RECORD KEEPING OF: Phone Messages, Emails, Texts...

This clinical update sheds light on issues regarding phone messages, emails and texting. It will clarify whether these communications are part of the clinical records and explain ways in which these messages can be incorporated into a clients’ file.

Almost all therapists have extensive experience with answering machines and increasing numbers of therapists are using email to communicate with clients. More recently, we are seeing that therapists are beginning to use texting as a mode of communication with clients, especially with those clients who use texting as their primary mode of communication.

Many complex clinical, ethical and legal issues are evolving through the increasing use of these modern, digital technologies and, these issues effect both us, psychotherapists and our clients. As this Clinical Update clarifies, even ‘old’ technologies, such as phone messages, can be archived, transcribed and stored online or offline, with the aid of digital technologies.

This Clinical Update Covers Areas

FIRST, we raise the question: Are phone messages, emails and text messages part of the clinical record?

SECOND, we review the variety of ways that therapists today communicate with their clients outside the office.

• Phone Messages: This is the traditional and acceptable form of communication.
• Emails: In the digital age, increasing numbers of therapists communicate with clients via email. Email communication has become one of the most common, acceptable and expected modes of communication in the 21st century.
• Texting: As more young people enter therapy, texting is used more frequently. Text conversations can be initiated by clients or therapists. Many therapists find this to be the most effective way to communicate with young people, as opposed to phone calls, phone messages or emails.

NOTE ON CONFIDENTIALITY

As with all new advancements in digital interpersonal communications, the use of text messaging and online recording services has ramifications regarding security, privacy and confidentiality which are not yet clear. Therapists must use caution and informed consent when using digital methods to communicate with clients, and when storing or archiving such communications online. A statement regarding the vulnerability of certain digital technologies can be included in the Office Policies or Informed Consent that all clients read and sign prior to the beginning of treatment. (An Informed Consent form is available via our Essential Clinical Forms.)

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