All Things Private Practice Podcast for Therapists

Episode 56: Notes & Other Private Practice Paperwork Made EASY [featuring Maelisa McCaffrey]

Show Notes

Writing notes and doing other private practice paperwork can be a HUGE stressor for therapists, but what if it didn't actually have to be tedious, hard, or take hours of precious time?

It's no secret that writing notes have become a sore point for a lot of therapists (and even has been a factor in therapists leaving the profession), but my guest in this episode, Maelisa McCaffrey, has created a simple and stress-free way to manage all private practice paperwork that has helped many therapists get on track and free up their time.

In this episode, I talk with Maelisa McCaffrey, owner of QA Prep and a psychologist, about her journey into creating a simple way to manage and simplify the note-taking process in private practice (and possibly even make it fun). We also talk about how to manage all the paperwork with a neurodivergent brain and stay on schedule to spend less time doing notes and more time resting and finding work-life balance.

More about Maelisa McCaffrey, Psy.D.:

Dr. Maelisa McCaffrey is a licensed psychologist, nail design enthusiast, and multi-passionate entrepreneur. With her business QA Prep, she empowers therapists through trainings and consultation on clinical documentation. Maelisa focuses on the “why” behind the usual recommendations and encourages clinicians to think outside the box while also keeping their ethics intact. As someone with ADHD who’s had to figure out what works through trial and error, Maelisa aims to make sure her trainings are practical, while also allowing for plenty of laughter and fun.

QA Prep Website: 

Instagram: @maelisamccaffrey


QA Prep YouTube Channel:

Also, check out Maelisa's Free Private Practice Paperwork Crash Course.


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A Thanks to Our Sponsor!

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PATRICK CASALE: Hey, everyone, you are listening to another episode of the All Things Private Practice Podcast. I'm your host, Patrick Casale, joined today by Dr. Maelisa McCaffrey, a psychologist out in Southern California, who is an expert specialist in QA, quality assurance prep for therapists who are trying to make sure they're doing things the right way and just protecting themselves. And we're going to talk about neurodivergence too. They may not feel like they tie in, but I'm glad that they do, because we're going to make a subject that might sound necessary, but not so interesting, really exciting and funny to talk about today. And I'm glad to have you here.

MAELISA McCAFFREY: Yeah, thanks for having me. I am very excited to be here. And I'm always happy to talk about it. Even though it doesn't sound like the most exciting topic, I know that it's what is on top of everyone's minds.

PATRICK CASALE: Yeah. And tell us a little bit about that. So, in your bio, it says that you make this fun and that you make it funny. And, you know, I'm not somewhat… I definitely understand the importance of like, doing things a certain way, and like, protecting the business and the clients, and ensuring like, everything's up to code. But I also realize, like, my eyes sometimes glaze over when I'm talking about this stuff. So, tell us about like, why you're passionate about this, and how you do make this fun or exciting to talk about?

MAELISA McCAFFREY: Yeah, that's a good question. I think the way that I make it fun is by actually making it like realistic and practical. So, one of the things that most of us from day one learn is that the message we receive is that paperwork is punishment, right? So, it's always this thing of like, even if the supervisor teaching you, and they're the best supervisor, and you love your clinical experience, it's like, "Oh." And then, we have this shitty documentation we have to do on top of it, right? And that's kind of how everybody talks about it. 

And the thing is, it doesn't have to be that way. And I find that a lot of therapists think, for example, like I'll share templates with them, and I create all these checklists and cheat sheets, and things to make writing notes, for example, really easy. And then, people will tell me, "Is this it? Like, is this all I have to do? Are you sure this covers insurance? Are you sure this meets whatever requirements?" 

And then, people will tell me, "Oh, well, I started using your templates. And it only took me five minutes to write a note. And I was like, no, there has to be more, this can't be good enough." Right? So, we have this mindset that it has to be really hard work, and it has to be painful to do. And once people find that it doesn't have to be either of those, it can actually be easy, it can be quick. And actually, you can… one of my big things is not just talking about, here's how you meet insurance requirements, or, you know, here's what a board might want to see. But actually, here's what makes your paperwork useful to you and may be useful to your clients, right? 

So, when you put all those components together then it's like, oh, it doesn't have to be big and scary, it doesn't have to be a big deal, and it doesn't have to be this huge, painful task that I dread, and that I spend hours on every single week.

PATRICK CASALE: I love that because so often I see, you know, therapists talking about, "Oh my God, I've got 100 notes to do." And that just keeps building and piling up on top of each other. And once that starts to happen, that feels like insurmountable. Like, how do I come back from this? And how do I actually sit down and put this into my schedule so that I actually do it. 

And you're right, I think a lot of people associate like note-taking and documentation to be like this laborious, long act that every note has to be unbelievably in-depth. And we've got to create this narration, these summaries, and explain why we're doing something, because of insurance and medical justification. 

But it sounds like if you find a creative way to hit both or check both boxes, then it really alleviates a lot of that stress and that overwhelm too.

MAELISA McCAFFREY: Yeah, yeah. And just like you mentioned, you know, I want anyone listening to know that if you are behind in your paperwork, because guaranteed a good percentage of people listening are actually behind in some paperwork as well, you are not alone. And most people feel very, very alone and very ashamed of that, because it's not necessarily something you like call up your ethics board and you're like, "Hey, I got 100 notes to do. Like, how do I figure this out, because they're from six months ago, or they're from last year." 

And if you're listening and saying, "Oh, I wish I only had 100 notes to do." Guess what? Like, I've worked with everything. I've seen it all and it is feasible to get caught up. But that in and of itself, even just that one thing is such a huge issue that so many therapists are dealing with and people tell me they're literally staying up all night, like, worrying about it, like, can't go to sleep, because they're stressed, because what if somebody requests some kind of record, or they do get an audit request or something. 

I mean, it's a big reason why I continue to do this. Like, I've had QA prep for eight years, and I didn't necessarily start out thinking, "I'm going to help people catch up on paperwork as a huge chunk of what I do with this business." And yet, it is. It's probably 540% of what I work with people on, is literally just getting caught up on paperwork. And with that, staying caught up, right? Like, avoiding having this happen again, because it's so easy to get caught up in this cycle. And then, that's when then people go into the shame spirals of like, I always do this, or I'll never be able to maintain this. 

And so, a lot of what I do is, you know, both practical, like hands-on tips, and then, also, like emotional support, right? And, you know, accountability. And it's one of the things where I really, really, really avoided doing groups for years. And yet, it got to a point where I was like, I can't avoid it anymore, because it's what people need, you know? Having 50 people in a month talk to me individually about being behind on notes is not nearly as impactful as getting those 50 people in like the Zoom room, right, together, and they all get to see, "Oh, my gosh, everybody else is dealing with the same thing."

And so yes, they're getting practical tips, yes, they're catching up on paperwork, but the most impactful thing, hands down, across the board, everybody says, is knowing, wow, I really am not alone. Like, other people get it, what I'm going through.

PATRICK CASALE: And that's so normalizing in terms of human behavior and how we move through life, because if we don't normalize it, and we don't understand that other people get it, we internalize it, right? Like, there's something wrong with me, how come I can't do this? Why is everyone else able to complete their notes or their documentation on time?

And you're right, then that shame spiral starts, and then, that's hard to climb out of. And it sounds like as someone who's not just giving logistical support, but the emotional side to that makes a really nice combination, because you could always give step-by-step instructions on how to do something and like practical implementation. But at the end of the day, if we don't have the emotional support, and take care of the emotional need around something, it's really hard to continue to have momentum after we go through a course, we watch a training. 

For me, to be honest with you, step-by-step stuff doesn't even work in my brain. So, like, if I'm not having that connection with someone who's able to kind of like, hold that space, share that story, give the normalization of like the human experience, I'm not really that invested in it, because I'm just not going to be able to do it. 

So, I'm glad that you said you're doing groups too, because I know for myself and my coaching, like, 16-minute chunks of my time don't really work anymore with the amount of people I see. So, group coaching is more powerful for that exact reason that you said, the normalization of like everyone's having impostor syndrome, everyone's second-guessing their decision to leave their agency job, everyone is struggling to name their fucking practice, or whatever the case may be. 

So, like, the stuff is totally a part of the process. And again, like moving away from the shame, and the insecurity and more into like, this can be okay, and we just have to work through this together as a team.

MAELISA McCAFFREY: Yeah. And it's been surprising to see how many people being in the group they'll hear, like, I have ADHD, I take medication for ADHD, it's been hugely impactful for me in a positive way to have that identified and I did not get diagnosed until later in life, until my mid-30s. So, a lot of other therapists have that experience, I think, especially, because women also tend to be in the group that are diagnosed later on in life as adults. 

And one of the things I remind a lot of my group members about a lot is okay, let's say, I can just use my own example, you know, I'm smart, I'm obviously a high achiever, because I have my doctorate degree, right? But I never thought of myself as outside the norm, in that way, and then, it's like, I have these stupid little things I can't get done, right? Like, I mean, still, you know, even with medication, but there are certain things, right? Like, I have this home security system that I've had for like a month and because it didn't work the way it was supposed to work, like, I still haven't called them to get it set up, right? And you know, that's just one example. 

And when you talk to people who aren't neurodivergent they're like, "Why haven't you just done it?" Right? Like, "Why don't you just do it, like, just call, just get it done?" And those of us who are like we get it, where those little barriers happen. 

But when you're someone who still has been able to be successful in life, and do well in school, for example, right? You can think like, "What's wrong with me? Why haven't I been able to do this? You know, how can I be in a place of like, I can run my own business, but then I let something stupid go by the wayside, or I don't get my taxes done." You know, like all these sometimes big and little things that come up. 

And so, through all of that, it's just really important to remember that we are, like, really high achievers, and often are very, very hard on ourselves, because we assume, well, I should be able to do this, this should be easy for me. All other therapists can't be dealing with this the same way I am. It's easy for them, why isn't it easy for me? And that's just not the case. Like, you have to look at what works for you. 

And even with people being in this, I do a paperwork catch-up group. So, for example, in that group, there are a lot of people who after hearing other therapists talk about their experience are like, "I think I have ADHD." Or they'll say, "I've been thinking for the last year or two that I might have ADHD." And actually, being in this group prompts them to, like, make an appointment with a psychiatrist and see if medication might work, because there are a multitude of strategies, as I'm sure you know, we're dealing with neurodivergence and sometimes we need a little bit of all of them. 

But sitting there and kind of avoiding admitting that and just giving ourselves a hard time about it, and expecting us to just do better without actually admitting to what we need assistance with and getting that help, it's not going to work and it's the thing that leads people… I mean, I can't tell you, every single week I meet with people who tell me, "I'm thinking about letting my license lapse, because of the paperwork. I'd rather just do coaching. Like, I love my job, I want to, basically, do the exact same thing I'm doing now, but not have to do paperwork."

I mean, that's significant, right? And there are strategies, and then, thankfully, like I meet with people, and they'll be like, "Okay, for the first time I have hope that I can make this happen." 

But that's huge if something like that is impacting your work to that level. And if you're just sitting there expecting that because you've been able to do all of the schooling and be successful in all these other areas, you just should be able to do it, that kind of mindset doesn't end up helping you in the long run.

PATRICK CASALE: All of those are really good points, there's so much to unpack there. And I'm trying to think of what feels like most immediate to me. 

I think what you just said about people wanting to leave the profession that comes from that internalized, like, that shamefulness, right, and that thought process of, if I can't just do something as "simple" as my paperwork, then clearly, I'm not competent enough to be a therapist, and that is just simply not true. 

And for those of us who are neurodivergent, that means we have to come up with creative and adaptive strategies to kind of deal with the executive functioning that we lack in terms of the way our brain has developed and operates. 

And you're right, something as, you know, insignificant to someone who may be neurotypical is like setting up an alarm system, but that can really start to build too, right? Like, you see the box on your couch, and you're like, "I should call, I should call, I should call." And then, you don't and then, again, that shame spiral can come up, or do you just forget, and you're doing a million other things, and then, it starts to come up when it's not a good time to do it. 

I want to also talk about women being under and misdiagnosed. I mean, that's a whole thing. We could talk about that forever, too. 

And, you know, I think what really stands out to me, though, is what you said about being high achieving. And so often we associate high achieving with high functioning. And I don't think we always see the behind-the-scenes of how hard the energy that it takes to be successful, the energy that it takes to have a business, the energy that it takes to overcome a lifelong disorder such as ADHD, or autism, etc. And we associate high functioning and achievement, but behind the scenes, what if you're struggling with compensation elsewhere? Like, you're struggling with that internal criticism, or that harsh perfectionism, or like, the energy drain from being successful just leaves you depleted, you know, aside from business ownership. I think we really tend to like, associate the two going hand in hand. Like, I can only be as successful as my productivity. And if I can't be productive, then what the fuck do I do and who the hell am I? 

And, you know, I think we think about that a lot in a society that places a lot of value on achievement, you know, and doing more and more and more. And what we do know about neurodivergence, right? The more we do, the more our brain works harder and harder to do these things, and then, we leave ourselves kind of more vulnerable, which I assume a lot of these therapists are really struggling with, because then they start to feel really insecure and really a lot of imposter syndrome and a lot of shamefulness. And we almost lose those resilience skills to like combat those feelings and thoughts. 

It's hard. It's hard, y'all. For everyone listening that, you know, is neurodivergent, we see you, like, we get it, it's really fucking hard, and you're doing a great job. And you're probably masking day to day to like, get through the day, and look a certain way, and perform a certain way. 

And I think what you said is really important when you can identify, and finally say, okay, this is what's been going on my entire life, that can be so freeing, that can be really, really liberating to say, "Finally, I have an understanding of what's kind of going on behind the scenes."

MAELISA McCAFFREY: Yeah, yeah, it truly is. I mean, I know for me, personally, I was diagnosed in couples counseling, because yes, this stuff impacts like every part of your life. And it was one of those things where the therapist started asking me questions. And you know, you can imagine we're like in couples counseling, and she's like, "I might focus on one of you at a time, right?" 

And so, she starts asking me these… and she's basically asking me criteria for ADHD. And so, as she's asking me the questions, and I'm answering her, I'm thinking in the back of my head, I'm like, "Holy shit, do I have ADHD?" And I'm, like, you know, having a little internal monologue as I'm answering her questions. And then, like, near the end, she asked, you know, basically, she was trying to see if I had, oh, my gosh, I'm totally going to blank on the word, but you know, like, being able to focus for a really long time. 

And then, I was like, "Yes, I can hyper-focus on things for hours on end, right?" And then, she's like, "So, I think you know, what I'm getting at?" And I was like, "Yeah, you think I have ADHD?" And she was like, "Yeah." And I was like, my mind was blown. 

And my specialty when I did clinical work was learning disabilities. So, it's not like I'm not familiar with ADHD, or didn't diagnose people with it frequently, right? You know, but it's that disconnect of often we're not able to see it in ourselves until something comes up that kind of forces it. And because we are this high achieving type of people, like, if you are a therapist, you're a high achiever. You have at least a master's degree. Like, that is not normal, right? It's just not. 

So, we expect a lot of things from ourselves, and we just never think like, "oh, well, I might have this." 

I mean, that was huge for me. And no, all the strategies don't work for me. But now I have a much better idea of where to go to get ideas for things or people that I can talk to who will understand specifically what I'm dealing with. And it was the catalyst for so many things in my life to improve. Like, for example, now, in my own business, and QA prep, I have said for years that I need a handler, because, you know, I'm like, totally the stereotypical entrepreneur of like, all kinds of ideas, I could start a new business every week, I could start a new, you know, program within the business every week, that kind of thing, right? Like, it is just never ending and the struggle for me is sticking to a couple, like one or two things. 

And I finally hired a project manager. And it is some of the best money I have ever spent. And she's expensive. And it was hard to do that. But it is so worth it to have… and so, I joke now, like I literally pay her to tell me what to do. You know, she'll send me a Voxer message. And she's like, "Hey, just remember to ask people in the group today, you know, about this thing." And I was fully going to forget to do it, right? 

So, it's just one of those things where I'm like, does everyone need to pay to have someone like this in their business? No. Right? Especially at the level that I'm at, right? If you're a large business, it's probably useful. But no, everybody doesn't need that. And that's okay. It's something I can pay for. And actually, it ends up making me money, because she makes me more productive, or she helps me not to waste time on different things that I don't need to waste time on, and think ahead, and plan ahead. But a lot of that is just me finally admitting if I'm going to be a business owner, this is the type of support I need.

PATRICK CASALE: That's perfectly said, I love that so much. And I can relate so much to that. And I hope some of you that are listening can as well. And I know when you're starting your business, and if that's where your stage of life is right now, you may not be able to pay for support and you know, admin support, but as you grow, and as you make more money, I do encourage it, because I have a similar relationship with my virtual assistant who's wonderful, and I could create a new business every day as well if she didn't keep me in check, and was like, "Hey, stop sending or stop creating folders in Google Drive of like new ideas that you have. We are focusing on A, B, and C." 

And that helps me check myself, I'm like, "Oh, yeah, like, rein it back in." But still, allow yourself to have that creativity. But I do think we need those strategies in order to support ourselves with things that are deficit areas for us, because we struggle with them. 

So, like, I know I use the schedule send text and email all the time, because if the idea is in my head I want to get it out before I forget it. And I think at one point in time people were probably like, "Why the fuck are you texting me or emailing me at whatever time during the day or night?" And it's like, "I'm not trying to actually get a response from you. I actually need it out of my head, or I will never see this again. And then, I will forget, and then, the next time we come in contact, I'll be like, sitting there thinking like, 'I know there's something, but I don't know what it is.'" And that drives me nuts. So, you know, all these little strategies. 

So, you mentioned before compensation strategies to deal with documentation, what are some of those strategies that you find are pretty effective, especially, for people with neurodivergence?

MAELISA McCAFFREY: Yes. And I will give you all one that you can do for free, right now, literally, like with the next client you see. And most people will probably laugh or smile to themselves when I say this, end your sessions on time. So, when I started working with people, right? Like I said, I didn't start QA prep thinking I was going to be helping people catch up on paperwork, right? I thought it was going to be teaching them like how to write notes and all of that. And yes, I still do that. 

But as I started working with people I realized so much of what ends up being a struggle is a struggle, because we are spending so much of our time trying to be productive, burning out, not giving ourselves the self-care that we need. And I know when I was doing therapy, like, I needed that time in between clients for me. I didn't need that time in between clients to write notes, I did that at a different time, because I needed the time just to either settle myself, to go to the bathroom, to get some water, right? Like, there are just basic things you need. And so, one of the most impactful things you can do is just end your sessions on time. 

There are different ways to do that. So, there are timers you can set up, there are alarm clocks that don't make noise, but have different like colored lights that shift so that you can have it in the room with you. You can also set alarm clocks that have, you know, maybe like a nice meditation-type tone to them that aren't like, you know, "brrng" like craziness that are going to scare you in the middle of a session. But, you know, try those different things. 

And another way that I think is super helpful is tell your clients, right? So, a lot of people are probably thinking, "Well, but I've always gone over session over time. And I've been seeing this, you know, a lot of my clients for two years, maybe, right? And so, they're used to it." Yeah, they're used to it. And that is not what they're paying you for, they are paying you for whatever time 45, 50 minutes, typically, whatever you do. 

So, you can tell them, "Hey, you know, I know we typically tend to go over time. But, you know, this week, I'm starting to end our sessions on time." And so, you know, use that language, tell them that you typically go over time, you're, again, reframing for them that you actually aren't supposed to be getting this whole 60 minutes, right? And, you know, we're going to start ending our sessions on time. And that's where you can introduce, you get one of those, like, light alarm clocks or something, "Hey, so, you know, you'll see this, you know, change to purple, or whatever, when we have five minutes left." Or, "So, I'm going to let you know when we have five minutes left." And that'll help keep you accountable if you let your clients know right off the bat, "Hey, I just want to let you know we're going to end on time."

Plus, it's just good if you are used to going overtime, your clients aren't going to expect it, and they're going to be like, "Whoa, you know, I thought I had 10 minutes left to kind of, you know, regulate myself before I leave or before I'm done." 

But that one thing impacts like, so many other things, because if you give yourself that time throughout the day, even, like I said, don't feel like you have to fill it with being productive. Like, just give yourself breaks. Just start with ending sessions on time, give yourself those breaks in between clients, then you can maybe work into, like, maybe you could do notes in between session, maybe you could answer emails, or phone calls, or whatever. But don't make it about being productive. Make it about giving yourself the time that you need to either digest what just happened in a session, or prepare for the next session, or like I said, you know, just take care of your physical body, like, whatever it is that you need to do. And then, at the end of the day, you will feel better.

And you might not feel better the first day. Like, it takes time for you to adjust to that. But this also makes me think of, I attended this, like, more of a more personal training, and the guy who was running the training, he said that people always come up to him, he's fairly well known, and are like, "Oh, you know, you must be so busy." And they'll often like kind of apologize for wanting to ask him a question, right? Or come up to me and say like, "Oh, I'm sorry, you must be so busy." And he's like, "No, I'm not." He's like, "Why would I want to do that? Why would I want to be busy?" 

And it was so refreshing to hear this, like, very successful entrepreneur type of person, like, say, like, "I'm not busy. Like, I'm not busy on purpose, I don't want to be busy, I want to have time to enjoy my life, you know?" And so, if ending your sessions on time is one of those things that helps you feel like that, you need to be able to take that breath and I'll be [INDISCERNIBLE 00:25:38] back and forth the whole time you're working.

PATRICK CASALE: Yeah, I love all of that. And I know so many people, and I used to do this myself who stack client on client on client, right? Like, 10 o'clock, 11 o'clock, 12 o'clock, okay, I'll take a lunch break or maybe I won't take a lunch break, because I just overwhelmed myself for so long that all I can do is like lay here in my chair. And then, see two o'clock, three o'clock, four o'clock, without, like you said, a break to go to the bathroom, a break to get up and go outside, a break to go let your dogs out, or let them back in, or like eat your lunch, God forbid, or like any of the things that we don't often do. 

And if you can reclaim that time throughout the day, even if it's like 10 to 15-minute increments in between sessions, and at the end of the day you come up with a full hour or hour, and a half of that time that you've gained back, your brain is going to thank you, your body is going to thank you, and in turn, you're going to have more energy to do the things that you maybe don't want to do like documentation, and call people back, and stuff like that, because you're not going beyond your capacity anymore. 

And also, like, I think naming the fact that you're no longer going to go over session is also a way to model boundaries, but it's also a way to normalize that you as a therapist also sometimes struggle with boundaries. And that you're like, "Hey, I've been doing this thing, we're going to actually move to this thing, because this is actually how we were supposed to be having… the way we should be doing this all along and now we're going to change this up."

And, you know, I think it's really important to just have the language so that you can relay that so the client's not surprised, right? Like you said, so that you don't just cut them off 10 minutes earlier than they expect to be cut off. And also, it allows you to kind of work through some of the struggle that you may have around setting boundaries around your time and just having that value behind your time too knowing that like, after a certain amount of time, if you're an insurance therapist, insurance stops paying you for these sessions. Like, so you're giving a lot of therapy away for free, or you have a client in the waiting room like waiting for you to end your session. And there's a lot that goes into that. 

So, I think that's a really good tip. And one that feels maybe simplistic, but in reality, is really hard for people to do. And really hard because now we're talking either time blindness or boundary setting. And both of those things can be challenges for different reasons. So, really having these strategies to compensate, and I like the idea of like an alarm that changes color or something like that. So, it's like, okay, this is more soothing than, like you said, just an alarm that starts blaring, or buzzing, or going off. And then, your client's like, "What the hell is that?" 

I always keep a clock on my wall, like, where I'm facing and out of my peripheral so I can keep an eye on time as I know we're getting closer. But time is not something I've struggled with in my life. I'm too sensitive to time, probably. But for most people who are really struggling with time management, I think that's a great strategy. And again, buying yourself breathing room, and then the tasks that feel menial, that feel like a chore, that feels like an extra add-on, they become a lot more doable at the end of the day.

MAELISA McCAFFREY: Yeah, yeah. And it kind of talks to another thing that I'll often mention, which is buffer time. So, yes, you will maybe in a week have one client that will need to go over a little bit, right? But if you kind of have that built-in, that most of my clients I end my sessions on time, I have time to recover, then when that one client does need to go over, where they ask you at the end of the session, like they need some type of form filled out or whatever, and you have to talk to them about that, then it doesn't become this thing that you're going to, like, try to quickly finish up with them, because you already have that buffer time built in. Like, okay, I can, you know, extend this by, you know, five minutes or whatever. And it doesn't mean that now my next client is five minutes late, which [INDISCERNIBLE 00:29:25] you know, et cetera. 

And I recommend that for all of your scheduling, like, literally build in buffer time, because one of the things, you know, with being time blind, which is definitely one of my struggle, is that you think you can get things done in a certain amount of time, and often that doesn't happen. And so, that's okay. It's not something that you have to beat yourself up about. But once you can admit that to yourself and say, you know, it's totally different to be like, okay, I'm probably being overly optimistic about this so let me build an extra hour around, you know, this. 

I mean, there are different strategies, there's also, you know, Parkinson's Law, which is that if you give yourself two hours to do it, you'll spend two hours. And if you give yourself five hours to do it, you'll spend five hours. So, you have to limit yourself at some point. But in your schedule, like your actual working schedule, have time in your schedule for like, general admin time, have time in your schedule, specifically, for notes. Notes are never part of your admin time, they are a completely separate thing. But most therapists I know build their schedule around having admin time. And so, if you do that, 100% of the time you're going to do emails, voicemails, everything else you could possibly do before you're going to do your notes, right? So, you got to have notes time and admin time, and then, building some buffer time there too so that you can plan ahead for those weeks when life happens and you have a migraine one day, and can't sit there and write your notes. But you know, okay, I have this extra hour plan on Thursday, or Friday, or whatever. 

PATRICK CASALE: I love those strategies and advice. And like you said, don't beat yourself up if that's something that is a hard thing for you to do, lots of strategies in order to kind of help you manage. If you really struggle with time blindness, or like, you know, I think I have an hour, I'm going to get it done in that hour turns into three, because of the distraction, because of something else that came up that became exciting, because of just plain forgetfulness, put a movie on, put a song on that you know, like, this album finishes in an hour, or this movie or this show finishes in an hour. Once it's over, I know the time is up, there are lots of strategies to kind of prompt you to kind of let you know like, 0kay, I know that we're getting close to time to be done with this task. 

And break your tasks down into littler steps to if it feels like the bigger task is too overwhelming. I do like the idea of separating admin time and documentation time. However, I think that's really important and a really, really useful tip. 

So, I think all of these are really useful. And I think it's a good way to change your perspective on something that maybe feels really overwhelming, and potentially, really monotonous. I know for us neurodivergent folks, monotony is pure hell sometimes. So, I think we need to be able to figure out creative strategies to make monotonous tasks feel a little bit less heavy or burdensome too. 

And I just want to thank you for coming on and talking about this stuff, I think it's a topic that often doesn't get covered, or it's glanced over, or, like you said, creates a lot of shamefulness. And I like the idea of really normalizing the fact that a lot of people struggle with this. And you're not alone in that. And that's the whole concept of this podcast in one form or another, for everyone listening, is you're not alone in this like life is hard, life is messy. And even on the outside, we can make something look a certain way and, on the inside, it can look very differently. So, just don't beat yourselves up for this. But definitely make sure that you are hiring someone like Maelisa or someone else in the field that's really helping support, not just the practical side, but the emotional side. And I think the combination of the two is really important.


PATRICK CASALE: Just as we're wrapping up, just please tell the audience where they can find more about what you are offering for QA prep and how they can access your services. We'll also have that information in the show notes so everyone has that available to them.

MAELISA McCAFFREY: Yeah, I tell everyone you can check out my stuff really easily by checking out the free private practice paperwork crash course I have. So, it gives you some quick and easy templates to use. And it's broken down into like five to 10-minute videos. So, if you just want to help around notes, you can just watch those videos, if you just want help around treatment plans, that kind of thing. And that is So, it's pretty easy. It's all over the website, too. If you just go to you'll find a place to click on the crash course. 

So, that's a good way you can kind of test out if you like my training style. If you are looking for more support, I would say, start there first. And if you need more then, I do consultations, and we're also going to be doing in August, so I'm not sure when this will release, but we'll be doing this probably on an annual basis a Summer Paperwork Blitz, so that's going to be a week of co-working in the mornings where other therapists are there and we're all just working on notes and getting stuff done together. 

And it's crazy. But you know, having that support and having that community is huge for your motivation. So, make sure you're following my stuff so that you can get that notice and join us. That will be a free offer in August.

PATRICK CASALE: Very, very cool. And that's an awesome offer. I may have to join that. So, and then Is that it?

MAELISA McCAFFREY: Yeah, crash-course you know, like a little hyphen.

PATRICK CASALE: Crash-course. It'll all be in the show notes. I promise now that I just confused everyone. But yeah, I appreciate that. And I appreciate these resources very much. And I appreciate you making the time to come on here too. 

MAELISA McCAFFREY: Yeah, thank you so much for having me. 

PATRICK CASALE: You're welcome. And to everyone listening to the All Things Private Practice Podcast, new episodes are coming out every Sunday with interviews with great people like Maelisa and other people in the industry. 

And you can like, download, subscribe on all major platforms. Make sure to share it with your friends, and we will see you next week. Doubt yourself, do it anyway.


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