Documentation and Record Keeping: Essentials for Mental Health Professionals (3 CEs)

This course qualifies as an ethics course.

“The information presented in this course will be very helpful with my documentation of psychotherapy and enlightened me about potential risk and legal issues. The presentation was clear and he gave real life examples to illustrate what he was saying. I learned the difference between a supoena and a court order, and specifically what goes into effective documentation of psychotherapy notes."-Claire H., Social Worker, Vermont

This webinar explains the goals and potential benefits of effective clinical documentation as well as the ethical and legal requirements for doing so. Documentation is addressed from a clinical and risk management perspective. Specific recommendations are made for how to document the clinical services provided in a competent and effective manner. Additionally, common pitfalls to avoid are addressed. How to store and maintain records is addressed for both paper and electronic records. Precautions to take to protect and preserve records are described in detail along with how and when to dispose of them. Guidance is provided for following HIPAA and other laws and regulations relevant to documentation and record keeping. Participants in this webinar will receive practical guidance that can be integrated into daily practice to document more effectively, to better achieve the goals of thoughtfully created treatment records, and to meet and exceed professional standards and practice guidelines relevant to documentation and record keeping.