Writing Clinical Notes & Daria

Daria Logo (source: en.wikipedia.org)
A couple of years ago I was asked by Centacare to work with clinicians on writing clinical notes.  This is important for both counsellor and client.  Well-taken notes have limited impact on the counselling session, while providing useful information for clinical records and to guide future sessions.

Counsellors have an unenviable task.  Anything that can be done to maximise outcomes and conveniently meet practice standards is valuable for these people.

I was struggling to figure out how I could give the participants a practical exercise in writing clinical notes on a low budget.  The solution I came up with was to show a dysfunctional family scene, and ask the students to write clinical notes summarising what they saw happening.

I asked the participants to take notes on the same scene, as I was interested in what was common across the participants' notes, and what they saw differently.  As I was teaching the SOAP Method of recording clinical notes, I was also interested in which elements they each recorded under each label - Subjective, Objective, Assessment and Plan.

I considered programs like Married with Children, Friends, Monty Python's The Meaning of Life, Neighbours, and others.  I kept coming back to Daria - a tv show about a sensitive, practical girl who is a goth (or who we would have called 'alternative' in my teenage years) growing up in a family in which she is misunderstood.  (That's a very short version of what it is about.  It is a show I really enjoy, and I recommend it to you.)

The segment I chose went for about two minutes.  Daria was in hospital with a stress-induced rash.  Her family was interacting with Daria, with each other, and with Daria's doctor.  Daria's perspective was being ignored, and Daria was developing a crush on the doctor.

The segment from Daria may seem trivial - after all, it is just a cartoon.  In the workshop it generated about 20 separate points, and resulted in a 30 minute discussion about the interactions and what they tell us about the relationships.  There was plenty of rich content to be turned into SOAP Notes.

Popular culture can be a useful piece of common ground, and the apparently trivial can lead to powerful interaction.