We analyze the session and record what our clinical thinking tells us is important. We choose what to write, what’s salient, want we want to remember, how we will describe what happened. On the other hand, I always referred to myself in notes as “I” or by my initials, “DR.” For variety, I use “T” for therapist, but mainly to indicate a back and forth dialogue between Cl and T.ĭR: Writing notes is almost more subjective than objective. Perhaps in some of those settings, therapists learned to speak of themselves in the third person. I had not trained in one of the many professions that therapists often do before becoming psychotherapists, especially, nurse, teacher, school social worker, protective service worker, case manager, discharge planner, residential treatment therapist, autism line therapist, psychometrician, and others. The last 25 years have been in a solo practice which morphed into a large private therapy clinic. The first was as a therapist on an inpatient unit. My only jobs in the field over four decades, all three of them, were therapy jobs. If I were giving my opinion, facts, or a promise, I referred to myself as “I.” If I were referring to a process involving others at the company or a company commitment, I used the first person plural, “We” or the name of the company.įrom day one of graduate school, I trained as a psychotherapist. It is a hard part of professional life to change jobs, to say goodbye to 30 clients and help that many new ones at a new job all in a couple of months.Īs the conversation continued, I realized that in my job in business management before I went to graduate school, I followed the practice in business correspondence of using the first person. Oh, if the therapist did it so much in this one session, more than in other notes, we could guess she is having a problem with clients’ feelings about her leaving, or is ambivalent about leaving. If the therapist wants it to sounds to objective all the time, that practice troubles me.ĭR: Exactly. LG: The whole point of the note is the meaningfulness of a relationship and attachment for the client. It denies the intimate connection that Joy (meaning the client) feels, her anxiety, like there isn’t a relationship. Worked on a cognitive restructuring task and forecast other feelings about this transition would come up, to please bring that to the next session.ĭR: For such an emotionally intense experience, doesn’t “WR” sound kind of distant.ĭR: It’s odd. Questioning uncovered her projections around why Wr. ![]() connected that event with the news imparted in last session. She reported since last session she was at the ER as a result of a bout of fear, tachycardia, and difficulty breathing which turned out to be one of her panic attacks. She said she understood, and that she has had to change providers in the past. Cl has hx of depression and SI, but reported no SI in this session. and Cl spent most of the session processing this event, including Cl ’s feelings of loss and disappointment, as well as Writer ’s recommendation to transition to another therapist in the clinic. informed Cl at the end of last session that Wr. ![]() ![]() ![]() The client is referred to by name, by her initials, JZ, or by Cl.Ĭl came for the first of three final individual sessions. Reading this note, Lynn and I together grasped the deeper meaning of my displeasure at the terms “Writer,” “This Writer,” or “Wr.” The therapist’s initials are LY. The term “This Writer” has always felt to me to be discordant, as dissonant as screeching.Īs it seemed to be a harmless practice, I did not tell my trainees to change the habit of referring to themselves in the third person, and I failed to examine my reaction in depth.Ī few days ago, Lynn Godec and I were reading the notes of a client we needed to refer after her therapist decided to move out of the state. I never referred to myself in written psychotherapy documents as “This Writer.”
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