Why you should record and annotate your therapy sessions

By Chloe Christoforou, M.S.

Can you remember an age when we didn’t use the internet? It seems very long ago now. We use the internet every day, for reading the news, connecting with family, discovering new places to eat, and posting on social media. Using the internet allows us to improve the way we conduct our everyday life; however, most of the research tools available aren’t very innovative or up-to-date compared to what we use everyday. Most of the qualitative and quantitative tools available are very expensive, time-consuming, difficult to use, and are attached to specific equipment. Clinicians, counselors, and psychotherapists are now asking for a way to conduct research studies that allow them to access their tools anywhere in the world and are less time-consuming than traditional methods.

Traditional Qualitative Methods

The most common forums for data collection are focus groups, motivational interviews, cognitive behavioral therapy (CBT), and participant observation. When qualitative methods are combined with quantitative methods (e.g., physiology, facial expression analysis) then it allows clinicians to accommodate their patients with even more impact (Palinkas, 2015).

A major reason to use qualitative methods is that they are the gold standard for eliciting the participants’ perspectives. Since they allow the participant to speak in his or her own voice, it enhances the validity of the data being collected.

Currently, a lot of researchers in this field use pencil and paper when observing, or collect surveys via mass mailings, etc. Since you’re not 100% focused on the participant, this could lead to missing something pivotal. Now there is an easier way to conduct your research, and it has an included fail-safe. If you use video collection as part of your research protocol, then you will be able to review this data over and over again – as well as take notes and annotate your participant’s behaviors.

Advantages of Web-Based Research Techniques

A series of researchers have documented the advantages to using a web-based platform in research. Video recording has not only proved useful in psychotherapy sessions, but also necessary for recall and analysis. Don’t take my word for it, look at the reasons below from renowned researchers across the world:

● Improved accuracy and simplicity of data entry (Ahern, 2005; Granello & Wheaton, 2004; Van Selm & Jankowski, 2006) ● Lower cost (Betz Hobbs & Farr, 2004; Fricker, Galesic, Tourangeau, & Ting, 2005; Granello & Wheaton, 2004; Parks, Pardi, & Bradizza, 2006; Tourangeau et al., 2004; Sax et al., 2003; Van Selm & Jankowski, 2006; Wright, 2005) ● Saves time (Ahern, 2005; Granello & Wheaton, 2004; Sax et al., 2003; Wright, 2005) ● Simplicity of administration (Betz Hobbs & Farr, 2004; Wright, 2005)

Recording the participant observations allows both the researcher and the participant to focus 100% on the experiment. Instead of writing down notes during the course of the experiment, the researcher is able to seek more insights from the participant. Due to the large number of participants within a given experiment, it is sometimes easy to forget what happened during a specific observation. With video, it allows the researcher to review the experiment multiple times to find the missing details that they would have previously forgotten. Seattle-based clinical psychologist, Tony Rousmaniere, states that, “everyone has blind spots and makes mistakes. That is human and happens in any field” (p.95). Recording your research observations will significantly improve the quality and accuracy of the research conducted and results collected from the experiments.

An Addition to Your Current Tools

You may be using a series of measurement tools in your research. In addition to assessment forms, screening tools, facial expression analysis, surveys, and electrophysiology, you can record and annotate your sessions.

Why would you annotate the behaviors that occur within your sessions? For one, it’s important to note the duration and the order of behaviors during the course of a session. According to Beidas et al. (2016), “the importance of an accurate diagnosis is an implicit prerequisite to the selection of evidenced-based practices, which are largely organized by specific disorders.” We can only increase evidence if we have an organized and specific way of keeping track of our findings, which will ultimately lead to better treatment outcomes and options (Bickman et al., 2011).

There are many coding strategies that you can follow; however, most include an initial preliminary coding scheme, followed by a secondary or focused ethogram (Simmons et al., 2013). If you need assistance with setting up a coding scheme, the trainers and technical support team at BehaviorCloud can help!

It is important to note how these codes are linked in the analysis, which can be portrayed in the sequence of events that occur. It can also be important to note the frequency of events that occur in order to see the salience of the chosen codes.

For example, a researcher could set up a study for evidence-based psychotherapies for PTSD, where participants would be interviewed using specific open ended questions. The video of these sessions could be annotated with behaviors of interest. The duration of these of these behaviors and frequency could be converted into a numeric value using a scoring rubric. The evaluation of this research could ultimately result in the implementation of a recovery-oriented therapy or training across a series of mental health practices across the country.

Reducing Bias

Most lab solutions include large pan-tilt-zoom and fixed-focus cameras; however, there is no need for this. With BehaviorCloud you can set up a small camera, even an Android or Apple device, which reduces distractions for the participant.

Now that you’ve reduced the number of obstructions in your recording sessions, and increased your participant’s comfort within the research environment, you should also reduce observer bias. You can do this by adding inter-rater reliability assessments or blinding your coders, which means that other researchers can code your videos with an outside perspective. As mentioned previously, by video recording your sessions, you can code and annotate your videos with behaviors of interest. In order to reduce your personal observer bias, recruit a couple of students or colleagues and have them code your videos instead. This is especially important if you plan on publishing your data as it increases the trust and transparency in your research.

BehaviorCloud

We offer some of the industry’s best video observation and capture software, which is accessible anywhere in the world with any device. Mobile recording, remote viewing, & annotation of your participant sessions allows you the freedom you need. A lot of researchers want to go about their day or work on data analysis from their home office. This is easily achieved with the BehaviorCloud web-based platform. Simply log on and access your data from anywhere.

We have secure video recording, multi-device support, secure sharing & collaboration, and portability. Audio-video recording in psychology research is steadily increasing, and is recommended by a large number of psychologists.

BehaviorCloud is perfect for clinicians, therapists, counselors, and psychologists who conduct research sessions in their office or away from their clinic. We turn your phone or tablet into a secure recording studio. Researchers can annotate each video session with notes, which is a helpful feature when recording your sessions.

BehaviorCloud is a web-based application, which is easy to install on any Android or Apple device. We automate the process of uploading and storing all of your uploaded or live stream video content for research purposes. Any authorized user can log in and view live sessions over a secure connection. There are user authentication and permissions employed by the BehaviorCloud platform ensuring that only authorized users have access.

We can create a customized solution for any researcher to solve any recording obstacle and customize the video recording experience. Our ultimate goal is to bring you technology that will enhance your research.

References

1. Ahern, N. R. (2005). Using the Internet to conduct research. Nurse Researcher, 13(2), 55-70.

2. Beidas, R.S., Steward, R.E., Walsh, B.S., Lucas, S., Downey, M.M., Jackson, K., Fenandez, T., Mandell, D.S. (2016). Free, brief, and validated: Standardized instruments for low-resource mental health settings. Cognitive Behavioral Practices: 22(1): 5-19.

3. Briggie, A. M., Hilsenroth, M. J., Conway, F., Muran, J. C., & Jackson, J. M. (2016). Patient comfort with audio or video recording of their psychotherapy sessions: Relation to symptomatology, treatment refusal, duration, and outcome. Professional Psychology: Research and Practice, 47(1), 66-76.

4. Betz Hobbs, B., & Farr. L. A. (2004). Accessing Internet survey data collection methods with ethnic nurse shift workers. Chronobiology International, 21(6), 1003-1013.

5. Bickman, L., Breda, C., de Andrade, A.R., Riemer, M. (2011) Effects of routine feedback to clinicians on mental health outcomes of youths: results of a randomized trial. Psychiatr Serv. 2011 Dec; 62(12):1423-9.

6. Fricker, S., Galesic, M., Tourangeau, R., & Ting Y. (2005). An experimental comparison of web and telephone surveys. Public Opinion Quarterly, 69(3), 370-392.

7. Granello, D. H., & Wheaton, J. E. (2004). Using web-based surveys to conduct counseling research. In J. W. Bloom & G. R. Walz (Eds.), Cybercounseling and Cyberlearning: An Encore (pp. 287-306). Greensboro, NC: CAPS Press.

8. Palinkas, L.A. (2015). Qualitative methods in mental health services research. Journal of Clinical Child Adolescent Psychology, 43(6): 851-61. doi: 10.1080/15374416.2014.910791

9. Parks, K. A., Pardi, A. M., & Bradizza, C. M. (2006). Collecting data on alcohol use and alcohol-related victimization: A comparison of telephone and web-based survey methods. Journal of Studies on Alcohol, 67(2), 318-323.

10. Rousmaniere, T. (2017). Deliberate practice for psychotherapists: A guide to improving clinical effectiveness. Routledge: New York, NY.

11. Simmons, M., Hetrick, S., & Jorm, A. (2013). Making decisions about treatment for young people diagnosed with depressive disorders: a qualitative study of clinicians’ experiences. BMC Psychiatry, 13: 335.

12. Tourangeau, R., Couper, M. P., & Conrad, F. (2004). Spacing, position, and order. Public Opinion Quarterly, 68(3), 368-393.

13. Van Selm, M., & Jankowski, N. W. (2006). Conducting online surveys. Quality & Quantity, 40(3), 435-456.

14. Wright, K. B. (2005). Researching Internet-based populations: Advantages and disadvantages of online survey research, online questionnaire authoring packages, and web survey services. Journal of Computer-Mediated Communication, 10(3).

15. Warnock-Parkes, E., Wild, J., Stott, R., Grey, N., Ehlers, A., & Clark, D.M. (2017). Seeing is believing: Using video feedback in cognitive therapy for social anxiety disorder. Cognitive and behavioral practice, 24(2), 245-55.

16. Imel, Z., Caperton, D., Tanana, M., & Atkins, D. (2018). Technology-enhanced human interaction in psychotherapy. Journal of Counselor Psychology, 64, (4); 385-393.