1st vs 3rd person in report writing

[singasongofjoy]

I'm in the depths of report writing. Often I have students/trainees or another staff with me on evaluations but in the summer I'm mostly on my own. When there are more people in teh assessment, I default to writing in third person, and generally even when I'm the only one. But writing my umpteenth ADOS and general behavioral obs writeups I find myself wanting to just write in first person instead of writing "the examiner" or similar which feels kinda awkward when it's totally clear I'm the examiner. But less professional? Idk. I'm overthinking it because I'm tired. Curious to know what y'all do. For the rest of the afternoon I'm going with first person.

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[AcronymAllergy]

I initially started in third person (e.g., in grad school). After a couple years in practice, I switched over to first person. At least in my opinion, it makes for clearer and more succinct notes and reports. Also mentally makes you take ownership of what you're writing.

Behavioral observations is the exception; I'll still include "...the examiner" there, for whatever reason.

 

[ClinicalABA]

I’ve melded into purely first person over the past few years. I think third person is weird, and I find using first person helps avoid awkward passive voice construction

 

[LadyHalcyon]

Interesting. I was just writing a clinical summary/medical necessity note for a PA approval and I found myself using "the undersigned." I then thought I sounded like a pretentious idiot, but figured that may help for insurance purposes

 

[BuckeyeLove]

1st. Always...and forever. Anything else sounds robotic and forced. And much more difficult (IMO) to make flow. 1st also shows more respect for the consumer of the product IMO. If an attorney or a court wants my opinion on something, I'm going to write in a way which demonstrates and own that as such. All of my mentors (Midwest and west coast ABFP's) did 1st though, so I guess I never really had any other exposure.

 

[LadyHalcyon]

So funny because my mentor wrote third person for forensic evaluations

1st. Always...and forever. Anything else sounds robotic and forced. And much more difficult (IMO) to make flow. 1st also shows more respect for the consumer of the product IMO. If an attorney or a court wants my opinion on something, I'm going to write in a way which demonstrates and own that as such. All of my mentors (Midwest and west coast ABFP's) did 1st though, so I guess I never really had any other exposure.

 

[ClinicalABA]

Curious- are there any theoretical roots (e.g., psychoanalytic) to using the third person? Kind of a way to remove the therapist, as a distinct person, out of the room?

 

[AcronymAllergy]

Curious- are there any theoretical roots (e.g., psychoanalytic) to using the third person? Kind of a way to remove the therapist, as a distinct person, out of the room?

Good question. I want to say we were specifically encouraged/instructed to use third person during one of my (non-neuropsych) assessment classes in (my heavily non-psychoanalytic) grad school. But that was a little ways back, so I could be completely mis-remembering it.

My take is that it might've been seen as more objective and professional, and less like a personal opinion, when using third- rather than first-person. But at the end of the day, the report really is our (clinical/professional) opinion. For me, after I entered practice, I appreciated the clarity and directness of physician's notes when using the first person, so I eventually switched over. I still do try to avoid hyperbolic or sensationalized language, though.

 

[BuckeyeLove]

So funny because my mentor wrote third person for forensic evaluations

Yeah a lot of forensic center people in my general area (at least the ones I know of) were trained by one individual who does this, who then trained others, and it sort of continued to tree branch off from there. Mostly for CST evals is where I see it. I'm not hating on it, it just would be tough I think to keep up and have sound legitimate the more complex the forensic issue being addressed. My last private case was a death penalty mitigation eval, and my discussion section alone was 20ish pages. I think I referred to myself and my observations, review, and opinions so much in that section that had I been saying "this evaluator" it would have been confusing as hell. I also use "me," "my," and "mine" on the regs as well. Maybe I'm a covert cluster b narcissist though

 

[PsyDr]

I've moved towards the first person in recent years. It helps with showing what is the review of facts, and what are opinions.

 

[LadyHalcyon]

All forensic evaluators are, at least a little
I was speaking to someone in your area who recently attended a forensic conference where they advocated for using first person in reports. Maybe I'll give it a whirl.

Yeah a lot of forensic center people in my general area (at least the ones I know of) were trained by one individual who does this, who then trained others, and it sort of continued to tree branch off from there. Mostly for CST evals is where I see it. I'm not hating on it, it just would be tough I think to keep up and have sound legitimate the more complex the forensic issue being addressed. My last private case was a death penalty mitigation eval, and my discussion section alone was 20ish pages. I think I referred to myself and my observations, review, and opinions so much in that section that had I been saying "this evaluator" it would have been confusing as hell. I also use "me," "my," and "mine" on the regs as well. Maybe I'm a covert cluster b narcissist though

 

[deleted343839]

I use the first person. It makes it easier to explain my reasoning and to differentiate my opinions/hypotheses from actual observations. And it makes it much less awkward to place a little thank you to the consulting provider at the end of the report.

 

[AbnormalPsych]

Third. Guess I'm in the minority. Although I will definitely be thinking about this for my next report and see how it feels.

All my supervisors were third which probably had a big impact on this.

 

[LadyHalcyon]

Same. Except is everyone doing third person in behavior obs/mse as well??

Third. Guess I'm in the minority. Although I will definitely be thinking about this for my next report and see how it feels.

All my supervisors were third which probably had a big impact on this.

 

[bcliff]

I agree that first person minimizes opportunity/risk for passive voice. APA manual says that first person is fine for APA style as well. I still write my reports in third person but that's because they're being signed by someone else, so it would seem a little disingenuous for me to use first person.

 

[Therapist4Chnge]

First person. It’s particularly useful when referencing another provider’s comments, while also differentiating from what the patient reported. It gets super clunky trying to read/write in the third person.

In my test selection area I write “the psychometrician was supervised by the neuropsychologist”, otherwise it is written in the first person. In the behavioral observations section it helps to differentiate between direct quotes from my psychometrician, quotes from the patient, and my own observations.

It’s mostly a style thing now, though it makes my dictations much easier/quicker for me. When I was in training I wrote however my direct supervisor wrote, which helped me try out a few different styles, but it wasn’t the most time efficient way to do it. I had my fellows write in their own style, though most of them adopted my style because they tended to be too wordy and their reports would run long. I have a much more structured approach to my reports, which has been particularly helpful when I do a document review bc it flows easier when reading.

 

[cara susanna]

I also use third person. It's just how I was trained. I don't usually see first person from other providers here, either.

 

[calimich]

bumping the thread as this author is preparing to write his first report in several years...
I'm curious if anyone has new thoughts on 1st or 3rd voice? or if/how your writing has evolved since this thread.
and is there any empirical data either way suggesting it matters to clients/readers?

 

[BuckeyeLove]

Still using "I" and "me." People are paying for my opinion, so why complicate the picture? Legit cringe anytime I see "the undersigned" or "this writer."

 

[cara susanna]

bumping the thread as this author is preparing to write his first report in several years...
I'm curious if anyone has new thoughts on 1st or 3rd voice? or if/how your writing has evolved since this thread.
and is there any empirical data either way suggesting it matters to clients/readers?

My writing has not evolved, lol. I still use third person!

 

[ExecutiveDysfunction]

I want to use first person. I try to use first person. But I can’t stop using third person.

I can’t shake the years of obsessive report editing and encouragement to be formal. But even though I keep it primarily third person, I do try to make my reports much more readable with as little formal jargon as I can. So baby steps, perhaps.

 

[MCParent]

There are some practical things about it.
PP - use of first person makes it clear things weren’t administered by someone under me and not me myself.
Training - first person can read as weird if the report is signed by the student and the supervisor (maybe first person then initials to make it clear who did what).

 

[WisNeuro]

3rd person is still what I see the vast majority of the time. Some of the arguments are that it tends to come off as more objective.

There are some practical things about it.
PP - use of first person makes it clear things weren’t administered by someone under me and not me myself.
Training - first person can read as weird if the report is signed by the student and the supervisor (maybe first person then initials to make it clear who did what).

I can see this, but this should also be very explicitly spelled out in the billing documentation section.

 

[WisNeuro]

I''ll add a caveat, in IME reports when you are addressing specific questions that are posed to you as an expert, the answer should be clearly stated as coming from you.

 

[AcronymAllergy]

I still use first person for clinical reports, although that's primarily only in the impressions section. Most of the rest of the report is, "Patient exhibited X. Patient reported Y. Records indicate Z."

I don't know of empirical data as to whether one is viewed as more or less clear than the other. I know (or at least seem to recall) surveys indicate shorter reports are preferred and more likely to be read (in clinical settings).

 

[WisNeuro]

I still use first person for clinical reports, although that's primarily only in the impressions section. Most of the rest of the report is, "Patient exhibited X. Patient reported Y. Records indicate Z."

I don't know of empirical data as to whether one is viewed as more or less clear than the other. I know (or at least seem to recall) surveys indicate shorter reports are preferred and more likely to be read (in clinical settings).

I'll agree with this, also how most of the body of mine reads. Helps keeps things concise.

 

[MCParent]

I don't know of empirical data as to whether one is viewed as more or less clear than the other. I know (or at least seem to recall) surveys indicate shorter reports are preferred and more likely to be read (in clinical settings).

I use a model where the things most likely to be read by others (referral q, dx, recommendations) are all on a first page summary, and then the actual report comes after. Ive read so many reports where the dx is buried in the middle of a paragraph on page 18 of 22.
Context: my reports mostly go to physician offices, disability services offices, and standardized testing companies.

 

[WisNeuro]

I use a model where the things most likely to be read by others (referral q, dx, recommendations) are all on a first page summary, and then the actual report comes after. Ive read so many reports where the dx is buried in the middle of a paragraph on page 18 of 22.
Context: my reports mostly go to physician offices, disability services offices, and standardized testing companies.

Also, how my reports are constructed. I talk to most of my larger referral sources, almost universally report that this is all that they read.

 

[AcronymAllergy]

I use a model where the things most likely to be read by others (referral q, dx, recommendations) are all on a first page summary, and then the actual report comes after. Ive read so many reports where the dx is buried in the middle of a paragraph on page 18 of 22.
Context: my reports mostly go to physician offices, disability services offices, and standardized testing companies.

I would also do exactly this if that worked with the (VA) records system. But with the way VA notes are when they're attached as addenda and to consults, that would put the impressions, diagnosis, etc., somewhere in the middle of everything.

 

[borne_before]

I like rarely ever refer to myself. But when I do I tend to use the 3rd person. However, I also assume that my readers are a "competent nonspecialist" so I often do use implied person. Instead of saying "Joe was observed to pick his nose". I'd say "Joe picked his nose" because the observation is implied, and the reader is competent. As a pet peeve, are behavioral observations without discussing their relevance for the evaluation. "Joe had challenges with understanding social conventions like when Joe conspicuously picked his nose several times." etc.

I barrowed the the term "competent nonspecialist" from Schneider, Mather, Lichtenberger, and Kaufman's (2018) essentials of assessment report writing. I view it as one of the most important works on report writing (although they don't do enough on integrated summary and are a little verbose at times (ain't nobody got time for that). Also check out Schneider's website assessing psyche. It's also super interesting.

From that book:

"Although many psychological and educational reports are written in the third person, the analysis of personality report writing in this chapter takes the possibly controversial position that testing consultants should write about their interactions with testing patients in the first person. For example, instead of writing “The examiner met with Ms. X for three appointments, and the patient was encouraged to ask about the testing before she began,” write, “I met with Ms. X three times, and I encouraged her to ask about the testing before we began.” These simple modifications make reports easier to read and follow. At a more conceptual level, the authors of this book, and of this chapter on personality assessment, are all committed to the view that test data include information that examiners gain directly from interacting with clients. Their observations of how people make them feel, the responses they elicit, their conversation before and during the formal tests, and what the examiners can infer about emotional states throughout add invaluably to their interpretations of TAT stories and Rorschach responses. Writing as if “the examiner” were someone—anyone—else masks the source of this information and its obvious relevance to the person’s modes of relating, most notably to the evaluators."

I'll try using 1st person more.

 

[foreverbull]

Old habits die hard—-I’ve maintained 3rd person in my mental health eval reports, progress notes, intakes, etc.

I still teach students to write in 3rd until they reach a section of their papers where I’ve clearly asked for their opinion. Not sure if it’s generational, but many of them want to use a lot of “we” (1st) and “you” (2nd) in papers that are just discussing facts from other sources. Maybe they’re just incorporating how they speak into their papers.

I was trained in hardcore 3rd person POV to sound professional and it’s still ingrained in me! Not sure if I’ll ever change it. I haven’t really had a situation come up where I felt 1st person was necessary yet.

 

[LadyHalcyon]

I'm still stuck in 3rd person. The "undersigned".....

 

[ExecutiveDysfunction]

I'm still stuck in 3rd person. The "undersigned".....

I simultaneously hated using this and felt oddly official at the same time.

 

[cara susanna]

I'm still stuck in 3rd person. The "undersigned".....

I'm "the writer" or "this writer" depending on my mood.

 

[erg923]

I'm "the writer" or "this writer" depending on my mood.

That seems too obvious and reductant to be meaningful, lol.

How often do you guys really needs to reference yourself in a report anyway? Maybe I write differently, but I really don't do this at all other than when I say, "In my opinion...." which I might just say a few times at most, and usually in reference to diagnostic impressions or treatment recommendations. And, IMHO, saying "In my opinion" (or something similar) is most appropriate, because that is exactly what your referral sources and audience wants to know. No need to play word games with it.

 

[WisNeuro]

That seems too obvious and reductant to be meaningful, lol.

How often do you guys really needs to reference yourself in a report anyway? Maybe I write differently, but I really don't do this at all other than when I say, "In my opinion...." which I might just say a few times at most, and usually in reference to diagnostic impressions or treatment recommendations. And, IMHO, saying "In my opinion" (or something similar) is most appropriate, because that is exactly what your referral sources and audience wants to know. No need to play word games with it.

I'd wager, outside of legal work, referral sources and patients could care less how it's worded. Either way works, also, best way to convey this info is through the feedback anyway.

 

[cara susanna]

That seems too obvious and reductant to be meaningful, lol.

How often do you guys really needs to reference yourself in a report anyway? Maybe I write differently, but I really don't do this at all other than when I say, "In my opinion...." which I might just say a few times at most, and usually in reference to diagnostic impressions or treatment recommendations. And, IMHO, saying "In my opinion" (or something similar) is most appropriate, because that is exactly what your referral sources and audience wants to know. No need to play word games with it.

I will sometimes say that something is based on my own clinical judgment during the interpretation section, especially for diagnostic assessments. But my grad program REALLY emphasized couching language.

 

[erg923]

I will sometimes say that something is based on my own clinical judgment during the interpretation section, especially for diagnostic assessments. But my grad program REALLY emphasized couching language.

Well, grad program are not particularly known for teaching students to write assessments reports in a way that reflects real world needs and situations. I think we should state what we believe/conclude, based on data and judgment, as that is what we are being paid for. There is nothing worse than 10 page reports with 10 instruments that results in "maybe this maybe that, and rule out this."

 

[LadyHalcyon]

I would imagine those of us that write forensic evaluations may refer to ourselves more often. Maybe as my reputation grows I will feel more comfortable using first person, as people are literally paying for my expert opinion.

 

[StellaB]

I use third person only in forensic reports, which is the standard where I work. There is one evaluator who uses first person, and at times their reports appear derogatory or biased, which is largely a reflection of that evaluator's attitude, but the first person writing make it more obvious (probably not a bad thing, from a fairness perspective). As erg said, I don't find myself really needing to refer to myself all that often, but the type of reports I do don't contain behavioral observations or descriptions of my interactions with patients, because it's not relevant to the legal questions before me. In private practice, I've just continued to use third person though I've thought about it. I can see that it would make sense and perhaps feel more approachable. I do like the idea of a summary page on the front, and will try that out on my next private practice eval, and ~maybe~ even try first person, though that might just feel too weird at this point...

 

[StellaB]

I would imagine those of us that write forensic evaluations may refer to ourselves more often. Maybe as my reputation grows I will feel more comfortable using first person, as people are literally paying for my expert opinion.

Your post made me think about a strange case I had recently in which my personal opinion and professional opinion diverged - in my gut, I felt one way about the case, but objectively following the evidence, I had a different conclusion. In that case, it was certainly "this evaluator's opinion" that I wrote up, not so much "my opinion," if you know what I mean.

 

[WisNeuro]

Your post made me think about a strange case I had recently in which my personal opinion and professional opinion diverged - in my gut, I felt one way about the case, but objectively following the evidence, I had a different conclusion. In that case, it was certainly "this evaluator's opinion" that I wrote up, not so much "my opinion," if you know what I mean.

Shouldn't it always be your professional opinion?

 

[foreverbull]

Your post made me think about a strange case I had recently in which my personal opinion and professional opinion diverged - in my gut, I felt one way about the case, but objectively following the evidence, I had a different conclusion. In that case, it was certainly "this evaluator's opinion" that I wrote up, not so much "my opinion," if you know what I mean.

That is fascinating. I would be interested to hear more, but certainly understand if you can’t share.

Shouldn't it always be your professional opinion?

I don’t see any indication that this isn’t the case from the above post. What I took away is that it would be exceptionally rare for the objective data to not match up with one’s gut reaction, if I’m understanding the “strange” comment correctly, and the poster clearly went with the objective data.

 

[AbnormalPsych]

I've noticed my writing shift from 3rd to 1st more so over the past year. Interesting to reflect on that.

 

[StellaB]

Shouldn't it always be your professional opinion?

Sure, and that’s what I gave. I’m just saying it was nice to have the modicum of distancing from “me/my/I” language in that very unusual case.

 

[WisNeuro]

That is fascinating. I would be interested to hear more, but certainly understand if you can’t share.

I don’t see any indication that this isn’t the case from the above post. What I took away is that it would be exceptionally rare for the objective data to not match up with one’s gut reaction, if I’m understanding the “strange” comment correctly, and the poster clearly went with the objective data.

My comment was aimed at when your gut and professional opinion divulge, it's not even a decision point, your professional opinion wins out, every time. Imagine trying to defend an opinion in court in which you relied on your "gut." There are plenty of clinical areas where one's personal opinion may differ from the statutes or standard of care, your personal opinion doesn't enter in to this when it comes to clinical or legal work.

 

[foreverbull]

My comment was aimed at when your gut and professional opinion divulge, it's not even a decision point, your professional opinion wins out, every time. Imagine trying to defend an opinion in court in which you relied on your "gut." There are plenty of clinical areas where one's personal opinion may differ from the statutes or standard of care, your personal opinion doesn't enter in to this when it comes to clinical or legal work.

And I don’t see where it was suggested otherwise, as I said. The poster didn’t say that there was a decision point (simply made an observation)—and that they stuck with the professional opinion even if the gut reaction and professional opinion diverged...as one would expect.

No one disagreed or argued that one’s gut reaction should be the final word, so I’m confused as to why this needed more explanation or questioning in the first place.

 

[WisNeuro]

And I don’t see where it was suggested otherwise, as I said. The poster didn’t say that there was a decision point (simply made an observation)—and that they stuck with the professional opinion even if the gut reaction and professional opinion diverged...as one would expect.

No one disagreed or argued that one’s gut reaction should be the final word, so I’m confused as to why this needed more explanation?

There was mention of a decision or consideration point, I commented that it was not really much of a consideration point. Not much else to it, really.

 

[StellaB]

There was mention of a decision or consideration point, I commented that it was not really much of a consideration point. Not much else to it, really.

There really wasn't much of a decision, and I didn't think I mentioned one, but maybe it came across that way. I was only saying that it would have felt awkward/disingenuous to state it plainly as "my opinion" rather than "my professional opinion," as you put it, or, "this evaluator's opinion," which is the style I utilize as it is the standard in my professional niche and location.

 

[WisNeuro]

There really wasn't much of a decision, and I didn't think I mentioned one, but maybe it came across that way. I was only saying that it would have felt awkward/disingenuous to state it plainly as "my opinion" rather than "my professional opinion," as you put it, or, "this evaluator's opinion," which is the style I utilize as it is the standard in my professional niche and location.

Fair, to me it seemed as if there was a decision point as you decided whether or not to use "my opinion" vs "this evaluators opinion." My comment was commentary on the issue that the wording should not change as your professional opinion is the only thing that matters in such reports.