Tools of the Trade: Soft ware for Counselors
Dominic's barbershop is a traditional establishment. Technology is sparse. There is one rotary phone, a TV stuck in the corner, power clippers, and a couple of hair dryers. The barber pole does not spin. The two barbers cut hair, comment on the weather or politics whichever is more volatile on a given day and toss out magazines dated prior to 1993. This was the backdrop for a fascinating conversation between a technology advocating patron and the venerable owner.
The technophile droned on about the virtues of making appointments on-line, tracking customer visits and preferences, building mailing lists, generating financial reports, offering computer simulated hairstyle demonstrations, and creating a web page. The barber answered each bright idea by either pointing to the pad of paper on the counter, the oversized calendar hanging on the wall, or by just shaking his head. The one-sided exchange ended with Dominic's statement, I've been cutting hair for over 20 years.
I think I can make it to retirement without ever touching a computer. Something told me, the eavesdropping customer in the next chair, that this barber had just uttered the last word. As a Christian counselor in contemporary practice, I can identify with both sides of the debate. Counseling is a person-to-person, high touch, and relationally rich profession. Its priorities revolve around service to people. When high-tech applications are introduced, there is not necessarily a positive correlation with improved outcomes. Enough effort is required to monitor and integrate the client's intricate physical, emotional, mental, and spiritual dimensions without adding complicated software to the interaction process. Yet, counseling is not giving a haircut. The ever-increasing expectations for assessment, accountability, and productivity make technology and other tools more attractive to and necessary for clinicians who intend to stay in the work for the long haul.
Due to my vicarious learning experience in the barber's chair, I am going to avoid discussing software applications where the primary appeal is to offer counseling or administrative tasks slicker and quicker. Numerous software and technology options exist that can improve marketing efforts, increase communication, or institute timemanagement procedures. The possibilities may seem overwhelming, butsome applications are worth mastering when a practice or practitioner needs to streamline a particular area. The multi-site, multi-counselor practice absolutely needs smooth communication systems to enhance responsiveness to client requests as well as to manage clinical and financial data. The practice specializing in a certain type of psychological evaluation will benefit from obtaining the most advanced tools to fulfill the task. Keeping current on practice related research can be accomplished through searches on an Internet database. 1 Such options are available and useful but will not be covered here.
There will be no pressure toward practice expansion or passionate challenges to take on new ventures. All that follows has been subjected to the following screening question: How would this idea go over in Dominic's barbershop? My goal is to suggest only a few tools of technology to keep Christian counselors vital in the work of soul care until the season arrives to retire, the Lord supplies a call into a new work, or he returns. Ideas offered here have passed the barbershop criteria: Is it sensible, simple, and straightforward? Three categories will be covered: (1) tools to assist counselors in seeking out or sifting through client information; (2) software to help strengthen the quality of clinical work by increasing depth or tracking details; and (3) applications that allow counselors to sleep easier and more restfully.
*Seeking and Sifting Information*
The classic definition of a psychological test is a sample of behavior which is assigned a value for measurement purposes? The basic theme in assessment is to collect adequate, relevant, and representative samples of behavior in order to make predications or statements about future behavior or patterns. In order to obtain these samples, it is not necessary to bury a client in endless questionnaires or condemn the counselor to tedious reading and scoring. Some form filling or checklist completion might be useful, but here is where the counselor may wa make use of available technology and developed counseling tools.2 For example, the Quick view Social History available through National Computer Systems (NCS) can be administered in an on-line format and printed in about the length of time allotted for a standard session.
The resulting report organizes information on personal history into nine major areas and provides a basic symptom screen to the clinician consistent with the standards of the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). The clinician can review this information prior to the next session and pursue face-to-face matters that need clarification and elaboration. Add additional clinical notes, make any necessary changes or deletions, sign off the report, and it is now ready to enter into the clients chart. A complex clinical procedure has been accomplished in a cost, time, and energy efficient manner. Notice that a computer generated report never becomes part of the clinical record without the counselor's careful scrutiny and approval, because it is the counselors report. After using such an approach for years, client feedback has been extraordinarily positive as direct contact time is more focused and productive.
The client has been helped to selectively communicate samples of confusing but necessary information. Using material gleaned through a personalized intake session along with the automated procedure, the clinician is ready to decide if additional assessment would be useful while the direction for counseling is being determined. If more data on symptoms is needed to support medical necessity of treatment, a checklist such as the SCL-90-R (NCS) might be useful. The seeking- and sifting-process using the assistance of technology may continue through the use of specialized scales or questionnaires to get a clearer picture of possible substance abuse, symptoms of depression, or career interests.3
Such assessment tools, usually of the self-report variety, supplement critical data obtained from personal interview and organize information in formats that make goal setting, progress evaluation, and outcome measurement manageable.4 Many tools that were once time prohibitive with hand scoring are worth a look now that computer assisted administration and/or scoring makes the task easier. If the tool meets applicable validity standards and has clinical utility, which means it adds useful information that can enhance treatment, check to see whether new technology makes its use a viable option.
*Strengthening Quality*
Today, the benchmarks of quality counseling typically center on three broad areas: appropriate evaluation relevant to the referral request to formulate a conceptualization of the issue for and with the client; a reasonable, planned approach to treatment, using interventions known to address identified concerns; and evaluation of client progress and the effectiveness of the services supplied. Christian counselors seek to address these matters in a manner that is consistent with the Scriptures and that honors our Lord. It is recognized that as those in a position of responsibility for guiding others, Christian counselors will be accountable to our Lord (James 3:1).
In addition, the practice standards of our field require that we also follow professional conventions. This means that documentation of the counseling encounter through the clinical record is essential for demonstrating that the counseling provided was done according to generally accepted guidelines. It is my view that in today's service climate, the quality of counseling services is strengthened when there is meaningful depth and purpose in the person-to-person interactions with sufficient detail documented in the clinical record. There are tools that may help add depth to clinical work. Here the term depth is being used to signify counseling efforts aimed at increasing client self-reflection, enhancing interpersonal relationships, or identifying and/or modifying long-term issues or concerns.
It is important to note before proceeding that not every client, request, or counseling situation needs greater depth.Thus deeper is not necessary better. Rather, ask what God might be seeking to change or accomplish through this counseling encounter. How can the counselor best fulfill this task, given the assigned counseling role and setting? These questions enable the counselor to determine where to target exploration and interventions.
Staying within the barbershop criteria, there are two suggestions to consider if the counseling context of your practice calls for more depth. Personality assessment has been a staple in psychological practice and counseling work for decades.5 Theoretical differences, controversy over the appropriate use of psychological testing with certain populations, or cost-cutting endeavors may have diminished enthusiasm for using such measures in clinical practice. However, personality tests have been steadily undergoing investigation and revision, while technology has made access to the information these measures yield more accessible to clinicians.6 As professionals we need to evaluate both the measure and the application carefully before use, just as the various ethical codes require. As evangelical Christians, we also need to recognize the values and implications implicit in these measures. Just as Christian clinicians take care to monitor ideas brought into the counseling room, the same discernment is necessary with the tools we use. Consider the biblical principle on the use of honest scales and balances found three times in the book of Proverbs (11:1; 16:11; 20:10), with its roots in the law (Lev. 19:35-36).
In the marketplace, when buying food or fabric, the transaction was based upon an established price per standard measure. God warned his
people not to follow the deceptive, but at times culturally acceptable, practice of using standards or scales known to be off in a given direction. This would create the illusion of honesty, when the entire procedure was only a sham for stealing and leaving the victim unaware. Buying and selling in Gods economy was to be an honest exchange, not a charade to take advantage of someone else. Based on this principle, when Christian counselors appeal to an objective or scientific measure, it is our responsibility to make certain that we understand its limits and the appropriate applications. Only when clinicians are ready to make a fair use of balanced tools can we use these methods without manipulation and with integrity to serve our clients in the name of the Lord. Therefore, clinical measures with potential for identifying psychopathology such as the Minnesota Multiphase Personality
Inventories or the Million Clinical Inventories may find their way into use depending on the setting, purpose, and training of the counselor.7 These can be easily administered and scored using fast mail-in services or through computer-assisted options. One tool, which I believe is undervalued in Christian practice and may add depth of insight into personality patterns, is the Sixteen Personality Factor Questionnaire (16PF). It is available in several forms, has an extensive research base, and was nor med on a non-clinical population, which is particularly attractive for many settings.
The fifth edition 16PF has eliminated the complex scale labels found on earlier versions, and I would describe it as a counselee friendly measure. The computer generated couples counseling report for the 16PF is worth a look by those who do marriage counseling. When a counselor determines that using a rating form or personality measure would add information useful for treatment planning and service delivery, the next step is to evaluate how frequently these measures will be put to use. The occasional user may benefit from using mail-in answer sheets, while the regular user may want to take on the expense of setting up a computer on-site for administration and scoring. Some software programs may be purchased that provide unlimited use of a measure, but most testing options have a per-use fee. The per-use option is usually less expensive for the occasional user. In most office applications, it is best to designate a separate computer for test administration. Having clients work on the same computer that contains clinical records can be done in a way that protects confidentiality, but such a procedure may not communicate such boundaries. There is another set of tools available in hard copy or interactive software that may add depth to the treatment planning process.
There are now at least a dozen treatment planning guides published by John Wiley & Sons that offer extensive information on treatment plan design for specific presenting problems. A few sample topics are: couples therapy, chemical dependence, group therapy, pastoral counseling, and family therapy. If you simply want a sourcebook to assist in the wording of presenting problems and selecting appropriate treatment goals, look at the guidebook that applies to your area of interest. Each of these planners is also available as a software add-on module to the core treatment planning program called The ascribe. The program objective is to assist clinicians in developing comprehensive treatment plans in printed form for outside accountability. In my review of this software in the summer of 1998, I found that after practice and orientation, it did add diversity, creativity, and precision to my treatment plans. However, I did not find the software to be a real time saver for a clinician already experienced in writing treatment plans. In addition, the software required establishing another database of clients, and that additional time commitment did not seem productive unless this software was also going to be used as part of the overall practice management system.
There are components that can be linked to The ascribe to turn it into a complete system. The purpose here is not to provide a thorough review, only to indicate how the clinician needs to discern his or her own strengths along with ways of doing practice before adding new procedures into client care. There is terrific information in these treatment planning guides, both in the hard copy and software that would take years of experience to reproduce. The software system is a powerful addition to deepen and document treatment plans yet will not be a match for all clinicians. It certainly has significant educational potential for new counselors.
Getting the myriad details of counseling plans, interactions, risk factors, and progress notes into a treatment record can become a burdensome duty and increase burnout unless the counselor has a good system for record keeping. There is no compelling reason to move to a client management software system if the paper/pencil or basic word processing format is getting the job done. Software systems designed for counselors do offer advantages because built-in prompts structure progress notes or allow for the quick insertion of checklists. Some of these procedures could be incorporated into more basic formats. Consider the use of a template for a standard mental status exam, which could be included as a file in a word processor or just printed out as a handy form ready to be completed.8 Having this ready to use or insert can save time and make the difference in documenting such observations at regular
intervals. Following is an example of an integrated client management software system that can be a huge help in maintaining an up-to-date clinical record.
Option by The Psychological Corporation is a sophisticated program with some high-level features, and therefore, it barely squeezes past the barbershop criteria. The setup and start-up commitment cannot be fairly described as ‘simple, since this is actually a subscription service that requires a monthly connection to update the software along with the built-in assessment features. It does have several standard assessment measures built right into the program. Once it is up and running, a steep learning curve must be factored in because it will take some work to gain familiarity with what options are available. The format itself is easy to follow, with the
inclusion of many templates and drop-down menus such as those for intake assessment, social history information and treatment plan generation. One attractive feature is the way it assists in formulating progress notes and goal tracking. The options for rating goal-level attainment after each session, with the potential to pull ratings over time into a graphic presentation of progress, is the type of outcome assessment feature that will become common practice in the not too distant future. Once the clinician becomes acquainted with this system, the features it offers fit well with routine practice.
*Sleeping Soundly*
In my early counseling days, some of the most dreaded phone messages were not client crisis calls but requests for information or billing records. A client who finished therapy eight months earlier phoned and wanted a complete, itemized account statement for tax preparation purposes. The information was obtainable but going through the receipts took time. Phone disputes surfaced with insurance companies over explanation of benefit (EOB) notices, which required going back?
through dates of service and payment records. A request came from a fellow counselor beginning work out of the area with a previous client and who expected a written summary of treatment. These common tasks needed to be transformed from major inconveniences to matters of doing everyday business. Hiring staff helped, but only limited hours could be afforded. Also, even office staff need good recording systems to manage information. This is where practice management database software is extremely useful.9 An example of such a system is The Practice Manager with Shrink from Multi-health Systems (MHS). This program has features for tracking clients, recording progress notes, billing management, accounts receivable, and producing insurance forms. It has built in DSM-IV and clinical procedure terminology (CPT) codes.
There are safeguards to protect confidential information and passwords to restrict access. Having all the typically requested information at ones fingertips in a central database is not just a dream come true, but it also allows for pleasant dreams instead of nightmares. It cuts out unnecessary worry about who is going to want what and when. The information available can be recalled when necessary. The use of such a system must work naturally into clinical routines. This might mean posting payments/ charges at the time of service, doing progress notes throughout the day, and closing client records with a summary of care. There are times when catch-up is required at the close of the day or at weekly times designated for clean up, but most information management is
seamlessly integrated into clinical practice. Having this done allows for more restful sleep. Another word from experience: Adoption of a practice management software system is a decision one will live with for
a long time, since conversion to a new system once the database is off and running is difficult and costly. Investigate your options fully and pray fervently.
*Keeping the Razor Sharp*
Last spring, I found my grandfathers old straight razors, left over from his days as a barber. I brought them into Dominic's shop and asked my barber if there was a way to sharpen them and put them into use. He laughed and showed me his new, up-to-date straight razor with replaceable blades. New blades keep it ready for use. He told me about what he does to keep his other cutting tools in shape. I was warned to keep my dull antiques in a safe place but not use them. This barber had some good advice. I noticed that when it comes to keeping his barbering tools ready, he stays on the cutting edge. There may be no software in his shop, but a good haircut requires sharp tools. A sharp Christian counselor is one in right relationship with God. But in your hearts set apart Christ as Lord. Always be prepared to give an answer to everyone who asks you to give the reason for the hope that you have. But do this with gentleness and respect (1 Peter 3:15). Online counseling is always available to help you out.
Software does not keep us ready to provide good soul care only walking close to the Lord can do that. There are no quick ways to gain wisdom or insight into people helping. It is a complex ministry. These ideas about a few contemporary tools are for use to stay current and fresh in day-to-day routine. Providing quality work in days when the standards are being raised is not easy. Even these attempts for simple solutions will require study, discernment, and work. It makes sense to take on these tasks in a straightforward manner, because this is part of what it means to be a professional today. May the Lord grant us wisdom as we seek to find the best tools to remain sharp in our practice as we serve him and the people he brings under our care. Online counselor is always available to help you out.
The technophile droned on about the virtues of making appointments on-line, tracking customer visits and preferences, building mailing lists, generating financial reports, offering computer simulated hairstyle demonstrations, and creating a web page. The barber answered each bright idea by either pointing to the pad of paper on the counter, the oversized calendar hanging on the wall, or by just shaking his head. The one-sided exchange ended with Dominic's statement, I've been cutting hair for over 20 years.
I think I can make it to retirement without ever touching a computer. Something told me, the eavesdropping customer in the next chair, that this barber had just uttered the last word. As a Christian counselor in contemporary practice, I can identify with both sides of the debate. Counseling is a person-to-person, high touch, and relationally rich profession. Its priorities revolve around service to people. When high-tech applications are introduced, there is not necessarily a positive correlation with improved outcomes. Enough effort is required to monitor and integrate the client's intricate physical, emotional, mental, and spiritual dimensions without adding complicated software to the interaction process. Yet, counseling is not giving a haircut. The ever-increasing expectations for assessment, accountability, and productivity make technology and other tools more attractive to and necessary for clinicians who intend to stay in the work for the long haul.
Due to my vicarious learning experience in the barber's chair, I am going to avoid discussing software applications where the primary appeal is to offer counseling or administrative tasks slicker and quicker. Numerous software and technology options exist that can improve marketing efforts, increase communication, or institute timemanagement procedures. The possibilities may seem overwhelming, butsome applications are worth mastering when a practice or practitioner needs to streamline a particular area. The multi-site, multi-counselor practice absolutely needs smooth communication systems to enhance responsiveness to client requests as well as to manage clinical and financial data. The practice specializing in a certain type of psychological evaluation will benefit from obtaining the most advanced tools to fulfill the task. Keeping current on practice related research can be accomplished through searches on an Internet database. 1 Such options are available and useful but will not be covered here.
There will be no pressure toward practice expansion or passionate challenges to take on new ventures. All that follows has been subjected to the following screening question: How would this idea go over in Dominic's barbershop? My goal is to suggest only a few tools of technology to keep Christian counselors vital in the work of soul care until the season arrives to retire, the Lord supplies a call into a new work, or he returns. Ideas offered here have passed the barbershop criteria: Is it sensible, simple, and straightforward? Three categories will be covered: (1) tools to assist counselors in seeking out or sifting through client information; (2) software to help strengthen the quality of clinical work by increasing depth or tracking details; and (3) applications that allow counselors to sleep easier and more restfully.
*Seeking and Sifting Information*
The classic definition of a psychological test is a sample of behavior which is assigned a value for measurement purposes? The basic theme in assessment is to collect adequate, relevant, and representative samples of behavior in order to make predications or statements about future behavior or patterns. In order to obtain these samples, it is not necessary to bury a client in endless questionnaires or condemn the counselor to tedious reading and scoring. Some form filling or checklist completion might be useful, but here is where the counselor may wa make use of available technology and developed counseling tools.2 For example, the Quick view Social History available through National Computer Systems (NCS) can be administered in an on-line format and printed in about the length of time allotted for a standard session.
The resulting report organizes information on personal history into nine major areas and provides a basic symptom screen to the clinician consistent with the standards of the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). The clinician can review this information prior to the next session and pursue face-to-face matters that need clarification and elaboration. Add additional clinical notes, make any necessary changes or deletions, sign off the report, and it is now ready to enter into the clients chart. A complex clinical procedure has been accomplished in a cost, time, and energy efficient manner. Notice that a computer generated report never becomes part of the clinical record without the counselor's careful scrutiny and approval, because it is the counselors report. After using such an approach for years, client feedback has been extraordinarily positive as direct contact time is more focused and productive.
The client has been helped to selectively communicate samples of confusing but necessary information. Using material gleaned through a personalized intake session along with the automated procedure, the clinician is ready to decide if additional assessment would be useful while the direction for counseling is being determined. If more data on symptoms is needed to support medical necessity of treatment, a checklist such as the SCL-90-R (NCS) might be useful. The seeking- and sifting-process using the assistance of technology may continue through the use of specialized scales or questionnaires to get a clearer picture of possible substance abuse, symptoms of depression, or career interests.3
Such assessment tools, usually of the self-report variety, supplement critical data obtained from personal interview and organize information in formats that make goal setting, progress evaluation, and outcome measurement manageable.4 Many tools that were once time prohibitive with hand scoring are worth a look now that computer assisted administration and/or scoring makes the task easier. If the tool meets applicable validity standards and has clinical utility, which means it adds useful information that can enhance treatment, check to see whether new technology makes its use a viable option.
*Strengthening Quality*
Today, the benchmarks of quality counseling typically center on three broad areas: appropriate evaluation relevant to the referral request to formulate a conceptualization of the issue for and with the client; a reasonable, planned approach to treatment, using interventions known to address identified concerns; and evaluation of client progress and the effectiveness of the services supplied. Christian counselors seek to address these matters in a manner that is consistent with the Scriptures and that honors our Lord. It is recognized that as those in a position of responsibility for guiding others, Christian counselors will be accountable to our Lord (James 3:1).
In addition, the practice standards of our field require that we also follow professional conventions. This means that documentation of the counseling encounter through the clinical record is essential for demonstrating that the counseling provided was done according to generally accepted guidelines. It is my view that in today's service climate, the quality of counseling services is strengthened when there is meaningful depth and purpose in the person-to-person interactions with sufficient detail documented in the clinical record. There are tools that may help add depth to clinical work. Here the term depth is being used to signify counseling efforts aimed at increasing client self-reflection, enhancing interpersonal relationships, or identifying and/or modifying long-term issues or concerns.
It is important to note before proceeding that not every client, request, or counseling situation needs greater depth.Thus deeper is not necessary better. Rather, ask what God might be seeking to change or accomplish through this counseling encounter. How can the counselor best fulfill this task, given the assigned counseling role and setting? These questions enable the counselor to determine where to target exploration and interventions.
Staying within the barbershop criteria, there are two suggestions to consider if the counseling context of your practice calls for more depth. Personality assessment has been a staple in psychological practice and counseling work for decades.5 Theoretical differences, controversy over the appropriate use of psychological testing with certain populations, or cost-cutting endeavors may have diminished enthusiasm for using such measures in clinical practice. However, personality tests have been steadily undergoing investigation and revision, while technology has made access to the information these measures yield more accessible to clinicians.6 As professionals we need to evaluate both the measure and the application carefully before use, just as the various ethical codes require. As evangelical Christians, we also need to recognize the values and implications implicit in these measures. Just as Christian clinicians take care to monitor ideas brought into the counseling room, the same discernment is necessary with the tools we use. Consider the biblical principle on the use of honest scales and balances found three times in the book of Proverbs (11:1; 16:11; 20:10), with its roots in the law (Lev. 19:35-36).
In the marketplace, when buying food or fabric, the transaction was based upon an established price per standard measure. God warned his
people not to follow the deceptive, but at times culturally acceptable, practice of using standards or scales known to be off in a given direction. This would create the illusion of honesty, when the entire procedure was only a sham for stealing and leaving the victim unaware. Buying and selling in Gods economy was to be an honest exchange, not a charade to take advantage of someone else. Based on this principle, when Christian counselors appeal to an objective or scientific measure, it is our responsibility to make certain that we understand its limits and the appropriate applications. Only when clinicians are ready to make a fair use of balanced tools can we use these methods without manipulation and with integrity to serve our clients in the name of the Lord. Therefore, clinical measures with potential for identifying psychopathology such as the Minnesota Multiphase Personality
Inventories or the Million Clinical Inventories may find their way into use depending on the setting, purpose, and training of the counselor.7 These can be easily administered and scored using fast mail-in services or through computer-assisted options. One tool, which I believe is undervalued in Christian practice and may add depth of insight into personality patterns, is the Sixteen Personality Factor Questionnaire (16PF). It is available in several forms, has an extensive research base, and was nor med on a non-clinical population, which is particularly attractive for many settings.
The fifth edition 16PF has eliminated the complex scale labels found on earlier versions, and I would describe it as a counselee friendly measure. The computer generated couples counseling report for the 16PF is worth a look by those who do marriage counseling. When a counselor determines that using a rating form or personality measure would add information useful for treatment planning and service delivery, the next step is to evaluate how frequently these measures will be put to use. The occasional user may benefit from using mail-in answer sheets, while the regular user may want to take on the expense of setting up a computer on-site for administration and scoring. Some software programs may be purchased that provide unlimited use of a measure, but most testing options have a per-use fee. The per-use option is usually less expensive for the occasional user. In most office applications, it is best to designate a separate computer for test administration. Having clients work on the same computer that contains clinical records can be done in a way that protects confidentiality, but such a procedure may not communicate such boundaries. There is another set of tools available in hard copy or interactive software that may add depth to the treatment planning process.
There are now at least a dozen treatment planning guides published by John Wiley & Sons that offer extensive information on treatment plan design for specific presenting problems. A few sample topics are: couples therapy, chemical dependence, group therapy, pastoral counseling, and family therapy. If you simply want a sourcebook to assist in the wording of presenting problems and selecting appropriate treatment goals, look at the guidebook that applies to your area of interest. Each of these planners is also available as a software add-on module to the core treatment planning program called The ascribe. The program objective is to assist clinicians in developing comprehensive treatment plans in printed form for outside accountability. In my review of this software in the summer of 1998, I found that after practice and orientation, it did add diversity, creativity, and precision to my treatment plans. However, I did not find the software to be a real time saver for a clinician already experienced in writing treatment plans. In addition, the software required establishing another database of clients, and that additional time commitment did not seem productive unless this software was also going to be used as part of the overall practice management system.
There are components that can be linked to The ascribe to turn it into a complete system. The purpose here is not to provide a thorough review, only to indicate how the clinician needs to discern his or her own strengths along with ways of doing practice before adding new procedures into client care. There is terrific information in these treatment planning guides, both in the hard copy and software that would take years of experience to reproduce. The software system is a powerful addition to deepen and document treatment plans yet will not be a match for all clinicians. It certainly has significant educational potential for new counselors.
Getting the myriad details of counseling plans, interactions, risk factors, and progress notes into a treatment record can become a burdensome duty and increase burnout unless the counselor has a good system for record keeping. There is no compelling reason to move to a client management software system if the paper/pencil or basic word processing format is getting the job done. Software systems designed for counselors do offer advantages because built-in prompts structure progress notes or allow for the quick insertion of checklists. Some of these procedures could be incorporated into more basic formats. Consider the use of a template for a standard mental status exam, which could be included as a file in a word processor or just printed out as a handy form ready to be completed.8 Having this ready to use or insert can save time and make the difference in documenting such observations at regular
intervals. Following is an example of an integrated client management software system that can be a huge help in maintaining an up-to-date clinical record.
Option by The Psychological Corporation is a sophisticated program with some high-level features, and therefore, it barely squeezes past the barbershop criteria. The setup and start-up commitment cannot be fairly described as ‘simple, since this is actually a subscription service that requires a monthly connection to update the software along with the built-in assessment features. It does have several standard assessment measures built right into the program. Once it is up and running, a steep learning curve must be factored in because it will take some work to gain familiarity with what options are available. The format itself is easy to follow, with the
inclusion of many templates and drop-down menus such as those for intake assessment, social history information and treatment plan generation. One attractive feature is the way it assists in formulating progress notes and goal tracking. The options for rating goal-level attainment after each session, with the potential to pull ratings over time into a graphic presentation of progress, is the type of outcome assessment feature that will become common practice in the not too distant future. Once the clinician becomes acquainted with this system, the features it offers fit well with routine practice.
*Sleeping Soundly*
In my early counseling days, some of the most dreaded phone messages were not client crisis calls but requests for information or billing records. A client who finished therapy eight months earlier phoned and wanted a complete, itemized account statement for tax preparation purposes. The information was obtainable but going through the receipts took time. Phone disputes surfaced with insurance companies over explanation of benefit (EOB) notices, which required going back?
through dates of service and payment records. A request came from a fellow counselor beginning work out of the area with a previous client and who expected a written summary of treatment. These common tasks needed to be transformed from major inconveniences to matters of doing everyday business. Hiring staff helped, but only limited hours could be afforded. Also, even office staff need good recording systems to manage information. This is where practice management database software is extremely useful.9 An example of such a system is The Practice Manager with Shrink from Multi-health Systems (MHS). This program has features for tracking clients, recording progress notes, billing management, accounts receivable, and producing insurance forms. It has built in DSM-IV and clinical procedure terminology (CPT) codes.
There are safeguards to protect confidential information and passwords to restrict access. Having all the typically requested information at ones fingertips in a central database is not just a dream come true, but it also allows for pleasant dreams instead of nightmares. It cuts out unnecessary worry about who is going to want what and when. The information available can be recalled when necessary. The use of such a system must work naturally into clinical routines. This might mean posting payments/ charges at the time of service, doing progress notes throughout the day, and closing client records with a summary of care. There are times when catch-up is required at the close of the day or at weekly times designated for clean up, but most information management is
seamlessly integrated into clinical practice. Having this done allows for more restful sleep. Another word from experience: Adoption of a practice management software system is a decision one will live with for
a long time, since conversion to a new system once the database is off and running is difficult and costly. Investigate your options fully and pray fervently.
*Keeping the Razor Sharp*
Last spring, I found my grandfathers old straight razors, left over from his days as a barber. I brought them into Dominic's shop and asked my barber if there was a way to sharpen them and put them into use. He laughed and showed me his new, up-to-date straight razor with replaceable blades. New blades keep it ready for use. He told me about what he does to keep his other cutting tools in shape. I was warned to keep my dull antiques in a safe place but not use them. This barber had some good advice. I noticed that when it comes to keeping his barbering tools ready, he stays on the cutting edge. There may be no software in his shop, but a good haircut requires sharp tools. A sharp Christian counselor is one in right relationship with God. But in your hearts set apart Christ as Lord. Always be prepared to give an answer to everyone who asks you to give the reason for the hope that you have. But do this with gentleness and respect (1 Peter 3:15). Online counseling is always available to help you out.
Software does not keep us ready to provide good soul care only walking close to the Lord can do that. There are no quick ways to gain wisdom or insight into people helping. It is a complex ministry. These ideas about a few contemporary tools are for use to stay current and fresh in day-to-day routine. Providing quality work in days when the standards are being raised is not easy. Even these attempts for simple solutions will require study, discernment, and work. It makes sense to take on these tasks in a straightforward manner, because this is part of what it means to be a professional today. May the Lord grant us wisdom as we seek to find the best tools to remain sharp in our practice as we serve him and the people he brings under our care. Online counselor is always available to help you out.
Source...