Amid increases in electronic health record adoption, many psychotherapists are concerned that in-session computing may harm the client-provider relationship, also known as the therapeutic alliance. The emerging practice of collaborative documentation (CD) is one strategy designed to prevent this outcome. Little empirical work has examined the effects of in-session computing generally or CD specifically within the psychotherapeutic context. This study explores how CD is being implemented in psychotherapy and examines how both the frequency of computing and the use of CD affects the therapeutic alliance. Psychotherapists in this study engaged in an average of 42 (SD = 38.5) computing episodes. CD was present in 39% of sessions (N = 21). Regression models found that among providers, increases in computing frequency predicted decreases in alliance (ß = -.18, p < .05). Conversely, among clients, the use of CD improved alliance (ß = .43, p < .01). Findings suggest that psychotherapists use computers often, but parties view the effect of electronic health records differently. Reconciling this disparity and continuing to develop effective technology-based best practices is imperative. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

中文翻译：

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在心理健康治疗中的计算机使用：了解协作文档及其对治疗联盟的影响。

随着电子病历采用率的提高，许多心理治疗师担心会期计算可能会损害客户与提供者之间的关系，也称为治疗联盟。协作文档（CD）的新兴实践是旨在防止这种结果的一种策略。很少有经验研究检查一般在心理治疗背景下进行的会期计算或CD的效果。这项研究探讨了心理治疗中CD的实施方式，并探讨了计算的频率和CD的使用如何影响治疗联盟。这项研究中的心理治疗师平均进行了42次（SD = 38.5）计算发作。CD出现在39％的会话中（N = 21）。回归模型发现，在提供者之间，计算频率的增加可预测联盟减少（ß= -.18，p <.05）。相反，在客户中，使用CD可以改善联盟（ß= .43，p <.01）。研究结果表明，心理治疗师经常使用计算机，但是各方对电子健康记录的影响却有所不同。必须解决这一差距，并继续发展基于技术的有效最佳实践。（PsycINFO数据库记录（c）2019 APA，保留所有权利）。