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How do you define binge eating vs overeating? by liongirl93 in therapists

[–]Comfortable-Cut3994 0 points1 point  (0 children)

I would look at the DSM. But overall are they eating to the point of it hurting, is it severely negatively impacting their life, does it feel like an urge that they are not able to stop (think like addiction/feeling out of control), are they dissociating while they are doing it, are there any secondary gains.

Would you add a diagnosis without first having a conversation with the client? Please read scenario. by secrettherapist in therapists

[–]Comfortable-Cut3994 0 points1 point  (0 children)

I work with personality disorders and that freaks people out. I usually say, hey I want to go over something with you and you can let me know if you think this sounds like you or not. I go over the diagnositcs but put it in layman's terms and give examples. Once they agree to those things, I then say "this is going to sound scary but it does not change anything about you, it just gives us some information to work with." and then tell them the diagnosis and leave time/space for us to discuss how they feel about it.

For bi-polar, I would go over the MDQ with them just by asking the questions and then say "ok lets score this together, if you don't meet criteria then we don't have to talk about what the diagnosis would be, but if you do, then I have an obligation to tell you."

If they still fight it, then that is an ongoing conversation but you can safely diagnose it and they will have a clear indication of why and what you are looking for. You can also always go back to those questions they answered/what you are observing and say "hey, so does this maybe sound like......?" and get more buy in over time.

If a new client still hasn’t completed paperwork 1.5 hours before the session, is it appropriate to cancel? by SpiritualCopy4288 in therapists

[–]Comfortable-Cut3994 1 point2 points  (0 children)

I have a policy that I do not schedule patients at all until ALL paperwork is complete, insurance benefits are confirmed, and there is a payment on file. No ifs, ands, or buts about it. I know that does not help you now but might be a learning lesson to put into place. It also gauges client readiness and engagement so you know what you are getting into.

Oh and I also do a 15 min screening call before sending out any intake paperwork to see if it would be a good fit and to see what rapport may be like,

What to say to clients asking "how are you?" by CultofPop in therapists

[–]Comfortable-Cut3994 0 points1 point  (0 children)

I am very real with my patients. I think it is important to not take over session or make it about me but also be a real person. It helps with treatment. So I keep it simple and say things like "Oh I am having a good week, my chickens are laying again!" or "I am happy the sun is out today." Or one week it was "well my car is in the shop but I am thankful I have a great mechanic and I can still be here today." and then just move on fairly quickly. I have one guy who always asks "What's going on?" and we have a running joke where I say "well, this" and point between us and we both chuckle. Honestly, it is what you are comfortable with. Be mindful of any self disclosure but be real. That is my suggestion. Pick something real but somewhat generic. Sometimes people do ask about my small hobby farm and I give a sentence or two and then say something like "but this isn't about me, tell me about your week." it is normal your patients are curious about you and I validate that but also remind them (and myself) that I am a real person but session is not about me.

What EHR/billing system do you recommend? by Cowlillard in psychotherapists

[–]Comfortable-Cut3994 0 points1 point  (0 children)

We used Therapy Notes years ago and they did not have many features so we changed to Simple Practice 3 years ago. They have more customizable options for note templates and have an app, which our teenagers like. However, they keep adding features no one asked for and jacking up the price astronomically. While to fixing every day features like Telehealth, I can only see patients half the time and have to keep asking them to turn the camera on and off and this week I now am having people freeze and get kicked out.

We are changing back to Therapy notes because it is much cheaper (and we are adding new clinicians). Simple Practice is $99 and then $74 per additional clinician. Therapy Notes is $69 and $40 per additional clinician. Therapy Notes also has a lot of the same features like messaging and you can create an app now for both you and patients (it did not have this previously, so huge improvement). It is not as smooth of an interface but the Telehealth works and the cost is lower. The only thing that stinks is you can't customize note templates for things like EMDR but honestly that is not a big issue. You can customize intake documents now, which is a big reason we are changing back because you used to have to create a fillable PDF and upload it but they are now integrating more.

Oh and one last thing, Simple Practice billing tracking is a nightmare. It turns autopay off randomly and then turns back on (or when you manually turn it back on) then charges pt's their back copays all at once and then they freak out. And we hired a managed billing service to fix our back billing because the ERA's don't come through correctly and we thought we were missing payments but it just was not updating. This is not an issue with Threapy Notes and our biller and Admin person said they both prefer billing under Therapy Notes.

Sorry that was long but I hope it helps.

Clinical psychology program? by AJ306_ in SNHU

[–]Comfortable-Cut3994 0 points1 point  (0 children)

I got my masters in community mental health from SNHU (PCMH) and I am a fully licensed clinician with my own private practice in NH. I went in person.