The Psychotherapy Documentation Primer
Download Free (EPUB, PDF)

Everything you need to know to record client intake, treatment, and progress—incorporating the latest managed care, accrediting agency, and government regulations Paperwork and record keeping are day-to-day realities in your mental health practice. Records must be kept for managed care reimbursement; for accreditation agencies; for protection in the event of lawsuits; to meet federal HIPAA regulations; and to help streamline patient care in larger group practices, inpatient facilities, and hospitals. The standard professionals and students have turned to for quick and easy, yet comprehensive, guidance to writing a wide range of mental health documents, the Third Edition of The Psychotherapy Documentation Primer continues to reflect HIPAA and accreditation agency requirements as well as offer an abundance of examples. The new edition features: Revised examples of a wider range of psychological concerns New chapters on documentation ethics and the art and science of psychological assessment and psychotherapy Study questions and answers at the end of each chapter Greatly expanded, The Psychotherapy Documentation Primer, Third Edition continues to be the benchmark record-keeping reference for working professionals, reflecting the latest in documentation and reporting requirements.

Paperback: 252 pages

Publisher: Wiley; 3 edition (December 27, 2011)

Language: English

ISBN-10: 0470903961

ISBN-13: 978-0470903964

Product Dimensions: 7 x 0.6 x 9.8 inches

Shipping Weight: 2 pounds (View shipping rates and policies)

Average Customer Review: 4.6 out of 5 stars  See all reviews (35 customer reviews)

Best Sellers Rank: #92,666 in Books (See Top 100 in Books) #52 in Books > Textbooks > Medicine & Health Sciences > Medicine > Clinical > Mental Health #183 in Books > Medical Books > Psychology > Mental Illness #246 in Books > Textbooks > Social Sciences > Psychology > Psychopathology

I'm a newer Social Worker and I work for a large agency. I was reading this book in the lunch room and it tended to drum up a lot of discussion. First of all, the title "psychotherapy" is kind of misnomer, it's more 'therapy in general'. But back to the discussion at hand. The conversation that my coworkers and I had was around the fact that none of had any real training in documentation. We all tended to just imitate each other and hoped that was correct. Personally, I had no training during my graduate program. During my practicum I looked at other documentation and tried to duplicate it with no explanation of the how's or why's. That's pretty much how it went in my current agency as well.As a newer mental health professional, I wanted to learn the basics of good documentation. This book was so much more to me than simply documentation than. It explained the ins and outs of a good treatment plan, how to conduct an intake, and even planning therapy sessions. In a lot of ways it's like a handbook for private practice which is something I'd like to look into down the road. Overall I found it an excellent overall in not only documentation and legal requirements, but also in how to be a good therapist.

This documentation primer is not complete. It contains some basics (writing up a mental status; not very good content) and then focuses primarily on writing treatment plans for managed care. In that sense, for people who may not have had experience writing such treatment plans (and treatment plan updates), the primer is excellent. It does not really address many other aspects of documentation. In this way, some of the claims on the cover appear to be somewhat overstated.

What I liked:-- Small chapters that present focused information-- Clear informative information needed to understand the Mental Status Exam (MSE) ~ while this is a common piece of any assessment (and sometimes visits) clinicians can easily forget terms to use in this heavily laden jargon section of assessments ~ this part of the book should be marked for easy reference-- steps for rule outs-- progress notes vs therapy notes-- what goes into a good progress note (one area I see sadly lacking in graduate training and even agency orientation)Things I would have liked to have seen- working with electronic medical records- privacy when therapists working within non-traditional therapist setting such as Primary Care Clinics- does not discuss documentation of things such as informing patient regarding limits of confidentialityWhile things could be better overall good reference on a topic there is sadly not enough "real world" references for how to document.

Perfect - and just what I was looking for. The writing clear and concise. The author handles the subject with ease. I've learned a lot from the book about documentation, diagnosis and treatment planning that I had not known before. I'm still reading the book but so far it has been a pleasure to read, professional and easy to understand.

This was a great book to read. I would recommend having this book as it has great examples for documentation and how to complete various sections. I would have liked a little more regarding the index.

I am so glad I read this before entering into practice. This is the stuff mental health practitioners need to know but are never taught in grad school. If you want to avoid issues with insurance reimbursement and more importantly, stay out of trouble, read this book

This book is an excellent resource for the small private practice. The author details problems he had when he was audited by an insurance company.He does a good job in this edition (third edition) of giving specific examples of what constitutes good record keeping. He does a good job showing what progress notes should look like. He documents how he lost money because an auditor said that putting down "1 hour session" wasn't good enough, they wanted time started and time finished. Ridiculousness of the auditor aside, that is a useful piece of information to have.The treatment plans are a bit redundant in my opinion and his bio social intake is a but over the top, at least for the field I work in. It may have uses in other mental health fields. The way I see it, is if you own your practice, this thirty dollars might save you thousands of dollars in the future. To me, that makes good sense.Buy it.

I'm studying for my second shot at the Florida LMHC exam. Knowing what is covered on it and where I fell short, this book is a must have. It covers subject matter I couldn't find else where. Most of what cost me on the first exam.

The Psychotherapy Documentation Primer WP205 - Bastien Piano Basics - Theory - Primer Level (Primer Level/Bastien Piano Basics Wp205) UNIX System Management Primer Plus (Primer Plus (Sams)) Primer Nivel: Aprende Saxofón Alto Facilmente (Level One: Alto Saxophone) (Primer Nivel) WP210 - Bastien Piano Basics - Performance - Primer Level (Primer Level/Bastien Piano Basics Wp210) Creatures of a Day, and Other Tales of Psychotherapy Theory and Practice of Counseling and Psychotherapy SM Theory & Practice Counseling & Psychotherapy Developing Your Theoretical Orientation in Counseling and Psychotherapy (3rd Edition) (Merrill Counseling) Counseling and Psychotherapy with Children and Adolescents: Theory and Practice for School and Clinical Settings Ethics in Counseling & Psychotherapy Mindfulness and Psychotherapy Hypnotherapy For Health, Harmony, And Peak Performance: Expanding The Goals Of Psychotherapy Treatment Plans and Interventions for Depression and Anxiety Disorders, 2e (Treatment Plans and Interventions for Evidence-Based Psychotherapy) Psychotherapy with Infants and Young Children: Repairing the Effects of Stress and Trauma on Early Attachment Theory and Treatment Planning in Counseling and Psychotherapy The Theory and Practice of Group Psychotherapy, Fifth Edition The Adolescent Psychotherapy Treatment Planner: Includes DSM-5 Updates Career Counseling (Theories of Psychotherapy) The Practice of Collaborative Counseling and Psychotherapy: Developing Skills in Culturally Mindful Helping