Ready for some great management and therapy session tracking skills? Join Lindsey and Dr. Lisa Ross, Ed.D., LPC for a terrific episode on how to manage large caseloads in an effective manner. Most importantly, learn how to say goodbye to working on weekends! From maximizing your everyday tools like Google Calendar to staying on top of your SOAP notes, Dr. Lisa and Lindsey have great ideas to keep your students on track to achieving those IEP goals while keeping you sane and prepared. Whether you take written or electronic notes, you will want to jot down some of these great ideas.
Lindsey:
All right, Lisa, give me some tips on organizing your cases. You have 60 students. All right. Everybody in the comments, I want you to drop how many kids you have on your caseload, if you’re mental health, SLP, or OT. Tell me if it’s a virtual setting or if it’s in your traditional brick and mortar. I know my SLPs, in that traditional brick and mortar, you got 60 kids and that’s a little cray cray as well. So you’re running groups, you’re doing individual. I want to know kind of what your caseload looks like, because Lisa’s got some great organizational tips for us. So let’s talk about first, how do you just manage your day? How do you break up your day? Especially when you are a virtual therapist, you’re at home, you might not have someone micromanaging you, so you really have to be the CEO of your own business and practice. So how do you like to manage your day? What are some tips that you do?
Lisa:
I set aside time every morning before I start work, at least a half hour, sometimes a little more, with my coffee in hand, looking at my calendar. I use Google calendar, which is fabulous and really supported by Global Teletherapy. And I will also work on the weekend a little bit, mostly just thinking about who I’m seeing and what progress they’ve made or trying to think of creative things to do with them. So first thing I do is some pre-planning in the weekend for the week, and then every morning, kind of review that before I start with my students. So if I have 10 that day, I make sure I know what 10 they are. And then from there, I use a Google document, a sheet with a tab for each of my students and kind of make sure I kind of jot little notes in there on how they’re doing, and what I’m going to talk about.
Lindsey:
That’s important. Yeah. I love that you gave me some examples, so I’ll bring those up to share with the group as well. But I know that sometimes, especially for new therapists, we are constantly thinking about our job, but we’re not getting paid for it, but we’re thinking about it. So we really want to be mindful of how we spend our time, blacking out sections on our calendar. I love how you say, yes, you do work on the weekends, but you want to have those actually like, this is work time. So when it’s not penciled in as work time, we should not be thinking about work, especially as mental health clinicians, we are always very mindful of what our stressors are and things like that.
Lindsey:
So this is a really good tip for everyone else. When it’s not on your calendar, it is not GT time. Don’t make it GT time, you’ll get burnt out, right? So I’m going to pull up your calendar so everyone can kind of see. Talk me through how this looks and what it looks like, how you organize it with students or what you do. And I see that there’s some stuff at the top, is that for the school, so you know their school day? How do you integrate all of these important dates?
Lisa:
Well, one of the good things with Global is, they will send me a calendar, which I can then add into this calendar, of all the schools I work with. For example, on Monday, the 20th, California had a holiday. North Carolina had a holiday. South Carolina had a holiday. Envisions, which is another California school, had a holiday, so I knew all those were holidays. My typical Monday, of course [a lot of Monday’s were canceled, but that’s what that shows at the top, and that way, I always know at the very top, if somebody is on a holiday, so I can kind of… And I usually, on the weekend, I’ll look the week ahead just to make sure, because sometimes those teacher workdays pop up on me and I’m like, oh, I need to reschedule that day because the students aren’t there.
Lisa:
Then going down on that. The blue lines I apologize for, but those are student names, so that way I’ve got them kind of blocked out, or they are some notes on how to plan for the day. So I make sure I least put a half hour in for that. Each week’s a little different because some of my students are every other week, some of them are once a month, so you have some variations in each week, but this is kind of typical for me of how I’ll plan my time.
Lindsey:
No, those are great. I love how it’s all blacked out, so each student has their time slot and it looks like you’re giving yourself a little bit of a break in between some students. That’s really important for documentation. I think it’s important to bring that up because that paperwork piece, that gets a little crazy, right?
Lindsey:
Okay. We all love our job. If we did not love our job and providing that direct service, we totally wouldn’t do it. But who here loves the paperwork that comes along with it? I don’t think any of us, right? I know that there’s some of us, me being one of them, that maybe doesn’t black out paperwork day. So it’s at the end of the day and you’re like, oh, I need to document everything. But if I don’t do it right away, I might forget something. So I like, how on your schedule, you have that little bit of a gap between, so you do allow for that documentation time. I think that’s really important. So let’s talk about documenting and keeping that information kind of organized. What do you have to do, to do progress monitoring? So monitoring those goals and tracking those students. So you mentioned that you use some sort of a service tracker, I got a copy of that here too, where you talk about all the student information. So I’m going to pull this up and make it bigger. Just walk me through this document.
Lisa:
Okay. So I blocked out some stuff, so the brown line would be kind of the student’s name, the goal, and maybe the in status. So as soon as a student is assigned to me, they go into my Google document. And this is a Google sheet, or you can use Excel if you don’t use Google, but Global uses Google drive very well and it’s real helpful. So I put everything I need about the student, as soon as they’re assigned. How many service minutes, so the time 30 times 31 means there’s 31 weeks left in the year when the student was assigned, he gets 30 minutes a week. I’ll kind of document as I’m reaching out to them, when I got started, if they’re a no show. And I have some other stuff in there normally, I just erased it for this screenshot, but I’ll have their goal so that I know what it is right when I look it up.
Lisa:
And there’s a link there to go in and document as soon as I get a few minutes, in the student SCIS system, student information system. And that’s kind of how I’ll do that, that way as soon as I finished the session… Well, before I do the session, part of my pre planning is I kind of flip through the goals. If you meet with them enough, by this point, I’ve got pretty much everybody’s goals in my head, but I like to just review them real quick before the session to make sure I’m providing the services I want to provide. And then I’ll make some little notes, like right here where you see left and right brain, I kind of did a little activity on left and right brain with the student. His goal was related to anxiety and depression and just ADHD, so learning skills are kind of part of his skull or executive function development.
Lisa:
So I’ll try to plan a little activity and then make a little note on how it went, because some of my activities are real duds, so sometimes I notice that too. It’s like being a teacher, you come up with this great lesson plan and you think, oh, this is going to be fun. Your students are like, nah. That didn’t work.
Lindsey:
And they don’t like it. Oh my gosh, it totally happens. I think this is great, using electronic documentation. GT, we’re online, right? We’re using paper pencil. So, I have an organization system, I highly don’t recommend it to anybody, however, this one sounds like a really good idea. Now it works for me, you have to find what works for you, but that documentation is really key. So you have 60 students, so managing them, I think this is a really great way because you have a tab for each student, you can quickly review it. You’re kind of planning out ahead of time to be like, oh. Because sometimes, I know my sessions, we don’t finish. Today I had a session and we did not finish all the questions that I had, and I was like, well, we’ll carry over. But then if I use this documentation system, I can remember, because next week I’m going to forget that’s a week away. I’m not going to remember what I did.
Lindsey:
So I like that we just have this little note in there that you’re like, okay, left brain, right brain. Maybe you only got through left brain, we didn’t get the right brain, next week we could. So there’s different things. I like how you document that, and then having one for each student, so that way it stays organized. Now sometimes we can reuse lessons, the students have similar goals and that’s helpful. So sometimes if I try to do a theme, when you’re planning, everybody’s going to be having this type of theme. So we’ve got February, one of the things that I like to do since it’s Valentine’s day, but I talk about love languages and wrap it around caring and feeling and things like that, that way the students know. But I can put that on that little tracker and be like, that’s kind of what I’m going to preplan ahead of time. Because part of your calendar does have to have some planning and prep time. Since we typically don’t see students during the weekend, would you say the majority of your planning time is spent on the weekend?
Lisa:
Yes, but I’ve gotten to where I don’t have to spend too much, maybe an hour or so. What I like about the tracker, that helps me I think, is I can see… It’s almost like having a quick review of the whole year.
Lisa:
Now that I’ve gotten into the second semester and we’re 18 weeks in, I want to go back and see, okay, what have I gone over with him? What lesson worked? Where is he a little weak on the goals? Because I get in that thing, I guess it’s like anybody, I’m like, am I repeating myself? Am I going to say what I said last week? Am I going to put up the same activity? And every now and then, that has happened to me. They’re like, “Dr Ross, we just did this.” And I’m like, “Oh yeah, I’m sorry.” But it might’ve been because I didn’t finish it the week before. But keeping a note like that, even just a one or two words on what topic I went over and then some little notes to the side on how that… He or she’s doing with their goal, helps me in that way. When I go back into writing detailed progress notes, I’ve got some ideas there on how well they did.
Lindsey:
And oh my gosh, I totally can relate to… Not recycling, but reuse that lesson. And I was like, did we go over this? I can’t remember. And so I just played it off. I was like, “That’s because it was really important and we need to review this. That’s why I’m showing it to you.” I am not a fool. I know what we did. I’m really like, I don’t really know. But that’s important to add. And you brought up a point about progress monitoring too, right? So it’s about progress monitoring data information. Oh, we got a few more people joining us. Hey Amanda, Amy, Linda. Thanks for joining us. If you are just tuning in, we’re talking about progress monitoring, organizing our caseload. Drop in the comment section if you’re team live or if you’re team replay, I like to go through and kind of see where everybody is. So hashtag team live, team replay, and I can kind of follow you guys along.
Lindsey:
If you have questions, if you have questions for Ms. Dr. Lisa Ross about organization or what kind of tools she uses, put those in the comments too, because she’s here to answer those and we’ll get those answered live for you. So we’re going to talk about a little bit progress monitoring. So we kind of organize our lessons, we’ve got our documentation system. We know we’re documenting shortly after the lesson, so we don’t forget what we did. We can review our lessons with our students to kind of help. But goal monitoring, it is progress monitoring time right now.
Lindsey:
A lot of us have deadlines that are due this week or maybe we just submitted them in. A lot of our schools have special forms or computerized systems, but how do you go through the data and how do you kind of monitor that? Sometimes we have a goal that maybe the student isn’t always working on, but it’s one that we’re monitoring because we’re working on other skills. So what is it that you like to do when you know your deadlines coming up, maybe a week or two before your progress reports are due, how do you get the most accurate data? What do you do during your session?
Lisa:
I do two things, usually. I try to combine two sets of data. One is from the student tracker, which are just general ongoing notes I’m making to myself of, they’re not using a lot of self-control this week. Or sometimes I’ll get a comment from the parent like, “They didn’t have a good week this week.” Or they’ll say, “They had a great week.” I’ll make all those little notes, so they kind of come together as a snapshot of where we are.
Lisa:
And then we also do SOAP notes with Global Teletherapy, so we either log them in a billing system, like Fusion or other billing systems. So with the good SOAP notes, which is something I learned from Lindsey, make sure I really document and use the numbers and say, okay yeah, in three out of five opportunities, they’re doing this, but their goals four out of five or five out of five. So I kind of use those two pieces of data, my SOAP notes and my student tracker to kind of pull them together. And then I can write, I feel like a fairly educated guess on, it’s pretty accurate, on how well they’re performing.
Lindsey:
All right. That’s really good. So yeah. Doing little toothpick checks. If you take good documentation in your SOAP notes and you’re reporting on the goals, then progress reports are kind of really simple. But now that we have data from those progress monitoring and then we’re going to prepare for the IEP, but also, can we use that data for figuring out individual versus group? You’ve got 60 kids on your caseload. Dotty, she’s got 54. That’s a ton too, right?
Lisa:
Right. Right.
Lindsey:
These are big caseloads. I don’t know if there’s enough time in the day to see all of those. You’ve got to have some of these kids grouped up, right?
Lisa:
Yes. I’m running two groups now and I might be starting a third one, I’m not sure yet. So I have a group of young ladies, very young, like first grade age in North Carolina. And then I have the exact opposite right after them, so it’s kind of a brain shift, 18 and 19 year old guys in California. So it’s like the two different sides of the country, developmentally, two different places. So it’s kind of funny that the groups both ended up being Friday, and kind of back to back. But yeah, when the IEP calls for a group, obviously I love doing them. They’re my favorite. I always loved doing them when I was in brick and mortar. And then also, sometimes you have these students that have IEP goals that relate to social skills and interacting with peers. So starting out one-on-one with me is great, but if the goal is really to be more appropriate with peers, I kind of need to see and help them with peers.
Lindsey:
Yeah, they have to learn how to generalize those skills. I know, running groups is one of my favorite things as well. I absolutely love it. Definitely have done 17, 18 year old high school boys, and it’s like, how do I do this? Mental health is a little different, so I’ll let some of our viewers in on a secret. Mental health, oh my gosh, this is going to blow your mind, we can have up to eight students in a group virtually. What? Okay, can you manage eight, 18 year old boys? Let me tell you, that’s super fun. That was one of my groups last year. But typically, my SLPs, a group is two students or three students. They’re really capped at around three at Global, but in mental health we can have more.
Lindsey:
And that’s a good thing because it really helps get dynamics of that social interaction. If we’re working on social pragmatics, right? Having more students to read those, is really good. But like you said, maybe they need to work on that skill, but they’re not quite ready in a group because they actually don’t have those foundational skills. So is that when you’re saying that you would recommend doing individual first before we transition to a group?
Lisa:
Yeah. In fact, I had one of those this year. We had a new student assigned to us and his IEP from his old school was for group. And then in my pre-call with the mom, before then, when I called to introduced myself, she’s like, “I don’t know. I don’t know that the students… He’s mature enough yet. He’s a high schooler, but he doesn’t act like it.” Because I was explaining my high school group. So in that case, we’ve got him right now, individually for 30 minutes a week, just working on some, I would call it executive function skills and maybe some impulse control. But one of the goals that we’re working on, or we need to move him into, is into some social interaction, so he acts appropriately with peers.
Lindsey:
That’s a really good point. Yeah, because they need to learn. But you can’t just put them in a group with somebody who might be higher functioning and then they’re just very immature, they’ll say things, and that could really hinder that relationship where it’s not going to foster what we’re looking for. So teaching those foundational skills. So then would you be able to use maybe the progress monitoring data to be like, is he ready to try group? And then if so, how do we make that transition? What steps do we need to take? If you’re like, he’s ready for group services now, what do you usually recommend through the IEP team, or do we just use goal data? Do you do any sort of assessment with them?
Lisa:
I usually, first of all, look at the goal data and a lot of times when I’m writing… If I’m thinking about making a recommendation, I almost always want to have a conversation with the parent first, sort of make sure they’re on board and they’re seeing what I’m seeing, because one of the things being in the online environment, the parent might see something differently or have a different opinion. And the same with the case manager, I’ll usually check in with them. But a lot of times, I look at what the goals were and I’m like, his goal is for social interaction, to improve those skills, to respond appropriately to peers. He’s getting better with me, I’m getting good responses, we’re having a conversation, I think we need to kind of move up the ladder of skill development, and let’s try them in a group, and lets sort of see how they go.
Lindsey:
Do you ever take the student and say, we’re going to have both group and individual? So that way you can do individual to train a skill, and then the group to generalize the skill. Do you ever keep that on the IEP at the same time?
Lisa:
I have one like that in California. He gets, I believe, 45 minutes a week on Mondays and then on Fridays he comes into the group. So it’s unusual, but I can see where it might not be a bad idea. And my other student I talked about, whose parents… And I kind of concurred after I met with them, felt like he maybe wasn’t ready for the group. I might recommend that for him at the next IEP, depending on how his progress goes this year, because the way we wrote it when he came into, the California school was like, let’s start individual and then we’ll revisit later on in the year or the next IEP in the fall, so that’ll probably be what I’ll do. I’m kind of, in the back of my mind, making notes on, I’d like him to get ready. He’s in high school, he needs to be able to talk to other people his age.
Lindsey:
Kind of important part of the transition goals.
Lisa:
Yeah.
Lindsey:
Make sure there’s space in that job market. So I think those are really great things, but yeah, and I don’t want any other therapists to be afraid. If you feel like your student needs a change in services, remember, we are IEP team members. We can ask the case manager, call an IEP, consult with everybody and say, do we think that the student is ready? Because the whole point is to work our way out of a job, right? So we are individual, let’s go to group, that’s least restrictive and then we can try to back off. And my groups, typically didn’t… We meet every week. They ended up once a month or every other week, so that’s again, titrating those services down because we do want these students to be able to generalize these skills. It’s really important that we make sure we put the students’ interests first, but we have to talk to the team. And students don’t progress based on their IEP annual date, right? So we need to, as clinicians, we really need to be tracking those goals. That’s what our progress reports are. That’s going to help us monitor how they’re doing.
