Open Charting in Psychotherapy
And my take on Dr Melfi and Tony Soprano
The best idea I’ve had about how to conduct psychotherapy, I got from visiting my allergist.
Whenever I have tears in my eyes during a session, it might be because of what the client was saying; sometimes I’m deeply moved, but probably my allergies were responsible. I once went to see an allergist to determine if there was something I could do about it. He gave me a bunch of tests and told me there was. All I had to do was…
“Got it?” the allergist asked.
“I understand,” I claimed.
Then he showed me the printed After Visit Summary where he had written out the instructions. I learned I had not understood. Not at all. I was completely confused.
The incident got me thinking about all the times I’ve had people in my office and watched them arrive at an important insight or learn an important skill, only to forget about them as soon as they left.
Many of my interventions, interpretations, recommendations, and homework assignments also get forgotten. I might prevent that from happening simply by writing an After Visit Summary just as my allergist had. In this document, he summarized the things I had said about my allergies. He gave the test results. He listed the steps I could…
