SUGGESTIONS FOR MAKING AUDIO RECORDINGS
RECORD YOUR WORK!
Studies of what each participant in a long-term therapy or psychoanalysis contribute that leads toward a favorable outcome have been rewarding so far click here to review our recent findings. But more deep and detailed studies require many more cases by more therapists and analysts than we have available now. We will be glad to help those who decide to consider this with clinical and technical aspects. In today’s connected world, it is not difficult, and almost all patients are comfortable with it. Please contact president@psychoanalyticresearch.org .
Recording therapy sessions offers many benefits to both the therapist and the patient.
First and foremost, it frees the analyst to focus entirely on the patient without the need to simultaneously record the facts themselves. The therapist can then employ higher level clinical skills in synthesizing observations in an initial note.
Secondly, if the patient agrees, the recordings can be used for teaching or research.
The recommendations provided below derive from extensive experience in recording many patients for over thirty-five years.
Consent to Recording
Prior to the first meeting with a patient, the analyst should decide whether there are any likely contraindications to recording. For example, if the patient is very suspicious and mistrustful in general, suffers from intense conflicts about being exposed, or is likely to become embroiled in a custody battle. Or if the patient would feel the procedure itself was strange, for example someone in the mental health field who expected an “orthodox” analyst. Absent these, the recording device should be ready.
When the patient is first invited into the consulting room and sits down, the analyst may say immediately: “Before we begin, I want to mention that it is my custom to record unless a person would rather that I not.” Or, if calling it a custom would be inaccurate, “I’d like to ask if I may record, unless you would rather that I not do so.”
Any immediate inquiries from patients may be answered saying that the recording is useful in preparing an initial note for the patient’s medical record (although the recordings will not be considered part of the medical record), and there can be other uses which we can discuss later.
Experience has shown that, in this technological age, 95% of patients readily agree at this point to the recording without further questions, and the machine should immediately be turned on. This approach avoids any extensive discussion at the beginning of treatment, when the patient’s concerns leading them to seek help are paramount.
If no long-term treatment plan is agreed to, the recordings remain simply a resource which the analyst may refer to for preparing an initial note, or, unless prohibited by law or otherwise, they can be discarded.
Experience has shown that, for patient and analyst alike, the recording process only comes into occasional focus during the course of treatment.
Consent to Teaching and Research Use
Where an agreement for regular sessions is reached, if no contraindication has been identified, the therapist might ask at the end of a session for permission to use the recordings for teaching and research. “In addition to serving as a reference for my notes, the recordings may also be useful for teaching and research purposes. I have materials which include a description of using the audio recordings for this purpose which you can take home and review at your leisure. We can then discuss these materials if you wish at your next session.”
The patient should then be provided with a copy of the form “Explanation of Potential Research and Teaching Uses of Audio Recordings of Sessions”. On the back is a consent form entitled “Consent to Audio Recording of Psychoanalysis or Psychotherapy Sessions and Possible Release of the Audio Recordings and Related Patient Information to Qualified Researchers and Teachers.” (1) About three-quarters of the time, the patient completes the consent form soon after receiving it.
Whether the patient accepts or declines the research use, and whether the patient returns promptly to the subject at the next session or avoids the topic, his or her behavior reflects wishes and conflicts, particularly as activated in relation to the analyst. The analyst needs to attend to these meanings, as to all other aspects of the analytic situation, whether introduced by the analyst (such as fee or schedule arrangements) or arising from other circumstances. Answering questions about the recording or research does not preclude an analytic approach to the patient’s reactions as well.
Support by the PRC for Analysts Undertaking Recording
Members of the PRC are happy to assist therapists wishing to begin recording. The PRC can recommend inexpensive high-quality recording software to use with your computer or IPad. You may want to use an external webcam, or you probably have one already on your computer. We can supply HIPAA compliant storage of the files as well.
Donation of Recordings to PRC
Since we are interested in developing a collection of psychoanalyses and psychotherapies, recordings of both are welcome, particularly as we believe that most analyses begin as psychotherapies nowadays.
The therapist has discretion as to whether or not the recordings will be contributed to the PRC. The PRC provides both a gift and a bequest form for the conveyance by the analyst of recordings to the PRC for which applicable research consent forms have been completed.
The analyst may retain possession of the recordings for as long as she or he wishes, usually until after the treatment is completed. Should the patient wish for the recordings to be destroyed for any reason, this can be accomplished to the extent permitted by law.
The PRC has procedures in place to protect the anonymity of analysts who contribute materials for research purposes as well as patients.
If only a minority of cases which are recorded initially are eventually added to our “library”, the result will be highly worthwhile for our field and the patients we serve.
This document has been developed with the benefit of extensive consultation with other analysts and legal counsel knowledgeable about problems of confidentiality and consent. Funds were provided by the Fund for Psychoanalytic Research and the PRC.