Patient-therapist codocumentation: implications of jointly authored progress notes for psychotherapy practice, research, training, supervision, and risk management.

Abstract

This paper describes patient-therapist codocumentation, a method of creating and using jointly authored treatment-progress notes. Codocumentation has five basic elements: (1) Patient and therapist agree to share responsibility for documentation of treatment. (2) During the last several minutes of each session, the patient records, by dictation, his or her views about the important issues covered, while the therapist listens. (3) The therapist can then dictate his or her comments, in the presence of the patient. (4) The notes are transcribed from tape-recorded to written form between sessions. (5) The typed transcriptions are available for joint review by patient and therapist during subsequent sessions. Sharing responsibility for documentation of treatment using this method promotes bidirectional feedback between patient and therapist. Several examples illustrate how jointly authored progress notes can help in the management of countertransference, as well as transference components of common problems in psychotherapy. The implications of patient-therapist codocumentation for psychotherapy research, training and supervision, and risk management are potentially significant. Further experience is necessary to refine the indications for, and limitations of, patient-therapist codocumentation.