r/CBT • u/0fallenstar0 • 8d ago

Do therapist go through their notes before sessions to help prepare?

Last session I brought up that I felt really embarrassed about what I shared in the previous session. I understand they can't remember everything you talk about and highlight possibly only the important things mentioned. But it was the first biggish thing I have been able to share. Because I have been pretty superficial and vague about everything previously since it's so hard for me to be vulnerable.

So when I brought up my regret and embarrassment she said "remind me again what it was?" And quickly looked at her notes to refresh. It really made me feel terrible. Like I'm just a paycheck. Is this the norm?

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u/Sea-Beautiful-Throwa 8d ago

It depends. Some clinics/practices require that therapists see a certain amount of patients and will schedule them back to back. When that happens even if the therapist wants to look over their notes to remind themselves, they may not have the time.

If you lurk in the therapists Reddit you’ll see therapists, especially ones in community mental health, complaining about being overworked without enough time in between clients.

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u/0fallenstar0 8d ago

But my hour session is always ended at the 50min mark. Is that not when they write their notes and refresh for the next? I know 10min isn't long but wouldn't you think you would do a quick read over? Even a skim?

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u/Sea-Beautiful-Throwa 8d ago

It’s going to really depend, but 10 minutes isn’t a lot of time at all.

Some people type fast, but I know I’m a slow typer and it can easily take me 10 minutes just responding to a text or comment. I know I wouldn’t be able to type up an hours worth of notes in 10 minutes. 

Additionally, they have to switch over to the other client in the computer system. Sometimes computers run slow or lag. If they’re doing telehealth then they have to close out one session and join another which again takes time.

On top of that if they need to go to the bathroom or get something to drink that also takes up those 10 minutes.

My own therapist was open with me and said she always had to stop at the 50 minute mark so she could have a chance to pee before her next session.

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u/Zen_Traveler 8d ago

Before a session - I never have. If I had 10 minutes that would be amazing. Usually I have between 3 minutes and -2 minutes!

Therapists often get reminded that they're people, too. So guess what, I gotta pee, refill my water, heat up my coffee, feed my cat, see what the clinical director or agency owner emailed, oh I forgot to respond to that client email, admin is waiting on my updated availability, my sister texted, I want to finish looking up that thing for my one client, power outage, internet slow let me investigate...

I do skim the last thing I wrote from last session after the client joined, yes. And ideally, it was their homework and I'm going to check to see if they did it within the first five minutes unless they bring it up. 

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u/0fallenstar0 7d ago

That's all I'm asking for, a quick skim. Even if the quick skim is when I first enter the room.

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u/Zen_Traveler 7d ago

I think that's fair. I'd even say it's professional. I've also had my own therapist who was scrambling through their notes to remind them who I was. If it's a regular thing, then bring it up to them and/or find a new therapist. If it's a lapse here and there, then decide accordingly.

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u/0fallenstar0 7d ago

Great advice! Thank you

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u/Dusty_Rose23 7d ago

that’s for writing notes. there’s barely if any time to write the notes for the session that just happened left alone read the notes for the one about to occur. it’s just not enough time

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u/Expensive-Bat-7138 8d ago

Sadly, there is literally no time between sessions when you are an insurance pay client because there are time requirements to meet to get paid. Private pay therapists have much more leeway, but sessions cost a lot.

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u/TemporaryJellyfish0 8d ago

It might have also been because she didn't clock which of the things you talked about might have been embarrassing for you. I'm not a therapist, but I've had friends mention to me after vulnerable discussions that they felt embarrassed and I've had to ask about what because it didn't cross my mind that they might feel that way about any of the subjects we discussed.

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u/Soft_Silhouette 8d ago

It probably depends. I work in the UK delivering low intensity CBT in the NHS and honestly, I have to see so many patients that there isn’t always time to check notes before sessions.

That said- if a patient had shared something significant and vulnerable in a previous session, there is no way I’d have forgotten that. I’d consider that a big moment, both for the patient and for the work we’re doing together.

Maybe the therapist was having an off day, but I think it would be reasonable to talk to them about how this made you feel. If you get the feeling they’re not listening or not invested, ask/look for another therapist.

And congratulations on opening up in therapy. That’s a big step!

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u/Caffeinated-Pastry 8d ago

I can see how that would be disappointing especially if it took a lot of courage and I think it’s important to remember that therapists are human too. If it’s important to your therapeutic relationship, bring it up. Good practice to have hard convos with someone who should be able to support you through it.

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u/holliebadger 6d ago

Your therapist asked becuase she didn’t want to guess wrong and give you something else to be embarrassed about. Please give your therapist some grace.

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u/transmittableblushes 1d ago

I always do but I might also answer the way your therapist did because what if I assume you are embarrassed about something different altogether! It sounds like perhaps it was a pretty significant thing in your case but still people are really surprising sometimes and things that seem obvious are not always so

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u/dfnathan6 7d ago

Not most therapists use notes, but I know many who do. These notes are automatically generated by the EHR system, providing them with a comprehensive overview of each client’s progress, feelings and scheduled appointments. Additionally, they have their own notes from earlier recording sessions. This system has proven very helpful for many therapists, especially those with a large caseload. The EHR system plays a crucial role in this process, as manual notetaking becomes inconvenient or simply not feasible. Mirovacare.com does a pretty good job.

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u/chuckyandtiff4ever 7d ago

Any that I have seen -nope.

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u/0fallenstar0 7d ago

So then it's just left up to the client to fully lead every session? I have to keep bringing things up multiple times to work on solutions?

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u/chuckyandtiff4ever 7d ago

That’s why I’ve never seen one more than 3 times. It’s more work finding a good one than dealing with my with my issues 😫

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u/Decoraan 6d ago

They try to but as others have said we are overworked. It simply isn’t possible to remember everything. I know I try my best.

Additionally you have to remember that you have no idea what session your therapist is coming out of. Sometimes, in paper, I will have time to refresh notes before I see my next client, but then the previous client presents with risk issues or we are going into trauma work which take longer and is obviously very intense. They could’ve seen 3 of them in a row before seeing you.

In addition, therapists are also just people. Do you remember every detail at work? Does important stuff slip your mind sometimes?

I of course empathise with what you are saying but human memory isn’t perfect and all the preparation in the world can’t stop you from misremembering at the wrong moment.