Photo Credit: FreeImages.com/Kristja
While I was in graduate school working towards my Master’s in Psychology, I was encouraged to take notes in therapy sessions, as a means of remembering important information. At the time it made sense, and I felt it was a good practice. I was used to taking notes, being a student for over ten years, so the idea of taking notes during a therapy session seemed like a reasonable idea. When I began my Practicum and later my Internship, I realized taking notes in the session did not work for me. As a therapist who works with difficult issues (Asperger’s & Internet Addiction), I found taking notes in sessions disconnected me from my Clients.
Therapy is About Trust
I am not a big fan of Rodgers and Humanistic therapy. During graduate school, I considered humanistic therapy a joke, with its loathing of asking questions and lack of structure. I focused mainly on Cognitive Behavioral Therapy and Gestalt therapy, as those schools of thought interested me. During my first six years of being a therapist, I realized Rodgers and Humanistic therapy did get one thing correct: therapy is about trust. Without a trusting relationship built over time, no therapy can work. Building rapport, or trust, is the main job of a therapist, especially at the beginning.
For me, sitting with a clipboard taking notes, especially during the first few sessions, damages trust. Often people enter into therapy due to a trauma or a major life change. There are specific reasons for entrance into therapy, and often people are not at their best. Many who enter into therapy have no experience with the process, with their understanding of therapy of what they see in the movies and the media. Most have no idea what therapy is about, and how it can be helpful.
Most clients are nervous and have problems opening up in the beginning. They do not know what to say and do not know what to expect. This is a critical phase for a therapist, as if the Client is not eased into therapy, they often will not return. For me, having a clipboard and spending time taking notes distracts the Client from my message, that I am here to help, but they are the ones doing the work. I need to make eye contract and show them my focus and attention is 100% on them. They need to see my commitment, my passion and know I am someone who can help them, and someone they can depend on.
Taking Notes Appears Cold
I have had numerous Clients tell me their previous therapists spent the majority of the session taking notes and asking questions. While I feel notes at times is appropriate, and asking questions is vital, at times Clients need to talk and express themselves. Clients have told me they have had difficulty with these therapists, as they felt they were “cold” and “detached” and did not seem to care about them or their issues. The worst mistake you can make as a therapist is to appear you do not care. Asking questions and taking notes, with little else, will appear scientific and sterile. Therapy is about relationships and working through difficult issues. Clients need to see their therapist as someone who will be there for them and not go on a script.
Each Client I treat is unique. While many have the same issues, these issues are slightly different and have different causes. I need to see the Client as a unique person and be ready to adjust my approach as needed. This is true for any therapist and any issue. If the Client feels a distance between themselves and their therapist, progress will be limited.
Body Language is Important
Often it is not what is said, but how it is said that matters. Body language is often more important than the words spoken. If a therapist is distracted writing notes and not looking at the Client, the therapist will miss vital clues as to what is being said. In the session, I am looking at the Client almost all the time, from their mouth to their eyes to their posture. Often I can tell the mental state of the Client by how they sit on the couch. If I am writing notes, I will miss some of this information and will be limited in how I can respond.
The body language of the therapist is also important, as what you say and how you present yourself matters to your message. By writing notes and not looking at the Client, I many convey via body language I am too busy with my notes to focus 100% on you. If I were seeing a therapist and taking about painful content, I would want my therapist focused on me and my issues.
When to Take Notes in Session
Sometimes you need to write down information. It could be a phone number or a piece of data you will have a hard time remembering. When I need to do this, I ask the Client if it is OK for me to write down something real fast. I have never had a Client refuse this request. I write down the information then put the clipboard down and focus on the Client. I sometimes do this in the first session while I am collection information. There is nothing wrong with this approach; it shows the therapist is considerate but also professional.
In Conclusion
As a therapist, your main job is building trust with your Client, so they know they can depend on you through their therapeutic experience. As therapy is difficult, therapists at times will ask the Client to do difficult tasks. Without trust, these tasks will not be done, and treatment will be limited. Taking notes has its place, but do not focus too much on the information when you could be focusing on the person.
Photo Credit: FreeImages.com/Kristja
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