Now to sound a very different note. An inevitable and necessary part of a counselor’s work is adminstrative. Writing notes in the chart…. Contacting agencies or counselors for previous records…. Dictating discharge summaries…. Contacting the referring party or others to whom a client will be referred….This is often perceived as a pain in the neck and the portion of one’s job most likely to get short shrift. However, attending to these details is an important part of good clinical care. Alcohol treatment is almost never a solo act, but instead involves the efforts of a team. How effectively the team functions often depends on the counselor who orchestrates and coordinates the various efforts.

The client’s chart or medical record is one very important vehicle for communicating information. This is especially true in a residential facility, with multiple staff working different shifts. There are often questions as to what should and shouldn’t go in a chart. To handle things that should be noted but are particularly sensitive, some agencies have adopted a set of confidential files, separate from the main record. Although not wishing to dismiss lightly the concern for confidentiality, nevertheless, it can be a red herring. In thinking about what to include in the chart, ask yourself “What do others need to know to respond therapeutically?” Rarely does this have anything to do with “deep dark secrets. ” More often it has to do with the everyday nuts and bolts— worrying over a date for discharge, preoccupation with an upcoming court appearance, a strained family meeting. The chart is not the place for putting forth verbatim accounts of individual sessions. But notation of any general themes, plus any modification of treatment plans is needed.

In addition to charting, it will also fall to the counselor to present cases at team planning meetings. On such occasions, a little preliminary thought helps: Are there special questions you have that you’d like to discuss with others? Along with these formal routes of communication, there are also informal channels. Take the opportunity to brief others.

Beyond orchestrating the activities of the treatment team, it falls to the counselor to be a liaison, and sometimes an advocate, with external groups such as employers, welfare workers, the courts. In these situations you must have the client’s permission before acting. Also, it is important not to do for the client what he can do for himself. Generally, it is more therapeutic to do a lot of handholding as the client takes care of business, rather than, in the interest of efficiency, doing it yourself.

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