Why Therapists Struggle with Admin With Dr Marianne Trent

By Dr Marianne Trent, Clinical Psychologist in private practice

I mean no-one loves admin right, but clinical work and clerical tasks linked to our practice often go hand in hand and so we must find a way to make our peace with it. When I look back on my relationship with clinician admin, I feel pretty thankful that my first ever qualified job as a clinical psychologist gave me a chance to develop structure and boundaries which have served me well (most of the time) ever since. So, I thought I’d take you through a few common stumbling blocks and a few of the things which help me and my practice to thrive.

How to Manage Admin Time in Private Practice (Without Burning Out)

Whether they’re electronic, paper or in my case both, when we look at our diaries it ought to be clear where our admin time is. It might sound simple but so many fellow clinicians I work with tell me that they accept work but don’t ring fence time in their schedule to do any associated admin.

When I think back to my first qualified job, we had job plans where we would have 2 to 3 half days of admin per full time staff member and that’s something I still do now. So, how might this look in practice? Let me explain.

If I am taking a booking for a new client assessment and a report is required by the client or funder then I will only book the appointment into my diary when I have time for the 90 minute clinical appointment itself and when I can ring fence a 2 hour block of time within the next 14 days to actually get the report written. If I don’t have time to write the report, I can’t accept the booking.

Even when planning to write this very blog article I needed to block out 3 hours of time for me to be able to sit and write. I cannot and will not expect myself to suddenly be able to squeeze time into the week for admin. It helps that I love writing of course, but if I was constantly doing it on the hop then I am sure that would change pretty quickly.

I know that it wouldn’t be kind to myself and ultimately wouldn’t be kind to my clients to do it any other way. This is particularly important when managing admin in private practice, where there’s no built-in structure for clinical documentation. It might all sound a bit structured, but having boundaries and giving yourself time and breathing space will help your productivity and your own workplace wellbeing.

Therapist Admin and Neurodiversity: Why Structure Can Help

You may be reading this so far and wondering how this can work for you if you’re neurodiverse. Let me explain. Whilst I don’t have a formal diagnosis, I understand I would likely fulfil diagnostic criteria for combined subtype ADHD and actually the structure and rules I self-impose help me to thrive.

They also allow me to have a variety of different tasks on the go and not drop any of the balls along the way. When I was training and when I was in school, I wasn’t taught about actually getting the work done and I would then berate myself for not doing things which in reality seemed simple on the surface.

It’s only with hindsight that I see clearly that from a young age I was expecting myself to do all the things, make all the money, have all of the fun and achieve everything. And yes, I did have fun, but I know I was capable of more than my results suggested.

I know, for example, that if I had made time to read my A Level Biology book, which I was interested in, I would have secured a better grade. But when it came down to it, my full time sixth form, working 15 hours a week in a shop, maintaining my social life and seeing my boyfriend meant there simply weren’t enough hours in the day.

It’s clear to me now that I had not left myself any time to study and since that was supposed to be my main job, that was problematic. I think that can set the foundations for how we continue in our professional life and is often reflected in how we make time for our work in clinical practice.

Perfectionism, Risk, and Writing Clinical Notes

I often find it helpful to remember the original function of the therapy hour. It was to give clinicians time to write notes, glance at the next client’s details and have a short break between patients.

This can be a useful reminder of the depth and detail required in clinical notes. This will depend on the model or type of treatment you’re offering and the way you’ve been trained, but it can also be helpful to consider how many of those standards still need to apply and how many can be adapted.

This is a good opportunity to review current rules and standards and consider whether perfectionistic tendencies are still serving you. For example, if you’re no longer working in a dynamic service, do you need to detail everything said in a session, or can you highlight key discussion points, elements of risk and agreed action plans.

Personally, I find the notes template function in WriteUpp useful as it helps to auto-populate parts of clinical notes that remain consistent. If the nature of your client work means risk is elevated, it is important to ensure you are not setting yourself up to fail. Where risk levels are higher, it makes sense to allow additional diary time not only for note writing but also for supervision and any associated team work.

Why Admin Time Should Be Built into Private Practice Costs

You might be wondering where the budget comes from to allow for admin blocks. I believe it should be built into the overall costing model.

In my work supporting aspiring psychologists and Psychological Wellbeing Practitioners, it is not uncommon for people to offer face to face clinical time for 5 to 6 hours per day. Many then find themselves working late to complete admin tasks.

If the workload is too high for people to safely complete all tasks, this becomes a management issue. We cannot continue to expect staff to compensate for an overstretched system.

In private practice, if more time is needed for specific tasks or therapy styles, then pricing should reflect that. This ensures essential admin can be completed while maintaining a profitable and sustainable service.

Choosing the Right Clinical Work to Reduce Admin Overload

If you find yourself procrastinating or noticing that certain types of reports, admin or session preparation take longer, it can be helpful to explore why.

I know the types of work that sit within my comfort zone. For me, that includes trauma, grief, depression and anxiety. Whilst I am qualified to work with other presentations such as psychosis, pain and autism, they are not my preference and I recognise I may not be the most appropriate person to take on that work.

If I need to revisit learning materials or feel uncertain about risk levels or evidence-based approaches, that is worth reflecting on. While I value learning, I also value being clinically effective. If a client requires significantly more effort for me to get up to speed, I may not be serving them as well as I could.

It is also likely to increase my mental load and impact my wellbeing, so I choose to say no. I recognise this is easier in private practice, where I have control over the work I accept. However, even in employed roles, it is worth considering whether the work aligns with your interests and strengths.

Final Thoughts: Why Admin Struggles Aren’t About Laziness

In summary, admin challenges in clinical work are rarely about procrastination. They are more often about capacity, cognitive load, responsibility and the emotional weight of the work.

Recognising this allows us to move away from self-criticism and towards systems and structures that provide real support. For me, this includes ring fencing time, setting realistic expectations and using tools like WriteUpp to streamline clinical notes and reduce admin burden.

Good admin is not separate from good clinical work. It is part of it.

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