ACA Blog

Ryan Thomas Neace
Feb 24, 2011

The Tech-Saavy Clinician: 3 Trendy Must-Haves for Counselors in Private Practice

HDTV, Blue Ray, iPad, iPhone, iPod, MP3, Notebook, MacBook, ThinkPad, Intel, Ram, Duo Core Processing, Gigabyte, Tweets, Apps, 3G, 4G…OMG!!!!!!! Phew! Buzz! Wwwwwwwwwwwwhir! Hiss! That’s the sound of technology (and life?) passing you by. The pace at which it does so can be dizzying, I know. But, dizzying, annoying, mind-numbing, and even frightening though it may be, it is also…compelling. Come on! Don’t be scared to admit it. You want to be cool! Every time you watch Nip/Tuck, Lie to Me, CSI, or some other prime time melodrama that centers around the strategic use of technology in professional settings, you go green with envy! I understand. Why wouldn’t you be envious? In the counseling business, we usually tend to think that being “low-overhead” is strategic. And of course, in some senses it is, at least initially. But after a while, everyone gets tired of circa-1976 wood paneling. Counselors find fluorescent lights and Windows 97 make the process of therapy, note-taking, and billing much less enjoyable. And ultimately, clients, who watch the same TV shows as you, are underwhelmed by the whole experience. I’m not saying that a well-designed office and the smart use of technology can offset really bad counseling. And I’m certainly not saying that the therapeutic bond can’t be powerful enough to overcome the fact that you’re still faxing everything (the fax was invented around 1900, by the way). But, I am generally finding that the strategic use of technology enhances the experience for our clients, and for me as a counselor. Here’s 3 trendy tech must-haves for the counselor of the future. And the future is now. 1. The iPad. In addition to being the ultimate in cool, this little beauty really is making my therapy sessions a lot more fun. It’s like having a really nifty computer, media center, library, and personal notepad all in one, but at just a pound and a half, you barely know it’s there. Want to show your adolescent client the “Adolescent Addiction” clip from the HBO Addictions series? iPad’s got you covered. Want your client to read along with you in-session as you move through Dr. David Burns’s “The Feeling Good Handbook”? iPad will make it happen. Want to listen to the latest podcast on effective mindfulness/meditation practices? iPad can make that happen too. Want to read your clients’ blogs, or check out their facebook pages? You guessed – iPad does it. Want to hand-write your notes in a personalized file for each client, make audio recordings of sessions, or maybe even have clients sign documents, or make payments? Yeah, it does that stuff too (see below). Bottom line – the possibilities are endless here. Starting at $499, why don’t you want this again? 2. Smartnote App (iPad or iPhone required). So, now that you’re convinced you must have an iPad, here is my favorite app that’s both practical and fun. It’s called SmartNote, and it would probably be easier for me to tell you what it can’t do then what it can. But I’ll take a whack at it anyhow. Here’s how it works. Once the app is downloaded, you create a new “notebook,” and name it appropriately for your client. At The Change Group, clients get a alpha-numeral designation that tells what number client they are, what they come in for, and their last name for easy identification. So, if I create a notebook entitled, “00123sa-Smith,” that tells me this is client #123, in for a substance abuse evaluation, last name Smith. Easy enough. I select my notebook options including what color or picture I’d like to be on the cover, what color paper I’d like inside, etc. Clients at The Change Group are required to provide a photo of themselves, so the cover becomes my client’s picture, and I select yellow legal paper for the inside. Now, I open my new notebook, and think about our upcoming session. I’m going to need a substance abuse criterion checklist, a list of possible instruments (MAST-R, DAST, CAGE, etc.), and a therapy note page. I have a standard form we use at The Change Group to hand-written notes during therapy that has a series of checkboxes, and mental status exam, an area for supplemental thoughts, etc. Because SmartNote lets me import .pdfs, I literally move each of these documents into the notebook, and a host of writing tools are available in the program ranging from different colored pens to highlighters, and even a text editor (i.e., I can type things if I so desire). I can literally write on things as if I was holding them on a clipboard in front of me. The difference? It’s green (no paper), it’s safe (password protected), and it’s cool. Plus, I can press record and literally input audio data onto my note pages as the client is talking (provided I have permission, of course). And, at the end of my session, or the end of a series of sessions, I can export my notebook into a .pdf, or print everything out to have a hard copy, and pull the audio off as well. Bottom line - this app boasts 28 notebook covers, 16 paper types, and over 150 widgets to help make note-taking easier. If you tried to gather everything SmartNote does at your local office supply store, I’m guessing you’d spend around $1k. SmartNote costs $2.99. Even including the purchase of your iPad, this still seems like a better deal, doesn’t it? 3. Square App (iPad or iPhone required) You like getting paid, don’t you? There are about a million solutions to billing private pay clients, some of which are more complicated than others. If you’re into actually swiping cards, there is always the standard ‘go out and buy a credit card machine’ route. That seemed like a really bad idea to me, simply because I didn’t want to have to learn how to operate a credit card machine. All those buttons and numbers and options. If I wanted to learn how to work a computer, I’d use a computer. Speaking of that, there are some pretty good options if you are into billing using a computer, particularly if you’re using the internet. The most direct experience I have is with PayPal, and, roughly 75% of the time, I was satisfied with their service and their products. But, PayPal has that annoying Microsoft circa-1990-2000 tendency that requires you to learn how to think like a software engineer rather than a normal human being. That is to say, while PayPal tends to do what I want it to do from an operational perspective, navigating its menus and systems is super counter-intuitive. That gets old after a while. I just want to be able to run reports like I want to run them. Don’t make me think. On top of all this, PayPal charges $360/year ($30/month) for the privilege of their system, and for their phone/email support (which is a 50/50 crapshoot as to its usefulness), and then usually about $3.20 for every $100 you receive (2.9% + $0.30 per transaction). Enter Square. No monthly fee – none. That was a big one right there. They send you a little swiper that you plug into your iPhone or iPad headphones jack, and as long as you swipe the card, you pay 2.75% per transaction ($2.75 for every $100). If you input the card manually, you pay $3.65/$100, but again – you don’t have the $30 monthly fee to contend with. In other words, you’d have to input a card manually about 67 times each month before you’d finally spend $30. Square is clearly the better deal from a dollars and cents perspective out of the gate. However, this is the one app I do have some reservations about. Without taking up too much more of your time, here they are in short form based on my experience so far: • I’m guessing that part of the way Square offsets their “no monthly fee” policy is that they hold onto your money longer. With PayPal, for example, you can transfer money into your actual bank account anytime you like. With Square, they immediately deposit your first $1,000 of sales per week to your bank account. The remaining amount above $1,000 is deposited within 30 days of the transaction. I didn’t read that when I signed up, but it was there. We haven’t run into any snags just yet, but I don’t like that. They say you can write and ask for a higher weekly deposit amount, but don’t say how they evaluate whether to grant you the higher amount. • Square’s customer service is TERRIBLE. They have no phone support, and so all help is generated through email or the contact form on their site. I was having trouble running a few credit card #’s at the beginning, and sent a support request. Never heard anything back until a few weeks later, and when I did, it wasn’t actually a response to my request. Instead, they told me *they’d* noticed something and decided to write. To make matters worse, when I wrote back, it took days for them to respond, only to tell me they were escalating my problem to the next level of support. I never heard back from them thereafter. Not exactly confidence inspiring. • Square does not do recurring billing. Period. You must enter the credit card every time. Bottom line – though I only give it about 3.5/5 stars, I still recommend it for it’s price-point alone. If you’re swiping cards only, my guess is you’ll have very little need for recurring billing or support, and unless cash flow is already a problem, the deposit thing probably won’t bug you either. Anyhow, trying it is FREE, including the swiper. So you can always back out. ** So, if all of this sounds daunting to you…I understand. My partner is 20 years my senior, and has remarked on more than one occasion he’s thankful that I’m around to help with technology. But, whether you have a Gen X’er or Millenial at your practice or not, government mandates moving everything electronic are around us in abundance. This trend isn’t showing any signs of receding. So, part of the greater journey is to manage your own anxiety as you work through all of this stuff. I grew up on Atari, Apple IIe, and the 386 PC, but I still get nervous sometimes. Rounding the technology bend can be a whale of a task. But remember how you eat a whale - one byte at a time.

Ryan Thomas Neace is a counselor, professor, and entrepreneur. He is the co-founder and managing director of The Change Group. More at http://changegroupcounseling.com

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