If you're new to our custom instruction feature, which helps you personalize how Quill writes your progress notes, hopefully this article will help! Based on feedback and usage over the past few weeks, we now have a better idea of how folks are now customizing their notes!
We've grouped them into some general categories. With this feature, you can do so much, but we hope this helps you experiment and get started! And these are just examples -- so you'll want to make them your own and make some modifications!
And if you're looking to configure your first custom instructions, just look under "Note Preferences" (either on the note generation page or on the My Account page). Customize away! And as you tweak, simply regenerate your note to see how it's impacted by your latest changes!
Tone and Style
These instructions shape the voice, sentence structure, and readability of the note.
- Make the language sound more clinical.
- Use full and complete sentences.
- Make the note sound more professional and less conversational.
- Write in a formal and objective style.
- Use British English spellings.
- Avoid using clinical jargon.
- Each section should be around five sentences long.
- Use active voice instead of passive voice.
- Keep notes concise and clinically relevant.
- Avoid combining multiple ideas into one sentence.
Content Emphasis
These instructions help determine what to include, emphasize, or omit in the note.
- Always include "continued therapy is medically necessary" under the assessment section.
- Include any risk assessments or safety concerns in the assessment section.
- In the objective section, include the client’s presentation and the therapist’s interventions.
- If cognitive restructuring or reframing is mentioned, state that CBT was used during the session.
- Include references to treatment goals and progress toward them.
- Highlight the client’s response to interventions in each section.
- Include the modality used, such as ACT, DBT, EMDR, or IFS.
- Include a clear justification for medical necessity.
- Always mention if the client denied suicidal or homicidal ideation.
- Only include mental status exam if it is explicitly noted.
Therapist and Client References
These instructions affect how the therapist and client are referred to in the note.
- Refer to the therapist in first person.
- Refer to the therapist as "this writer".
- Refer to the client using their first name when provided in the summary.
- Use gender-neutral pronouns for the client.
- Do not refer to the client as "client"; use their initials instead.
- Refer to the therapist in third person as "clinician".
- Use "they/them" pronouns for the client at all times.
- Refer to the therapist as "provider".
Specific Phrases and Sentences
These instructions ask for specific lines to always be included in the note.
- Always start the note with "Session duration was 60 minutes and conducted via telehealth."
- In the objective section, include: "Client attended session via HIPAA-compliant platform."
- In the assessment section, include: "Client denies suicidal and homicidal ideation."
- End the plan section with: "Next session will continue exploring client’s mental health needs."
- In the assessment section, always include: "Client does not appear to be a danger to self or others."
- Add "Therapist utilized person-centered interventions including validation and reflection."
- Always include: "Therapy remains medically necessary due to symptom severity."
- Always include the sentence "Session was conducted face to face at the office location."
- Always include "Ongoing treatment is clinically indicated" under the plan section.
If/Then Logic
Conditional instructions that depend on whether certain topics or keywords appear in the note. This is something that can be super powerful, augmenting what's said in your summary with additional detail that should always be included (without having to be said each and every time).
- If "parts work" is mentioned, include that IFS was used during the session.
- If the session mentions "black and white thinking" or "cognitive distortions," note that CBT was used.
- If the session was virtual, begin the objective section with "Session was held via telehealth."
- If the note references mindfulness, state that ACT was used with mindfulness interventions.
- If the session involved exploring past relationships, include that attachment theory was used.
- If a client discussed "exposure" tasks, state that ERP was used in the session.
- If the session exceeds 53 minutes, justify extended time in the objective section.
- If the client discussed suicidal ideation, clearly document risk assessment and safety plan.
- If "cognitive reframing" is noted, include that CBT interventions were utilized.
As a reminder, Quill is still reliant on you, the therapist, to tell it what to include in your notes! But with custom instructions, you can now personalize how those notes are written, and also include additional details (per your explicit instruction) based on other details! We hope this will save you even more time when writing your notes.
Have you found another good use case for custom instructions? Let us know! Send us an email at jon@quilltherapynotes.com.
What can't custom instructions do?
Yes, there are limitations. We want to generate great and reliable notes, and we do have some guardrails in place! So for the time being, here are some things you can't do with this feature:
- You can't rename a section.
- You can't introduce a brand new section.
- You can't change the format (like paragraph vs. bullet points) of a section.
We have some features on the way that will let you do that, but until then, we wanted to be transparent about these limitations!
