner of Green Oak Accounting. I love talking taxes and accounting. So I hope you guys will join us for that episode because just like we're talking about in today's episode, if it's not documented, it didn't happen. Well, if you're not tracking it, you can't change it or or improve it.

[Katie Lemieux]

Yes, very well said. And also, let's take a moment for our Startup Nation Superhero Shout out. This comes from Brandon Santan. We actually had him as a guest on our podcast recently, so it's so cool to see his review here he says, I'm thankful to have come across Kate and Katie and the Private Practice Startup. I've enjoyed their thorough resources about starting and growing a private practice. They have some great lessons to share from their own experiences. So who better to listen to to than those who have been exactly where we are and where we are going. I highly recommend them to anyone thinking of being in private practice. Brandon, thank you so much for the feedback. And if you guys have feedback for us, don't forget to subscribe, rate and review the show. We always appreciate getting that and knowing that the content we're providing is really on track to meeting your needs.

[Kate Campbell]

So Startup Nation, thank you for allowing us to inspire you from Startup to mastery. Have a great day everybody. Take care.

[Katie Lemieux]

See you next time. Thanks for joining us on the Private practice startup. Visit theprivatepracticestartup.com for awesome resources, free trainings, attorney approved private practice paperwork, and so much more.

[Barbara Griswold]

SA.