Oh Really! This is something we have been saying in the trenches for years. I believe this is one of the biggest detractors, from why people are choosing not to enter the field of counseling, along with low pay. The paperwork is drowning us and we add more to keep Medicaid at bay. Thirty One years ago I learned SOAP notes formatting and it's still as relevant today as it was then. I hope we can go back to the time where the patient becomes important again rather than satisfying bureaucracies.

After 35 years in the field and with 13 of those in recent years spent working overseas, I returned two years ago and have been working in New York State and I have never seen such a mess in my life. I thought my Navy experience would prepare me for any bizarre bureacratic antics, but was I ever wrong. The saddest thing was the whole set up has nothing to do with quality of service, it is just a quantitative exercise.

Bless the folks at TRI for raising awareness of the growing problem of paperwork. I have seen countless cases of failure to take action on patients needs until paperwork, whether psych tests or behavioral notes, confirms the obvious. Not only is staff time wasted performing unnecessary work, but the rhythm of recovery is lost.

About 20 years ago, I went to the Small Business Innovation Research Program and ADAMHA (forerunner of SAMHSA)with a proposal to tailor a (then new)office suite for treatment programs,because I had found treatment was 5% inspiration and 95% documentation. Didn't fly. The underlying purpose was to make it easy to collect large amounts of outcome data to improve assignment. Now we know more about complex adaptive systems and a shared information system could reap even greater benefits (like what Ebay and Amazon have done for retailing). SAMHSA tried to fund such a system, but got shot down by the commercial database providers. Maybe its time, with the Obama commitment to medical informatics, to try again.

What a news flash. Now how does this message get relayed and acted upon by all the various State and Federal licensing, funding and "quality assurance" people? Believe me, it's not as if anyone actually WORKING in the addictions field is clamboring for more paperwork.

I am guessing that all of the comments so far are from therapists using a kluge paper trail that hasn't been updated in 20 years. My agency started using an electronic record over a year ago and it has cut my documentation time by at least 80%. Let's quit whining about the bureaucrats- they aren't smart enough to understand the isssues anyway. Get you agencies to convert to electronic records.

After 35 years I have little hope that there is any magic bullet like electronic medical records that will reduce paperwork. How will electronic records stop JAHCO or state licensing boards or outcome researchers from demanding ever more paperwork documentation. We start electronic medical records in May. We'll soon see.

Duh! I do have to say Amen...now let's get on with minimizing the redundancy of paperwork and more focused on services. Doesn't matter if it is electronic or not, the state and feds need to help reduce what is being done in the programs as we are trying to meet their requirements to stay licensed and opened.

Note from the authors: To clarify, this study was conducted with outpatient substance abuse treatment providers in one state system of care. Although a similar process would likely be effective with inpatient providers, we focused on outpatient because 90% of all treatment in our country is delivered in outpatient settings. The “Paperwork Reduction” project was our way of trying to address the overwhelming data collection demands on service providers in a systematized way that could be replicated by other states or counties. It was one of our most enjoyable and rewarding projects to date and, of great satisfaction, was the knowledge that the process can be undertaken in other states and counties. We have already consulted with the state of NY on Paperwork Burden issues and are involved in a project with the county of Philadelphia to achieve similar results.

A well known advocate for Social Model Treatment that will remain nameless once said that we could put all the information we need about our clients on a 3 x 5 index card. Paperwork is killing one of the most effective and cost efficient treatment models as we turn to professionalism, licensing of counselors and the use of medications. I've been in field long enough to see it go back and forth a few times and I hope it returns to a more reasonable approach soon.

Michael Abbott, I am envious of you. Obviously you live in a place that still has money to have funded a paperless system. Having been with the VA System, Betty Ford Center, Hazelden, Adolescent Half-Way Houses in Minnesota, Hospital based programming and, now the director of a program in Northern Michigan for the last 19 years, I have been around the field for 31 years. Our State has had flat funding for the last decade, and beyond, for treatment; and, many States are drastically decimating their substance misuse treatment funding to salvage their budgets. You are fortunate to live where you can afford an electronic medical record. The only way we are going to get that is through a grant for technology improvements or the State will fund the efforts. Maybe some stimulus monies can head our way. LOL Enjoy your system; the rest of us are drowning.

I am so glad this subject is finially being addressed. Our work is suppose to be about our clients, but it is more about the paperwork than the person we are treating. It is a shame that our clients are not getting the care we went into this field to give because we are tied to our desk and computers doing paperwork. If not at the desk we are in meetings being told about more paperwork to be added to what we already are doing. I have considered getting out of the field because of the growing documentation required. I love working with clients, but don't get to do a lot of that because of paperwork. I have to agree with Donna, "Doesn't matter if it is electronic or not, the state and feds need to help reduce what is being done in the programs as we are trying to meet their requirements to stay licensed and opened."

TECHNOLOGY TECHNOLOGY TECHNOLOGY -It can change your business overnight. with the technology available it is inexcusable that some agencies/facilities like mine will not invest in technology- we would be more efficient, able to patient focused, stay in compliance without manual auditing records. Amazing that our field is in the business of helping others- there is rarely a case where technology can not positively impact business- in our field we would enable us to get back to the real work.

I still haven't heard from anyone who is actually using an electronic record.........

ValleyHope uses an electronic clinical that was developed by actual clinicians that is affordable and very easy to use. It is the best I have ever seen!

We have known this for years. So now that we are being “evidenced based” then let’s take this evidence and get the legislators, administrators, regulators and lawyers to cut the ridiculous amount of useless paperwork. Then we can eliminate other process requirements done in the name of “Quality Improvement”. QI has never demonstrated one scintilla of evidence that it improves treatment outcomes for clients. QI improvement & research to practice in theory is a good idea, if it didn't result in an endlessly additive, multi-layered process who's cumulative weight has just the opposite effect than intended. Then lets talk about the huge waste of $$ it is forcing everyone to do "Evidence-Based Practices". As unbeleivable as this may sound there is no legitimate scientific proof that any EBPs outperforms any other treatment model that's intended to be therapeuitc in a fair head to head research analysis (Wampold, 2001). We spend huge $$ training people on EBP and reconstructing our provider systems and educational requirements so we can get funded. Like the banking system let's get the politics and greed out of here and on with good treatment!