TY - JOUR
T1 - Open notes in psychotherapy
T2 - An exploratory mixed methods survey of psychotherapy students in Switzerland
AU - Kharko, Anna
AU - Buergler, Sarah
AU - Bärkås, Annika
AU - Hägglund, Maria
AU - Gaab, Jens
AU - Fagerlund, Asbjørn Johansen
AU - Locher, Cosima
AU - Blease, Charlotte
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/3/28
Y1 - 2024/3/28
N2 - Background: In a growing number of countries, patients are offered access to their full online clinical records, including the narrative reports written by clinicians (the latter, referred to as “open notes”). Even in countries with mature patient online record access, access to psychotherapy notes is not mandatory. To date, no research has explored the views of psychotherapy trainees about open notes. Objective: This study aimed to explore the opinions of psychotherapy trainees in Switzerland about patients’ access to psychotherapists’ free-text summaries. Methods: We administered a web-based mixed methods survey to 201 psychotherapy trainees to explore their familiarity with and opinions about the impact on patients and psychotherapy practice of offering patients online access to their psychotherapy notes. Descriptive statistics were used to analyze the 42-item survey, and qualitative descriptive analysis was employed to examine written responses to four open-ended questions. Results: Seventy-two (35.8%) trainees completed the survey. Quantitative results revealed mixed views about open notes. 75% agreed that, in general open notes were a good idea, and 94.1% agreed that education about open notes should be part of psychotherapy training. When considering impact on patients and psychotherapy, four themes emerged: (a) negative impact on therapy; (b) positive impact on therapy; (c) impact on patients; and (d) documentation. Students identified concerns related to increase in workload, harm to the psychotherapeutic relationship, and compromised quality of records. They also identified many potential benefits including better patient communication and informed consent processes. In describing impact on different therapy types, students believed that open notes might have differential impact depending on the psychotherapy approaches. Conclusions: Sharing psychotherapy notes is not routine but is likely to expand. This mixed methods study provides timely insights into the views of psychotherapy trainees regarding the impact of open notes on patient care and psychotherapy practice.
AB - Background: In a growing number of countries, patients are offered access to their full online clinical records, including the narrative reports written by clinicians (the latter, referred to as “open notes”). Even in countries with mature patient online record access, access to psychotherapy notes is not mandatory. To date, no research has explored the views of psychotherapy trainees about open notes. Objective: This study aimed to explore the opinions of psychotherapy trainees in Switzerland about patients’ access to psychotherapists’ free-text summaries. Methods: We administered a web-based mixed methods survey to 201 psychotherapy trainees to explore their familiarity with and opinions about the impact on patients and psychotherapy practice of offering patients online access to their psychotherapy notes. Descriptive statistics were used to analyze the 42-item survey, and qualitative descriptive analysis was employed to examine written responses to four open-ended questions. Results: Seventy-two (35.8%) trainees completed the survey. Quantitative results revealed mixed views about open notes. 75% agreed that, in general open notes were a good idea, and 94.1% agreed that education about open notes should be part of psychotherapy training. When considering impact on patients and psychotherapy, four themes emerged: (a) negative impact on therapy; (b) positive impact on therapy; (c) impact on patients; and (d) documentation. Students identified concerns related to increase in workload, harm to the psychotherapeutic relationship, and compromised quality of records. They also identified many potential benefits including better patient communication and informed consent processes. In describing impact on different therapy types, students believed that open notes might have differential impact depending on the psychotherapy approaches. Conclusions: Sharing psychotherapy notes is not routine but is likely to expand. This mixed methods study provides timely insights into the views of psychotherapy trainees regarding the impact of open notes on patient care and psychotherapy practice.
KW - autonomy
KW - clinical psychology
KW - electronic health records
KW - healthcare ethics
KW - informed consent
KW - online record access
KW - Open notes
KW - patient-centered care
KW - psychotherapy
KW - qualitative survey
KW - survey
UR - http://www.scopus.com/inward/record.url?scp=85191265694&partnerID=8YFLogxK
UR - https://pearl.plymouth.ac.uk/context/psy-research/article/1757/viewcontent/kharko_et_al_2024_open_notes_in_psychotherapy_an_exploratory_mixed_methods_survey_of_psychotherapy_students_in.pdf
U2 - 10.1177/20552076241242772
DO - 10.1177/20552076241242772
M3 - Article
AN - SCOPUS:85191265694
SN - 2055-2076
VL - 10
JO - Digital Health
JF - Digital Health
ER -