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Maximizing Effectiveness in Dynamic Psychotherapy Self-Compassion in Psychotherapy101 Healing StoriesA Clinician's Guide to Legal Issues in PsychotherapyA Map of the MindA Primer for Beginning PsychotherapyACT With LoveActive Treatment of DepressionAffect Regulation, Mentalization, and the Development of SelfAlready FreeBad TherapyBecoming an Effective PsychotherapistBecoming MyselfBefore ForgivingBeing a Brain-Wise TherapistBetrayed as BoysBeyond Evidence-Based PsychotherapyBeyond MadnessBeyond PostmodernismBinge No MoreBiofeedback for the BrainBipolar DisorderBody PsychotherapyBoundaries and Boundary Violations in PsychoanalysisBrain Change TherapyBrain Science and Psychological DisordersBrain-Based Therapy with AdultsBrain-Based Therapy with Children and AdolescentsBrief Adolescent Therapy Homework PlannerBrief Child Therapy Homework PlannerBrief Therapy Homework PlannerBuffy the Vampire Slayer and PhilosophyBuilding on BionCare of the PsycheCase Studies in DepressionCaught in the NetChild and Adolescent Treatment for Social Work PracticeChoosing an Online TherapistChronic DepressionClinical Dilemmas in PsychotherapyClinical Handbook of Psychological DisordersClinical Intuition in PsychotherapyClinical Pearls of WisdomCo-Creating ChangeCognitive Therapy for Challenging ProblemsCompassionConfessions of a Former ChildConfidential RelationshipsConfidentiality and Mental HealthConfidingContemplative Psychotherapy EssentialsControlConversations About Psychology and Sexual OrientationCoping with BPDCouch FictionCounseling in GenderlandCounseling with Choice TheoryCouple SkillsCrazy for YouCreating a Life of Meaning and CompassionCreating HysteriaCritical Issues in PsychotherapyCrucial Choices, Crucial ChangesDeafness In MindDecoding the Ethics CodeDeconstructing PsychotherapyDeep Brain StimulationDemystifying TherapyDepression 101Depression in ContextDialogues on DifferenceDissociative ChildrenDo-It-Yourself Eye Movement Techniques for Emotional HealingDoing CBTE-TherapyEarly WarningEncountering the Sacred in PsychotherapyEnergy Psychology InteractiveErrant SelvesEssays on Philosophical CounselingEssentials of Wais-III AssessmentEthically Challenged ProfessionsEthics and Values in PsychotherapyEthics in Plain EnglishEthics in Psychotherapy and CounselingExistential PsychotherapyExpectationExploring the Self through PhotographyExpressing EmotionFacing Human SufferingFairbairn's Object Relations Theory in the Clinical SettingFamily TherapyFavorite Counseling and Therapy Homework AssignmentsFear of IntimacyFlourishingFolie a DeuxForms of Intersubjectivity in Infant Reasearch and Adult TreatmentFoundations of Ethical Practice, Research, and Teaching in PsychologyFreud and the Question of PseudoscienceFrom Morality to Mental HealthFundamentals of Psychoanalytic TechniqueGenes on the CouchGod & TherapyHalf Empty, Half FullHandbook of Clinical Psychopharmacology for TherapistsHandbook of Counseling and Psychotherapy with Lesbian, Gay, and 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MeaningMetaphoria: Metaphor and Guided Metaphor for Psychotherapy and HealingMind GamesMindfulnessMindfulness and AcceptanceMindfulness-Based Cognitive Therapy for DepressionMindworks: An Introduction to NLPMockingbird YearsMoments of EngagementMomma and the Meaning of LifeMotivational Interviewing: Preparing People For ChangeMulticulturalism and the Therapeutic ProcessMultifamily Groups in the Treatment of Severe Psychiatric DisordersNarrative PracticeOn the CouchOne Nation Under TherapyOur Inner WorldOur Last Great IllusionOutsider ArtOutsider Art and Art TherapyOvercoming Destructive Beliefs, Feelings, and BehaviorsOverexposedPathways to SpiritualityPersonality and PsychotherapyPhilosophical CounselingPhilosophical Counselling and the UnconsciousPhilosophical Issues in Counseling and PsychotherapyPhilosophical PracticePhilosophy and PsychotherapyPhilosophy for Counselling and PsychotherapyPhilosophy PracticePhilosophy's Role in Counseling and PsychotherapyPillar of SaltPlan BPlato, Not Prozac!Polarities of ExperiencesPower GamesPractical Psychoanalysis for Therapists and PatientsPrinciples and Practice of Sex TherapyProcess-Based CBTPsychologists Defying the CrowdPsychology, Psychotherapy, Psychoanalysis, and the Politics of Human RelationshipsPsychosis in the FamilyPsychotherapyPsychotherapyPsychotherapy and ConfidentialityPsychotherapy As PraxisPsychotherapy East and WestPsychotherapy for Children and AdolescentsPsychotherapy for Personality DisordersPsychotherapy Is Worth ItPsychotherapy Isn't What You ThinkPsychotherapy with Adolescent Girls and Young WomenPsychotherapy with Children and AdolescentsPsychotherapy without the SelfPsychotherapy, American Culture, and Social PolicyRapid Cognitive TherapyRational Emotive Behavior TherapyRational Emotive Behavior TherapyRationality and the Pursuit of HappinessRebuilding Shattered LivesReclaiming Our ChildrenRecovery OptionsRelationalityRent Two Films and Let's Talk in the MorningSaving the Modern SoulScience and Pseudoscience in Clinical PsychologySecond-order Change in PsychotherapySelf-Compassion in PsychotherapySelf-Determination Theory in the ClinicSelf-Disclosure in Psychotherapy and RecoverySerious ShoppingSex, Therapy, and KidsSexual Orientation and Psychodynamic PsychotherapySigns of SafetySoul Murder RevisitedStaring at the SunStraight to JesusStrangers to OurselvesSubjective Experience and the Logic of the OtherTaking America Off DrugsTales of PsychotherapyTales of UnknowingTalk is Not EnoughTalking Cures and Placebo EffectsTelling SecretsThe Behavioral Medicine Treatment PlannerThe Body in PsychotherapyThe Brief Couples Therapy Homework Planner with DiskThe Case Formulation Approach to Cognitive-Behavior TherapyThe Challenge for Psychoanalysis and PsychotherapyThe Child and Adolescent Psychotherapy Treatment PlannerThe Clinical Child Documentation SourcebookThe Clinical Documentation SourcebookThe Complete Adult Psychotherapy Treatment PlannerThe Couch and the TreeThe Couples Psychotherapy Treatment PlannerThe Crucible of ExperienceThe Cure of SoulsThe Death of PsychotherapyThe Education of Mrs. BemisThe Ethical Treatment of DepressionThe Ethics of PsychoanalysisThe Gay and Lesbian Psychotherapy Treatment PlannerThe Gift of TherapyThe Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work The Healing JourneyThe Heart & Soul of ChangeThe Heroic ClientThe Husbands and Wives ClubThe Love CureThe Making of a TherapistThe Mindful TherapistThe Mirror Crack'dThe Mummy at the Dining Room TableThe Neuroscience of PsychotherapyThe Neuroscience of Psychotherapy: Healing the Social BrainThe New Rational TherapyThe Older Adult Psychotherapy Treatment PlannerThe Other Side of DesireThe Pastoral Counseling Treatment PlannerThe Philosopher's Autobiography The Pornographer's GriefThe Portable CoachThe Portable Ethicist for Mental Health Professionals The Present Moment in Psychotherapy and Everyday LifeThe Problem of EvilThe Problem with Cognitive Behavioural TherapyThe Psychodynamics of Gender and Gender RoleThe Psychotherapy Documentation PrimerThe Psychotherapy Documentation PrimerThe Psychotherapy of HopeThe Real World Guide to Psychotherapy PracticeThe Schopenhauer CureThe Sex Lives of TeenagersThe Talking CureThe Therapeutic "Aha!"The Therapist's Guide to PsychopharmacologyThe Therapist's Guide to Psychopharmacology, Revised EditionThe Therapist's Ultimate Solution BookThe Trauma of Everyday LifeThe Trouble with IllnessThe UnsayableThe Way of the JournalTheory and Practice of Brief TherapyTherapy with ChildrenTherapy's DelusionsTheraScribe 3.0 for WindowsTheraScribe 4.0Thinking about ThinkingThinking for CliniciansThinking for CliniciansThoughts Without a ThinkerThriveToward a Psychology of AwakeningTracking Mental Health OutcomesTrauma, Truth and ReconciliationTreating Attachment DisordersTreatment for Chronic DepressionTreatment Plans and Interventions for Depression and Anxiety DisordersUnderstanding Child MolestersUnspeakable Truths and Happy EndingsWhat the Buddha FeltWhat Works for Whom?What Works for Whom? Second EditionWhen the Body SpeaksWhispers from the EastWise TherapyWittgenstein and PsychotherapyWorking MindsWoulda, Coulda, ShouldaWriting About PatientsYoga Skills for Therapists:Yoga Therapy
For nearly all mental health-care practitioners, the most satisfying
aspect of our practice is our clinical interaction with patients.
However, any practicing psychotherapist can attest to the frustrations
in dealing with the mountains of paperwork that are required by
various managed care payers and other regulatory entities. But
theses demands are not necessarily all bad. Clear and well written
treatment plans, progress notes, and homework planners can assist
patients' progress in treatment. It also gives clinicians a clearer
sense of their patients' progress and facilitates accountability.
An ideal solution to this problem would be a system that automates
much of the repetitive and laborious processes required in our
daily clinical practice. Therefore, an ideal computer software
system would be one that is simple to use, does not require a
steep learning curve, is flexible enough to accommodate our individual
clinical styles, intuitive to use, and, most importantly, can
easily and effortlessly be incorporated into our practice.
There are several computer programs that purport to help clinicians
in organizing the labyrinth of paperwork that is required. TheraScribe
4.0 is the latest offering from PEC Technologies. It comes in
three versions: 1) Solo / Small Group Edition - to install on
one computer, 2) Solo / Small Group Edition - for installation
on a Network of up to 10 Users, and 3) Enterprise SQL Edition
Server Installation with Enterprise SQL Edition-Client. According
to the company's literature, TheraScribe "is simply
the most robust, yet easiest-to-use, behavioral health clinical
management system available."
Strictly speaking, TheraScribe 4.0 is more than a simple
tool that organizes paperwork. What separates this program from
others is the "ability of the software to put the contents
of Wiley's best-selling Practice Planner books (Treatment Planners,
Homework Planners, and Progress Notes Planners) at user's fingertips…with
thousands of prewritten clinical management components and tools…with…clinically
sound language, and on-screen help to expertly guide you through
each stage of the treatment process: intake/assessment, treatment
planning, progress monitoring, and outcomes analysis."
The various features available in this program are too numerous
to mention in this review. However, as expected, essential features
like psychosocial assessment, billing authorization date (with
numbers of remaining visits available), DSM IV codes, ability
to input demographic information, mental status exam, and progress
notes are all included in this program and they function as advertised.
A significant aspect of this program is its flexibility and the
expandability via the use of various treatment and treatment-setting
modules. For example, TheraScribe 4.0 integrates Wiley's
Practice Planner books into the program, thus allowing clinicians
easy assess to their bundled treatment planners and homework planners.
Other treatment planner modules that can be purchased separately
from the vendor include addictions, adult psychotherapy, child
psychotherapy, family, group, and personality disorders. These
treatment modules can also be custom-tailored to various treatment
centers (e.g., adult criminal justice planner, behavioral medicine
planner, pastoral counseling treatment planner, and the psychiatric
evaluation and pharmacology planner). The same applies to the
different progress note planners; the add-on module for adult
progress notes planner, the adolescent progress notes planner,
the addiction progress notes planner, and the child progress notes
planner also can be purchased separately.
Another important feature of this software is the ability to customize
it. Adding fields and creating custom reports can be relatively
easily done, especially after getting familiar with the program.
Yet to this reviewer, that is the most important question regarding
migration to a computerized system in assisting with our clinical
No matter how powerful the features are, it means very little
if the program is too difficult to understand and cumbersome to
use. There is an inherent flexibility in using pen and paper in
keeping records and creating a treatment plan. It allows for the
freedom to be flexible and creative, and paper allows the leeway
to use our clinical judgment without having to follow a rigid,
prescribed course of treatment.
Of course some of this flexibility can be introduced into TheraScribe
4.0 but not without having sufficient familiarity with the details
of the program. There is a substantial learning curve associated
with this program though TheraScribe 4.0 comes with a CD-ROM
based tutorial designed to help. The makers also offer telephone
and onsite training for additional fees.
TheraScribe 4.0 essentially delivers what it promises in
the promotional literature. The program interface is well designed,
and with some practice, is relatively intuitive to navigate throughout
the program (those who do not have much experience with using
computers may have more difficulty.)
In this reviewer's opinion, TheraScribe's biggest strength
is also its weakness. The programs' flexibility, power, and multitude
of features require a great deal of time, energy, and effort to
learn and understand. It requires a near-complete commitment to
the program on the clinicians' part. Therefore, the essential
question clinicians must ask when assessing the possibility of
migrating their clinical information/practice to a computerized
system such as TheraScribe is the degree of commitment
to change their present way of doing things. Halfhearted commitment
may be counterproductive as this may mean maintaining both handwritten
notes and the computerized system at the same time, thus doubling
The TheraScribe 4.0 under review was a Demo disk with several
key features disabled, including printing. Given these limitations,
it was difficult to make a full commitment to switch more records
to this program. It was difficult, therefore, to adequately assess
the day-to-day practicality of using this system in clinical practice.
TheraScribe 4.0 is more than a simple record management
program. It is a set of various tools. As with any tool, in order
to use it effectively, it is important to understand how it is
used and the strengths and weakness of that tool. In this case,
TheraScribe 4.0 delivers what it purports. The ultimate
question is whether that is sufficient to change the tried and
true pen and paper method. This can only be answered by individual
needs of clinicians and organizations.
TheraScribe can be a tremendously powerful practice aid
but its real start-up costs must include a realistic calculation
of the time and effort and motivation required to truly commit
to optimal utilization.
© 2001 Chae Kwak
Chae Kwak is a psychotherapist in the Adult Outpatient
Community Psychiatry Program at the Johns Hopkins Bayview Medical
Center in Baltimore, Maryland.
Wiley.com Web Page for Therascribe