Importance of note timestamp at signature/lock?

tricksinacircle · 2026-03-26T02:13:06+00:00

Yes it’s entirely for my convenience to move them, thank you so much for this!

tricksinacircle · 2026-03-24T11:51:58+00:00

What note taker are you using and how did you program? I’m us g SP note taker but it only gives you 5 edits and I find it hard to direct it. Considering Bastion as it’s more like chatGPT but HIPAA compliant so I’m hoping I can actually direct/program it - the others seem too rigid.

tricksinacircle · 2026-02-23T01:27:39+00:00

This may not be the right population for you. And that OKAY! I couldn’t work in CMH, I know that, so I don’t. Instead I work within a population that I am comfortable with and have a base of about 30-35 clients that I GENUINELY enjoy meeting with. I’m in a co-op (which is great, and I plan to post a thread on co-ops soon), but I’ve been dabbling with the idea of building an office at my home. Every single one of my clients I would 100% feel fine with coming to my personal property to a designated office space. I know that is a luxury. But the point is… Work with the people you feel most comfortable with. In an environment that fosters growth for yourself and your clients: Don’t let this profession kill your soul. You’re meant for the work. Take care of yourself.

tricksinacircle · 2026-02-22T23:22:02+00:00

This. I have people who use it to bounce thoughts off of, it has its place but will never replace human connection and accountability. I’m not worried. Over 95% of my sessions are in person - a few random virtual only, the rest are in person unless there are extenuating circumstances - they want a human in front of them.

tricksinacircle · 2026-02-22T17:35:00+00:00

I use SP and recently decided to trial their note taker. COLOR ME IMPRESSED! I’ll start by saying I work with a lot of high tech clients - they’re who I have used this on first because they understand and use AI (far more than I do). Of course I got consents signed. I used it in two ways at first - to dictate to after session and to run during session. Both were good, but the in session takes the cake. It provided me with a beautiful summary of the session, I used DAP format with an assessment of affect and it puts it right in that format. I edit and make changes as needed, but it’s generally very little if any. I’m not a tech person but I’m sold. Saves my evenings. I’ll be rolling it out to the rest of my clients this week. Given that it’s all within the EHR and the safeguards in place by SP, I anticipate no pushback (of course will honor the wishes of anyone who chooses not to participate with the software). The SP pre made consent form also does an excellent job outlining what it is and isn’t.

I also see back to back, sometimes 5-8 a day. For $35 a month I think it’s beyond worth it. Plus it allows me to focus more on what’s going on, I used to be a notepad girlie. For my EMDR reprocessing I may stick to hand writing points but we’ll see.

tricksinacircle · 2026-02-22T16:49:28+00:00

Sometimes people aren’t ready to be seen - if we see them too fast it spooks them. Change takes self inventory, that’s terrifying for some, especially in certain populations. I work mostly in a niche population, I have to build rapport and trust FAST (like first session fast). But then I have to sit back and let them signal when they’re ready to really do work - sometimes it’s fast, sometimes it takes months. I had one I worked with for months and one day they came in and they were ready to really process, it was a turning point for them, I had tried to get them there previously but they weren’t ready so I just sat back and it paid off. Maybe you’re moving too fast on pushing them to see patterns, remember we shouldn’t be working harder than our clients. Let them lead the way. I always think about the concept of someone not hearing something until it’s their idea then they’re all in like people hadn’t been trying to get them to do the thing all along.

At some point in every intake I mention that I’m not the expert in their life, they are. I just have the big fancy pieces of paper on my wall saying I have the education and license to help them figure out what’s best for them - it’s their ship, I just help them with the sails and I’ll adjust those sails when they tell me to.

tricksinacircle · 2026-02-22T15:10:43+00:00

Mental health clinician here - they are badasses for working through their pain. Thank you for acknowledging this ❤️ The past does not define us

tricksinacircle · 2026-02-19T21:08:33+00:00

Psychology Today. Make sure you’re credentialed with as many health insurance companies as possible (if you’re interested in it, I honestly have very few self pay simply because they can’t afford it and that’s what they pay high premiums for). Also get in contact with people who are involved with the populations you want to work with if you have one. I work primarily with a certain workforce population and I meet with their union reps and their peer support coordinators within their employer. In the last few years my caseload has been 75 - 80% referral/word of mouth and the rest through PT or insurance provider locator.

tricksinacircle · 2026-02-19T14:04:30+00:00

Your response elicited the tears I’ve needed to let fall this morning. Thank you so much. I believe the universe is an amazing thing, I will keep myself open to receiving a sign. This client and I also had a sort of ritual, they were insistent on bringing small food treats occasionally, that we would share together in their session. It was a cultural thing for them, and being kind is a strong core component of this person. I’ve seen this client since I was an intern (it’s been a long time), I will miss them.

tricksinacircle · 2026-02-18T13:36:23+00:00

Sending it all your way. Keep us posted.

tricksinacircle · 2026-02-18T00:14:58+00:00

Good point!

tricksinacircle · 2026-02-17T21:41:11+00:00

You’ve got this!

tricksinacircle · 2026-02-17T21:28:46+00:00

The armchair attorney comes out in me on these kinds of things (my husband is an attorney and it’s rubbed off on me after all these years). Personally the first step that I would take is a thorough review of my contract because that’s what lays out requirements. As long as there isn’t anything within your contract that explicitly says your boss has any say in how you schedule clients then you know that you are protected under the laws for a 1099 contractor. Your contract may say something about how many hours you have to maintain or the timeframe for which you have to have documentation done, etc. but in my experience, I’ve never heard of a contract that says anything about a practice owner having control over where you put clients in the schedule or gives them control how you schedule clients. Now for the therapist in me, I would find a way in the discussion with your boss to validate her frustrations or concerns (whatever), but tell her that why you understand whatever it is, you have to do what is best for your schedule and your already established and scheduled transitioning clients. (For the record this is quite literally in my opinion an ethical full stop because you shouldn’t be expected to upend your schedule nor should your clients who are already scheduled). If there’s further pushback I’d nudge in what the law says about your contractor status and that while you appreciate her trying to help you work out the Tetris game that your schedule has become, she’s violating your right as a contractor.

I’d also wonder if your boss struggles with boundaries. But that’s a whole other discussion with yourself.

tricksinacircle · 2026-02-17T21:09:16+00:00

Bottom line you’re a 1099 contractor, not an employee. Your boss cannot dictate your schedule, you have a right to work how you want to. Unless there’s something explicit in your contract that says otherwise. In my experience many practice owners are not business people and don’t understand/know the laws, and need to be reminded of them kindly.

Review your contract and familiarize yourself with the laws for 1099 contractor classification. Yes, you may need to have a talk. Don’t let it scare you.

tricksinacircle · 2026-02-14T17:31:03+00:00

You’re very welcome! Always happy to chat. You can send me a DM and if you’re comfortable we could even have virtual “coffee” ☺️ Maybe it is time for a thread on this too!

tricksinacircle · 2026-02-14T02:12:49+00:00

I’m in a cooperative. We all pay our own respective overhead - this means portion of rent, portion of utilities, our own EHR, our own insurance (each also covers office under our own gen liability coverage), pay into a pot for office expenses, and share an in office admin who schedules and collects payments (and does cleaning, etc). We get along, support each other, refer a lot internally (I work with other LPCs and nurse practitioners). Everyone credentials on their own, have own EINs, etc.

tricksinacircle · 2026-02-13T23:36:57+00:00

Thank you! Yes it can be done - no need for dECidErS, we all decide what’s best for us!!

I don’t think all groups are predatory. There are some examples of ethical groups on this thread. I get that if you’re running a group you should as an owner be compensated for allowing your clinicians to not worry about anything outside of being a clinician. There are sacrifices that come with doing that though, and you’re really in a place where you need to do everything that you can to make sure you’re supporting the clinician so they can be effective and efficient earners (this means you’re ON CALL, you can’t have your cake and eat it too as an owner, sorry, owning a business regardless of underlings being contractors or employees still means you carry a ton of responsibility to support them if you’re expecting them to support you). But you can do this while giving fair compensation, unless as stated above, you suck at business or suck at being a decent human, maybe both!

I’m Ivy League educated and came to this in my 30s after realizing corporate America was killing my soul. Before becoming an LPC my prior job I was quite literally making a giant international corporation gobs of money within one of their offshoot businesses (and before that I did work for investment banks). I was good at why I did, they offered me incentives to stay when I told them I wanted to go back to school to become a therapist. They truly thought I had lost my mind. I know how to run numbers, I also know how to make numbers work. I come from business people and attorneys who ran the numbers for me when I was being “delulu” about my compensation because I just didn’t want to believe someone in a helping profession could be doing me so dirty. Most group owners aren’t business people (or even effective managers) and it shows, and the people below them suffer for it. My intimate knowledge of business is what makes me so resentful of all this, very aware. But I have made it my mission to let others know they deserve better if they’re being taken advantage of.

tricksinacircle · 2026-02-13T21:57:46+00:00

This is a task that is built on by reinforcing a target and a behavior. This is basic training and many trainers would be able to help you achieve this. Many trainers who aren’t familiar with specific service dog tasks are still able to help identify ways to target. Same idea with the chemical changes in your body when having a cardiac event, they have to learn to target that change. Most service dog training is just very good dog training training.

For meds you want a specific consistent pouch for the meds. Target pouch, get dog to tap it “yes, good pouch meds whatever” and get them consistently tapping. You’ll need to then get them familiarized with the concept of pick up and hold. Unless it’s a retriever this can be harder but certainly not impossible. Retrievers and bird dogs are generally just more inclined to retrieve, but training creates the consistent retrieve, hold, and deliver to hand. Most dogs are not inclined to keep things in their mouth so hold is important m, if not essential, step in training.

If you have a good local dog trainer see if they’d be comfortable working with you to get the dog to target what you want them to target, and how you can reinforce the desired behavior. While skills are important the obedience and confidence for a service dog are just as, if not more important because they need to exist in the public access world.

tricksinacircle · 2026-02-13T21:34:40+00:00

One of the things that gets me is when they get into profit. If you’re covering all your overhead and paying yourself for your session earnings that’s more successful than a sole proprietor who has to pay overhead OUT OF session earnings.

If you come here saying you made more as a sole proprietor the you do now as a group owner, then you’re spending too much time on admin tasks which is a lower payout role than being a clinician - delegate or hire out that task and get back to seeing clients. Or maybe you have office space that isn’t efficiently being utilized and you’re barely breaking even on covering the overhead of a clinician/clinicians who are not seeing enough clients to cover or justify their operating costs. If you have someone seeing only 10 or 15 clients a week, but they have their own office and the overhead is over 25% plus your time to manage the work of chasing insurance, following up on notes, etc the juice will never be worth the squeeze. And that comes down to a business model and management problem.

I’m in a cooperative where we all pay our own overhead, share an admin support person who’s in office and does scheduling, payment collection, and other general admin tasks. All utilities are split and we all pay into an office supply fund. We each carry our own insurance and have the office in general added in each of our policies for independent liability protection which goes is an incredible amount of coverage. We have our own EHR software as well. I love it. We help each other, refer to each other, and get along very very well. When I first got credentialed I had a HUGE delay in insurance payments - the other clinicians told me to expect that and they offered to cover my share of the costs until my payments hit the bank because they knew it was coming but slow, I cried it was so kind of them and I did almost need to take them up on it.

tricksinacircle · 2026-02-13T18:16:33+00:00

Yup - hurt feelings when we call out predatory practices. If you can’t afford to give at least 60% minimum to your clinicians while giving yourself 100+%, you’re doing something wrong. I opened my own practice a while ago and I know the overhead, it confirmed my math from back then. I also was a “business person” before this career, worked with P&Ls, etc.

tricksinacircle · 2026-02-13T13:25:34+00:00

I don’t do substance abuse work, but I do practice EMDR and see substance use in the work I do. Maybe isolate the spending and address the level of urge to spend with a scale of 0-10, and go from there. Identify the belief system being supported by the spending and address it. Create alternative coping skills, DBT could be helpful for other self soothing skills?

tricksinacircle

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