The Recording of Personal Information as an Intervention and~as~an Electronic Health Support

Freud & Breuer (1976) were likely the first to advocate the recording of dreams and memories. Recently, this recording has ramified into a variety of practices. It has expanded to include the recording of current experiences, and the recording of thoughts about the future. This growth continues unabated in response to multiple influences: ideas from cognitive psychology (Clark, Beck, & Alford, 1999), better research methodology (Barlow & Hersen, 1984), the availability of personal technology (Appendix) and the need to contain care costs. We will review current recording practices and those on the horizon. To do so, we will distinguish practices in terms of recording format and purpose. There are two basic recording formats: journal and diary. Others are a hybrid of these two. Journal formats entail a prose response. Journal subtypes involve differences in topic choice, prose formats, time schedules, and social context. Journal hybrids contain a few diary features. The diary format replaces prose with quantitative responses: rating scales, counts, magnitude estimates and checklists. The topics are assigned by a counselor, with input from the client. Recording takes a few minutes one or more times per day. Recording can be done quickly on a handheld computer, and then uploaded to the Internet where the recordings are automatically graphed to show symptom trends (Appendix). This practice is a form of electronic health support. There are two recording purposes: recording as an intervention, and recording as a support to intervention. Intervention recording is a procedure for promoting positive personal change. That is, the act of recording is viewed as having a restorative or habilitative agency. Supportive recording has a different purpose. It is a procedure that enhances the impact of an intervention such as using a workbook, engaging in psychotherapy, or using a psychotropic medication, etc. Supportive recording provides feedback. For example, if indices of distress are recorded, the response of these indices to an intervention can be used to guide decisions about modulating, reconfiguring, or redirecting the intervention for maximum benefit.