Play Therapy and Documentation

Who loves writing progress notes? Trick question; no one does. Therapy is nuanced, and good sessions often do not go in the direction intended. I have said many times, my job is not to make a specific therapeutic thing happen in a session, but to make whatever happens in the session therapeutic. Often what is best for the client in that moment does not fit easily into some treatment plan check box.

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Insurance companies and insurers typically do not agree with my philosophy, though. They want me to justify everything that happens in a session. What exactly was the intervention? How does it fit with our time-limited treatment goals? How is it evidence-based?

The therapeutic relationship is the number one component in treatment, the thing that most impacts “progress.” So any activity that preserves or enhances that relationship is, by definition, therapeutic. But you can’t write “Built relationship” by itself in your notes, and it can be difficult to articulate the skills and emotional processing that occurs in sessions.

This is extra true when it comes to play therapy. We know play therapy is beneficial, especially non-directive play, because kids process emotions through this play. But documenting this play can be challenging.

This is where YOU come in! Send me your favorite play activities from your sessions, and I will share how I tie these activities into treatment plans and the therapeutic wording for your notes.

If this is popular enough, I will make it a regularly occurring column on this blog. Fill out the form below to submit!

Published by Dr Marschall

Dr. Amy Marschall received her Psy.D. from the University of Hartford in September 2015. Her clinical interests are varied and include child and adolescent therapy, TF-CBT, rural psychology, telemental health, sexual and domestic violence, psychological assessment, and mental illness prevention. Dr. Marschall presently works in the Child and Adolescent Therapy Clinic at Sioux Falls Psychological Services in Sioux Falls, South Dakota, where she provides individual and family therapy and psychological assessment to children, adolescents, and college students. She also facilitates an art therapy group for adolescents and college students with anxiety and depression. Dr. Amy Marschall is certified in Trauma-Focused Cognitive Behavioral Therapy and Telemental Health.

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