Writers writing about writing is in no way annoying.

26 07 2012

Possession is, apparently, nine-tenths of the law. (I’m not totally sure, I’m not a lawyer.) Documentation is, in fact, eleven-tenths of social work. (I’m also not a mathematician.)

As social workers, we have to document everything. Everything. Sessions, group meetings, phone calls, outreach attempts, collateral contacts…”collateral contacts” are essentially “everything else, if you’re unfamiliar. This can be problematic, and not just because it’s time consuming.

There are ways we say things, and there are ways we write things. There are, especially, ways we write things professionally. At times, it’s hard to say things in a professional manner, but we still need to get them out there. (If you were wondering why this blog exists.) You might indicate that there are concerns about a teenager’s hygiene. You wouldn’t write, “Jesus Christ, can this child not smell himself?”

Reframing, a social worker’s annoying best friend, sometimes helps. When my teen girls went on a tangent about why Justin Bieber is hot (I felt like I was going to get put on an FBI list just for being present for that one) I explained it as them sharing qualities they admire and would like to emulate in one of their role models. Apparently the Biebs has been through a lot?

When a mother was listing her strengths as a conference and said that, “Don’t nobody fuck with my kids. They get what they need,” we were able to note that as the mother being an excellent advocate and provider.

There are occasions when this doesn’t work. I was at a meeting once that a mother would not allow to end until it was noted on her service agreement that, “I want ACS out of my fucking life.” The poor worker tried to compromise several times, but mom wasn’t hearing it. Finally, a comic strip style #$%! had to suffice.

Sometimes, when more than one agency is involved in a case or when a family is transferred, we have to read things that other people write. That’s when we wonder how it’s possible that we were hired for similar jobs.

Not everyone is a good writer. Ask a teacher. Most people can barely write a clear sentence. How to write a proper progress note, at least in my experience, is something you’re expected to learn in the field. It’s not formally taught in Doggie Day Care social work school. Some people get too wrapped up in writing a narrative, detailing everything from what cartoon characters were on the kids’ shirts to what was blaring on the TV in the background. Others think mentioning that no one was on fire or bleeding to death is sufficient.

Some are just simple mistakes. It seems wrong that “now” and “not” are so similar. “One of the family’s strengths is that the child is not going to school regularly.” What’s wrong with you? Oh, the child is now going to school regularly. “Mother is concerned that the children’s father is now abiding by the order of protection.” That is bizarre…or is he not abiding by this? Why does this keep happening to us?

Some are mistakes that seem to require effort, in order to be so wrong. What are the odds that the parents both have the last name Jones, and their children all have the last name Tones?

Some errors go beyond poor execution or a rushed job. Those notes are the stuff of legend.

“This child is being denied the BEST OPPORTUNITIES EVER!!”

This was written by a worker who transferred a case to me, who was concerned that the parents were taking advantage of a scholarship their high school age daughter was being offered. Caps lock, and stacked punctuation. Here’s a tip: exclamation points are rarely appropriate in a progress note or service plan. I can’t even get into the stunning hyperbole.

“CPS told mom that she has a lot of work to do, so get chopping.”

Never say this. In person, or writing. No.

“This worker suspects that the preventive worker is not accredited and qualified to provide play therapy.”

Writing this in a database the preventive worker has access to is essentially using that database as a Mean Girls-style Burn Book.

“Mother shared that her childhood was not all cookies and cream.”

Bummer. That would have been a delicious childhood.

Progress notes are a necessary evil, of course. Without them, transferring a case would be pretty impossible, and it would be a lot easier for an unscrupulous worker to go to Dunkin Donuts while claiming to be out on a visit. (Not that I’ve ever contemplated this.)

And they can be entertaining. Maybe next time you’re working on a note, slip in a little humor for the next person reading it. Silly, unnecessary caps lock, or throw in a “stop reading, it’s a trap!” midsentence. Your supervisor will thank fire you.

How clean is your house? Can we use scaling?

5 06 2012

As we social workers know, all problems can be solved by red wine more paperwork. Are we not addressing culture enough? Ok, we’ll do a special cultural note once a quarter. Is there a problem getting kids’ attendance records every marking period? Add a checklist to each file! It’s never failed. (Except for all those times it’s failed.)

At some point, it was decided, probably by a cranky auditor, that we weren’t focusing enough on safety in the home. As in, the physical environment. Food in the home? Appropriate place for everyone to sleep? Any rooms on fire routinely? That should be addressed.

As a result, we got a checklist.

It looks pretty straightforward. At first. But is anything straightforward in social work? No. (Ok, just that question.)

I have a bit of experience in this area, from when I interned working with homebound senior citizens. We always had to assess the home for safety, to ensure that these people really were all right to be living on their own. You would note that they had rails in their shower, one of those toilet booster-seat-type-things that meant that I could never use my Gram’s bathroom, and things like that. If we thought they were at a point when they really ought not be living on their own, there wasn’t all that much we could do, but dammit if we didn’t document.

Some of the same safety factors carry over. There are the standard things we look for, starting with smoke and carbon monoxide detectors. Isn’t it great that carbon monoxide detectors are expected now? I mean, my family always had one, because I watched an episode of Rescue 911 when I was eight in which an entire family nearly died, and I camped in the backyard until my dad bought it.

Anyway, these are things that landlords and managment companies are supposed to provide. In my entirely correct and unbiased opinion, landlords and management companies are terrible and seek to do ill, so this isn’t always done. We might need to note that the detectors aren’t present, or aren’t working. Did the family request a new one? Did they check the battery? Well, the ceilings are high and the don’t have a twelve foot ladder. Whose responsibility is this? Wasn’t this just supposed to be a checkmark!?

We move on. Is there adequate space and privacy for everyone?

The short answer, especially if you talk to the teenagers, is no. (Personally, I bitched about my room being too small from the time I could talk until I moved out to share a much smaller college dorm room which I loved.) Most of our kids share rooms. I’ve worked with multiple families who have lived in a one bedroom apartment. So no, space isn’t adequate, and many of the girls I work with lock themselves in the bathroom for a few minutes of privacy.

But you don’t just say that. You talk about how the family makes “good use of their space” and throw in the magic words “bunk beds.” The place looks a bit like a Dickensian orphanage, but everyone has a place to sleep, and what else are they supposed to do?

Then we get on the the trickiest question. “Is the home neat and clean?”

Well, by whose standards? If my boyfriend were judging, the answer would just be yes. Every time. Perhaps a “maybe” if there the dishwasher was overflowing with dirty clothes. If it were my grandmother, it would be “absolutely not,” every time, because she would just know that you hadn’t really vacuumed under the furniture.

For me, it depends on the day. I usually think if how my apartment looks. If I’ve just gone on a cleaning spree, I might judge a bit more harshly. Why didn’t you dust your TV screen, eh? Mine is positively shiny. If I’m in that phase where I’m trying and failing to maintain the cleaning spree, I’m more sympathetic. Yeah, I know how annoying it is to keep putting every single thing in its place, every single time. If I’m at a point where I keep coming up with excuses not to put away my clean laundry, or turn on the vacuum, I write that the client’s home looks lovely, hoping to hide my shame.

It’s always relative, and it’s always about how people manage. When I worked with seniors, we had some borderline hoarders. This was before that horrible TV show where they’re always finding dead roosters in people’s homes, but I did encounter stacks of newspapers that I’m fortunate I wasn’t crushed beneath. If a person was really unsafe, then of course we’d do what we could to address that. But a lot of our job was to figure out how they made it work. They set up pathways that they stuck to, their kids came over once a week and left with garbage bags full of old junk, and the elderly parents allowed it on the condition that they weren’t told what was taken.

It’s all about the story. Maybe the home is super clean, with nothing out of place. You can’t even tell kids live here! Oh, maybe that’s not the best. One of the moms I worked with prided herself on keeping up her apartment, until one week it was such a disaster that even I judged. It got us talking about what was going on with her, and the fact that she was having a hard time with her depression again. That’s the thing–it was about what a messy house meant to her, rather than what it meant to me.

“Is the home neat and clean?” is a loaded question that I’ll never be able to answer properly, at least not by ticking one of two boxes. Filling out a checklist like that makes a lot of us feel judgmental, or like we’ve been handed a copy of “Social Work for Dummies.” And it can be this way, if you let it. Those kind of forms, lame as they are, really are not the worst starting off point, though. Everything in social work is about drawing out that narrative. I’m not just going to count how many bedrooms you have. The kids and I will talk about what sharing is like and how they manage it. I’m not just going to check for window guards, we’re also going to talk about what safety means to you and if your landlord is as big a jerk as mine.

Yeah, it takes me a long time to get those assessment forms done.

SWAAFI (Social Workers Against Acronyms, for Irony)

17 06 2011

In high school, my friends and I went through the early motions of starting an official group called, “SAA: Students Against Acronyms.” We thought we were smart and funny. I’d say we were half right, but it seems like a bit too much credit. We were also lazy, so it never got off the ground.

Little did I know that my future would be AF. That’s acronym filled, for those of you not in the know.

Social workers, or SWs, as I refer to them in my progress notes, simply adore acronyms. We use them in the referral process, in writing up intakes, assessments, and service plans. That all makes sense. Condense everything as much as possible, because we’ve got enough to talk about.

Family was referred by ACS (Administration for Children’s Services) following a CPS (Child Protective Services) investigation. BM (Biological Mother, not Bowel Movement, though it always makes me giggle) reports a history of DV (Domestic Violence) with BF (Biological Father.) MGM (Maternal Grandmother) took custody when children were placed in FC (foster care.) BM (tee hee) denies a history of MH (Mental Health) and SA (Substance Abuse.) Contact information for the children’s GAL (Guardian Ad Litem) is included.

Oh dear. So much work to be done. I’ll have to include it all in my FASP (Family Assessment Service Plan.) What if BM (sorry, it’s still funny) wants to pursue a PINS (Person In Need of Supervision) warrant on the oldest teen? Is the family receiving PA (Public Assistance)? BM (OK, I’m done) is attending a BTW (Back To Work) program, but she missed a few days because her ACD (I honestly don’t even know) child care voucher didn’t come through. If they’re sanctioned, she might need an EVR (Eligibility Verification Review) and that’s a huge pain in the ass. Are they asking for a PE (Psychiatric Evaluation) for any family members? Did we talk to the CM (Case Manager)? Or was it the CW (Case Worker)?

Do any of the children identify as LGBT? Is the family going home to DR for the summer? Do the kids know their ABCs? Are they posting on FB? Do I have time to stop for cash at the ATM? What did I get on my SAT?

After a while, you start to go a bit mad. (We all go a little mad sometimes.)

Using these acronyms says something. It says, hey, I’m busy and important! I have things to say, and very limited time in which to say them. It also might say that you’re well-versed in the world of Twitter.

The acronyms say more than that, though. As I’ve said, social workers are insecure and annoying. Speaking in jargon lets people know that we know the system. I am a professional, dammit! I know what I’m talking about. Oh, you have to ask what PINS or CASAC means? I’ll explain it. And you will recognize that I know more than you.

This sends a message, and often not the message we want to send. I’ve seen workers, social workers and protective workers, or psychiatrists and case managers, or any other variation of well-intentioned helpers, talk in circles in front of their clients. Most of the clients we work with know public assistance lingo. They often know some child protection speak, as well. Odds are, they aren’t familiar with all of it, though. Public assistance, child protection, mental health…it’s a lot of language to be up to speed on.

I felt incredibly out of place when I first started in this field. I thought I sounded like an idiot when I had to ask what one of these things meant. I try to keep that in mind, before I drop initials on a client. I can’t stand when doctors prattle on in medical terminology about…whatever it is they do (I don’t often go to doctors, but I did watch ER) and act like a patient who never saw the inside of a medical school should know exactly what they mean.

I think it does us all well to remember what it’s like to feel like the newbie, like the dumbest person in the room. Some of us feel like that more often than others, but that’s not the point. There are reasons we sound like this sometimes. Sometimes it becomes second nature, sometimes we want to sound like we know the drill, sometimes we try to make ourselves look better than an obnoxious worker, or someone talking down to us.

But sometimes, being so comfortable with the jargon shows how comfortable we are on the inside track, which makes others feel that they’re on the outside. Sometimes making ourselves look better makes someone else look worse.

SA, DV, MH and the rest aren’t technical terms, but they are confusing when you’re the new guy, as a worker or a client. And to be honest, since we’re all friends here–they’re kind of obnoxious. Occasionally, they make us sound like a bunch of douches.

So please, join me in fighting back. Talke back entire words along with me. I’ll be emailing out an invite to SWAAFI later today. Let me know if you want me to CC you.

Soapbox, high horse, whatever you call it, here I am.

11 04 2011

I’ve hesitated to write about the Marchella Pierce case, in which two ACS workers are being charged with criminally negligent homicide. I’m not a lawyer. I’m not well-versed enough in the law to decide what constitutes manslaughter vs. criminally negligent homicide vs. murder, first or second degree whatever. No matter how much Law & Order I’ve watched.

But I am a social worker. So there are some things I can comment on.

This was the case of a medically fragile four year old, who weighed fifteen pounds at the time of her death. (I weighed fifteen pounds at about four months.  True, my family produces fatty hearty babies, but still. At four years old, that’s bad.) ACS was involved with the family due to the mother’s drug history and the child’s medical condition. Mom called the police after her daughter had been unresponsive for about an hour. The child had marks that indicated she had been tied to the bed and beaten. She died in September of 2010.

All around, a tragedy. Of course. And, of course, people are looking for someone to blame.

What’s unique here is not that the child protective agency is being blamed. That happens whenever a child dies from abuse or neglect. What’s unique is that they are being held criminally responsible.

In six months, from March through August, when the ACS caseworker was meant to be conducting biweekly visits with the family, he entered two contacts in the city database. One was a phone call in March. The other was an (unsuccessful) attempted home visit in June.

After the child’s death, he and his supervisor miraculously recalled five other contacts he had with the family, and entered those. What we ethical fucking human beings social workers call, “falsification of records.”

I decided to write about this topic after reading many other people’s reactions. One concern that’s been brought up many times is that fear of criminal prosecution will keep people out of the profession.

Guess what? I’m ok with that. This job is serious. I am not being dramatic when I say that child protective workers have children’s lives in their hands. This man did not take his responsibilities seriously. This child was at risk of death. This isn’t a case of hindsight being 20/20. This isn’t a situation in which no one called the abuse in because they didn’t want to get involved. This was a malnourished child who had visible bruises and rope marks on her body, who had a team of people assigned to protect her.

They failed.

Some people say that the system failed. I’m not often trying to defend our child welfare system. It’s deeply flawed. But this is not an example of that. This is an example of deeply flawed workers.

Six months. Without seeing this child. An eighth of her life.

We hear about these workers being overwhelmed. They’re claiming that they were so overwhelmed and busy that they forgot to enter all of the contacts with the family, but they did, in fact, see them.

Sorry, but that’s bullshit.

The opinion piece I linked to above talks about the need to appreciate the improvements that ACS has made, especially since the death of Nixzmary Brown. Caseloads are smaller, they’re trying to recruit better workers (they make more money than I do, with less education), and more referrals are being made to quality preventive programs.

They’ve got a long way to go, but these points are true. New York City child protective workers have an average caseload of ten. People in other parts of the country would kill for that. I would kill for that. Yes, it’s a difficult, thankless job, often dangerous, with crazy hours. But it’s doable. I have met a lot of CPS workers that I wouldn’t wish on my worst enemy, but I’ve also met some wonderful ones. CPS workers who are dedicated, knowledgeable, and put children first. The idea that this worker only had time to enter his contacts after the death of this child is ludicrous.

Sometimes people fall behind. There is a chain of command, supervisors on top of supervisors, for this very reason. Someone is looking over your shoulder, insuring that things are getting done as they’re supposed to.

Meaning that the supervisor in this scenario failed miserably as well.

Falsification of records happens. It should be unheard of, but it’s not. I’ve seen it. I’ve reported it. And I’ve seen that worker kept on their job. It’s inexcusable. It’s the one thing (well, one of very few things) my supervisor tells us she will absolutely not defend.

Because this is what it can lead to.

What can we learn from this?

  1. We need to take our jobs seriously. Social workers, child protective workers, investigators, preventive workers…we can be the last hope for a child in this type of home.
  2. We can’t defend others just because they share our profession. Our first instinct is so often to stand up for our fellow workers. But in cases of ethical violations, especially when they lead to tragedy, we owe it to the profession not to do this.
  3. Supervisors cannot become so overwhelmed or detached that they ignore their responsibility. Even if their direct contact with clients is limited.
  4. DON’T FALSIFY YOUR RECORDS. It will never be worth it. Some people are told to do this by their supervisors. Some people feel pressure to do this in order to make their numbers. But it’s inexcusable. There aren’t a lot of things I will say that about, but this is one.

So I don’t see this case as an indictment of ACS, or the social work profession. I see it as an indictment of two people who failed to do their jobs, which contributed to the death of a child. A child who was clearly at risk, and should have been protected.

A child who would probably be alive today, if those smaller caseloads had been taken advantage of and those stricter requirements followed.

It’s something we all need to keep in mind.

Honesty is the best policy. Right?

7 04 2011

I’ve written about my love of progress notes before. Truly, nothing gives me greater joy than reliving a session, remembering who was there, why we met, what I planned to discuss, and how everything was derailed what was accomplished. I know I speak for all of us.

Sometimes, though, I feel like I’m being dishonest. Reading my notes, or the notes of other workers at the agency, you get the picture of a calm, collected social worker, in control of the situation at all times.

I don’t lie. I just don’t use direct quotes. (I don’t have to do process recordings ever again, and you can’t make me.) I don’t include my hesitations, my random stutters, or perhaps the occasional look of fear.

What would an honest progress note look like?

“SocialJerk conducted a scheduled home visit with the family. Visits have been scheduled the past two weeks, but no one was at home for these. This visit was conducted in sheer desperation and with little hope for a positive outcome.

SocialJerk apologized for being late, which the family thought was weird because she was supposed to be there at 4:30, and arrived at 4:33. SocialJerk needs to chill.

The children were appropriately groomed and dressed, for the most part. Teen 1 is doing some kind of experiment with his hair, and let’s just say it’s not working. Braids were his friend. Toddler 2 didn’t have pants on, but SocialJerk supports freedom of expression within the home. Also, no marks or bruises were observed, except for “Bitch” written in (magic, not permanent) marker on Teen 2’s hand. Eh, kids are weird. Mom was in jammies, which is a little odd considering it was so late, but she’s grown and can do what she wants. Also, they were Tweety Bird PJs, which is kind of cool.

The home was neat and clean. Well, by SocialJerk’s standards. You should see that bedroom. SocialJerk needs to keep up on her laundry, but it’s hard to always have enough quarters. SocialJerk digresses…

The TV was on. Mom was kind enough to reduce the blaring volume, but left it on Oprah. SocialJerk was mesmerized by the topic of suburban housewife prescription drug dealers, and had to request that it be turned off. This did not go over well. SocialJerk pretended not to notice.

We discussed the children’s absentee fathers. Mom tends to blame them for the teens acting out. Mom also blamed the teens falling in with the wrong crowd. SocialJerk attempted to introduce the idea that Teen 1 and Teen 2 are the wrong crowd that the other parents are blaming their kids’ bad behavior on. However, SocialJerk was distracted by Teen 2 calling Teen 1 a “fucking retard” and Teen 1 threatening to set Teen 2 on fire. SocialJerk had a moment of panic and considering making a break for it out an open window. Cooler heads prevailed and SocialJerk reminded the teens of our anger management techniques. Teens clearly humored weirdo SocialJerk, which is enough for her.

Toddler 1 tripped over the carpet. Teen 1 and SocialJerk laughed. Toddler 1 insisted that it was” not funny,” while SocialJerk pointed out that it was, in fact, a little funny.

Wacky Neighbor popped in and spoke rapid fire Spanish, clearly not wanting SocialJerk to follow. SocialJerk nearly got a contact high from his jacket. Wacky Neighbor left, and Mom apologized. She then took a phone call. SocialJerk enjoyed her Notorious B.I.G. ringtone. Brooklyn represent.

We got back on track and discussed Teens 1 and 2 and their attendance. They missed two days last week. We celebrated this as a victory, which SocialJerk secretly felt sad about. Teen 2 then said she had something she wanted to share with SocialJerk. SocialJerk was terrified that she was going to be presented with a positive pregnancy test, until Teen 2 produced a science test with an 86 at the top. SocialJerk praised Teen 2 as if she had cured polio. Mom rolled her eyes and SocialJerk encouraged her to be proud of Teen 2, while thinking that Mom was kind of being an asshole. SocialJerk then remembered the time Teen 2 stole Mom’s credit card, and cut her a break.

Next steps- SocialJerk will plan to see the family in the office next week. SocialJerk will call in vain to remind them, but their phones will be disconnected. SocialJerk will be tempted to Facebook Teen 1 or 2, but recognizes that would be inappropriate. SocialJerk will ultimately conduct more home visits than necessary, to ensure that contact is made, and will question the therapeutic value of her work, which will lead to a personal existential crisis.”

I think it could work.

This is what you get for lack of IT.

17 12 2010

All right, loyal readers, friends, Mom. We’re due for an update, but computers are down office-wide. So this is my first ever post coming at you from my phone (hint-it was the Droid I was looking for.) I apologize in advance for any autocorrect errors that might turn participants into presents, or groups into gropes.

But it got me thinking-this is a pretty regular occurrence. What else happens so often in this field that you can pretty much count on it? Add to that the fact that we’ve got our agency Christmas party this afternoon, and I saw only one option-SocialJerk drinking game. (Completely different from ghetto bingo.)

Let’s get crunked up.

  1. Computers go down- take one shot.
  2. Computers go down during the only free time you blocked off for writing notes- take two shots.
  3. Client is late-one shot.
  4. Client shows up at a completely made up time-one shot.
  5. Client is right on time-call me and I’ll take you out for a drink, so you can teach me.
  6. Distressed coworker calls the office for directions, after getting lost on the way to an initial home visit-one shot. If you manage not to laugh at them, treat yourself to a beer.
  7. A public assistance or child protective specialist is rude to you- a shot, plus a beer to share with the cranky worker. Maybe that will help?
  8. A parent or referral source seems to be under the impression that you have magic powers and will “fix” difficult children- a six pack should do the trick
  9. You get a nervous call from your mother, because you forgot she follows you on Twitter and posted about being harassed in a sketchy neighborhood- a bottle of wine, to be split with Mom.
  10. A little kid cracks you up, by saying something hilarious like “I’m the best!” or “I love marine life.”-the joy of a child’s laughter should be enough. If not, take a shot.
  11. You find out you can still be surprised- have a Flaming Dr. Pepper. (This was a SocialJerk college specialty, email me if you need details.)

All right. Computers are back up and running, so it’s time for this Jerk to be on her way. Happy drinking, and try not to slur in your progress notes!

How to put off writing notes? Writing blog entries!

2 11 2010

I love writing. It’s kind of why I do this blogging thing. I was worried, when I started social work school, that I wouldn’t have time to write anymore. But I was wrong.

I just don’t have much time to write things that I like.

Most social work job listings (not that I’ve been looking) specify that they are looking for someone with good writing skills. I don’t think most people think of this as a field that requires tons of writing.

Let’s all take a minute to laugh at those people, shall we?

Document, document, document. It is the social work mantra. (Well, that and “be nice to each other.”) If you’ve written it down once, surely that isn’t enough. At my job, we have one computer system where we enter contacts that we have with clients. Seeing them in the office, seeing them on home visits, running into them in the bodega (seriously) it all goes in. Along with the purpose of the visit, who you saw, how long it went for, and if anyone looked fat.

Then you get to write progress notes. Every social worker’s dream. (Did a chill just go up anyone’s spine? Just me? Oh, OK.) This is where you record everything else. Did you see the kids? Did any of them have marks or bruises? How was everyone dressed? What did you talk about? If you were in the home, was it clean? Was there food? Why were you there? Type faster, dammit, you’ve got four other people to see today!

I’m beginning to suspect that my computer judges me when I take too long to get my notes done.

Notes can be difficult. It’s like reliving a session. Sometimes, this is fine. We played with play-doh, talked about how we feel about Deadbeat Dad, and drew a picture of an angry monster.

Sometimes, it’s not.

Hmm, what happened first? Well, I think the teen revealed that she had a girlfriend. Then mom screamed at her. Then the teen stormed out. Oh no wait, first she told her mother to “fuck off.” Never mind, she stormed out, came back for her jacket, then told her mother to fuck off.

Am I allowed to write “fuck” in a progress note?

It’s better than social work school, though. In social work school you have a smaller caseload, because you’re in the office for fewer days, but you are still expected to do all the usual documentation. With one additional assignment.

PROCESS RECORDINGS. (OK, I know you all felt it get colder in here that time!)

Is there anything worse than a process recording? Really, one thing, aside from waterboarding?

For those who might be unfamiliar, there are some variations, but here are the basics. One starts off a process recording by making a nifty three column chart. This is where the fun ends.

The first column is where you write what happened in the session. Not bad, right? We do that in the progress notes!

Oh, you poor, naive bastard.

Process recordings are verbatim. Write down word for word what was said in that 45 minute meeting. And don’t leave anything out! You think it’s unimportant, but what the hell do you know? The kid interrupted you? Interesting. The dad needed a bathroom break? Was this before or after you brought up depression screenings? How long was he in there for?

The second column is where you write about the therapeutic interventions and theories you were using. “Yes, that was one of Minuchin’s techniques.” “I brought in CBT to the process.” “I’m going to say this was Freudian, but I’m pulling that out of my ass.”

Then in the third column, talk about how you were feeling while all of this was going on. “I was nervous when she brought this up.” “I experienced some counter transference at this point.”

It’s all so social work-y I could die.

The real fun happens when your supervisor goes over it with a red pen, tearing your work apart and convincing you you’ll never have a clue as to what you’re doing.

But thank goodness we get beyond that. I’ve grown into such a confident, competent, worker.

No time to write about it now, though. I’ve been working on this same note for three hours, and I’m having an anxiety attack about handing it in.