Inclusive Note-Taking in Therapy
It's Pride Month (a.k.a. June)! And for those of you reading this post during any other month of the year, welcome too. Today, we're talking about note-taking and documentation…and to add a little more sparkle, we'll be looking at it through the lens of the queer community. After all, love is love, and note-taking is note-taking. As trainees and practicing therapists, we know that documentation is at the heart of every session. So if you're looking to make your note-taking more inclusive, keep reading as we learn something new together.
A Personal Trainee scoop:
During my trainee days (which are still ongoing!), one concept that has always stood out to me is: ask, don't assume. While taking a case history, it can be helpful to explore a client's gender identity and sexual orientation, provided they are comfortable discussing it. Asking about preferred pronouns is equally important. These conversations not only help us understand our clients better but can also affirm their identity and lived experiences. So the next time you're filling out an intake form, taking session notes, or addressing a client, be mindful of the language you use and the information you document. Small changes in documentation can go a long way in making therapy feel more inclusive and affirming.
Educating oneself is always in trend:
Before we even get into the actual note-taking part, let's talk about something equally important: education. Being an ally to the LGBTQIA+ community is a great start, but it doesn't automatically make someone a queer-affirmative therapist. Queer-affirmative practice requires ongoing learning, reflection, and a willingness to understand experiences beyond our own. If you're a therapist or trainee looking to make your practice more inclusive, take the time to learn about topics such as inclusive language, minority stress, identity exploration, and the unique challenges faced by LGBTQIA+ individuals. Attend webinars, enroll in courses, read books and articles, or even turn to YouTube for accessible educational content. The more informed we are, the better equipped we become to support our clients in meaningful and affirming ways. After all, one of the best things a therapist can do is never stop learning. So stay curious, keep educating yourself, and continue building a practice that is both informed and inclusive.
Inclusivity everywhere:
Whether it's your intake forms, research forms, or client documentation, inclusivity deserves to be normalized everywhere. And let's be honest…if there's one trend worth following, it's inclusivity. One simple way to make your forms more affirming is by including details such as:
Legal Name:
Chosen Name:
Pronouns:
Sex Assigned at Birth (Optional):
Gender Identity:
Sexual Orientation (Optional):
Small changes like these can go a long way in helping clients feel seen, respected, and affirmed from the very beginning.
Use Zensible:
No note-taking post is ever complete without a mention of Zensible! But on a more serious note, did you know that Zensible can help you record your therapy notes ethically…with proper client consent…and keep them accessible only to you? What's more, you can also revisit and edit your notes whenever needed. When it comes to inclusive documentation, this means you can ensure that important details such as a client's chosen name, pronouns, and other identity-related information are recorded accurately and respectfully. Small edits and mindful documentation practices can go a long way in making clients feel seen, heard, and affirmed. After all, being an inclusive therapist isn't about being perfect…it's about being intentional. And sometimes, that intention begins with something as simple as the notes we write.
And with that, we've reached the end of this week's post! I hope you learned something new (I know I did while writing this). Until next time, keep being curious, keep being inclusive, and keep being your wonderful selves. Take care, you lovely human beans!
