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Want Better Documentation? Tell a Story

Dan Thorne • Aug 27, 2021

Many behavioral health professionals find it troublesome to develop clear and concise documents. Assessments, treatment plans, and progress notes take a long time, are ambiguous, and don’t flow. Subsequently, the staff runs into trouble when treating the client and billing for services.


Rather than focus so much on the paperwork, professionals should look at the story the client is trying to tell through their actions and their life. By looking at their lives as a story in a book or a movie, the professional has the foundation for the client’s plan. Since most everyone is familiar with the movie The Wizard of Oz (or its other forms, the Wiz or Wicked), here is a story that shows how Dorothy behaviorally achieves her goals.


Once upon a time, a girl named Dorothy lived in Kansas with her aunt Em and Uncle Henry (family history), along with their farmhands Hunk, Zeke, and Hickory (informal supports). She liked to sing and walk with her dog Toto (hobbies), but she wanted to get away from the troubles caused by her dog going into Ms. Gulch’s yard and decided to run away (problems). But as she tried to do so, a tornado started to touch down (stressor).


While seeking cover, she bumped her head, went into an altered state, and dreamed of a colorful world called Oz (trauma). In Oz, her house hit the Wicked Witch of the East, which created many happy Munchkins (support system) but an evil Wicked Witch of the West (communication conflict). Dorothy felt alone (fears) and only wanted to go back home (goal). Guarded by Glenda, the Good Witch (support), Dorothy was given ruby slippers (intervention) and told to follow the Yellow Brick Road (treatment plan).


While on the road, she was frightened by the animals and characters, but she made friends (objective) with the Scarecrow, the Tinman, and the Cowardly Lion (informal supports). The Wicked Witch of the West tried to poison Dorothy with poppies (stressor), but Glenda stopped this effort by making it snow to wake Dorothy up (intervention). Once at Oz (achievement of goal), Dorothy met with the apparition of the Wizard, who told her and her friends that she could go back to Kansas only if she brought back the broomstick of the Wicked Witch of the West (new objective).



Terrified but brave (stressor), the four companions went to the Witch’s castle (intervention), only to have Dorothy captured by the Witch (stressor). Her friends were able to get into the castle and rescue her (intervention), but they were surrounded by the Witch’s soldiers (stressor). With quick thinking, she took a bucket of water (intervention) and doused the Witch’s broom as she was trying to burn the Scarecrow, and the water made the Witch melt. Thus, Dorothy could get the broomstick (achievement of goal).


When returning to Oz, Dorothy asked to go back to Kansas (assertion skill), only to find the “Wizard” was not who he claimed to be. But he offered her a balloon ride home (intervention) which didn’t pan out. Finally, Glenda (support) told her that the ruby red slippers would take her back if she clicked her heels and said, “There’s no place like home (intervention).” When Dorothy awoke, she was back in her bed, surrounded by her family and farmhands (formal and informal supports), happy to be back in Kansas (achievement of goal).


Praxes provides training and consulting services to agencies that want to improve their treatment planning. For more information, please contact us. 



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