Background
The practice consultant receives a call from Esther, an occupational therapist working in the community, to discuss a client's request to record an occupational therapy session. Esther wonders if she should allow the recording of the sessions and considers what to do. Esther contacts the practice consultant to find out if there are resources on the College website to support her decision-making.
The practice consultant mentions that recording an occupational therapy session may be requested for many reasons, some examples include:
- recording of an assessment or intervention to share with family or caregivers
- recording the session for legal purposes to use in a personal injury case
- recording client progress to monitor change over time.
The practice consultant suggests Esther review the document Guidelines for Working with Third-Party Payers. The practice consultant also points Esther to an external resource that may be helpful: Canada Audio and Video Recording Laws - Recording Law.
Esther notes that the Guidelines state: "Any decisions regarding requests to audio or video record OT service by the client or the OT [ideally] should be discussed in advance and agreed upon by both parties before proceeding." Esther also reviews the resource on audio and video recording laws for Ontario.
Considerations
Risks and benefits
Esther knows that an audio or video recording may not accurately capture the OT analysis and opinion. Esther thinks about potential risks if she moves forward to allow the session recording.
She considers the risks associated with privacy if the recording is not on a secure network where there is an opportunity for unauthorized access. Esther also thinks about the impact of the OT session with the presence of a recording device that may distract from the assessment and alter the assessment results.
Alternately, Esther recognizes that there may be benefits for the client recording the session as it would be helpful to recall the discussion, show functional change, or demonstrate proper use of equipment.
Professional and Organization Processes
Esther reviews the College website for additional guidance documents and decides to use the decision-making framework to identify her options and determine how to proceed. Esther reviews her organization's policies that require written approval and consent from all parties for video and audio recordings.
Impact of the therapeutic relationship if declined
Esther recognizes if she refuses to have the session recorded because she feels uncomfortable, it may jeopardize the client-therapist relationship. She knows if she declines the request, she must document her rationale in the client record.
Outcome
Esther speaks with her client to understand the reason for the request to record the session. The client confirms that her mother could not attend the session and would like to see her performance during the assessment.
Esther explains some of the risks and benefits of recording the session. She alerts the client that personal health information may be communicated during the session recording, posing privacy concerns if the client later shares the recording with others.
Esther also discusses her company's policy requiring prior approval for video and audio recordings. Esther and the client agree to record only a portion of the session at the next appointment.
Conclusion
Occupational therapists must recognize that clients may have specific and valid reasons for requesting video or audio recording of occupational therapy sessions. Occupational therapists should clarify the reason for the request and confirm expectations. Occupational therapists should remain client-centred and should try to accommodate client requests for video and audio recordings of occupational therapy sessions. All decisions regarding client requests to audio or video record sessions should be discussed in advance and agreed upon by both parties.
Some organizations have policies or procedures about the recording of client-therapist interactions. The client should provide informed consent for the video or audio recording even though they may have initiated the request. The occupational therapist should document client-therapist agreements about consent, use and access to the recordings by both parties, and retention. The occupational therapist should address any questions about storage, copying, release, and interpretation of the recordings ahead of time. Occupational therapists may also seek legal advice to discuss any concerns from a risk management perspective.
There may be situations where an occupational therapist is unaware that they are or have been recorded. Clients may have personal digital devices, or an occupational therapist may observe cameras in a client's home, such as security monitoring devices or private webcams. Clients are rightfully able to possess and use these devices. Occupational therapists may think that it is unfair to be recorded without their knowledge; however, occupational therapists should always act in a manner that is ethical and professional; essentially, they should conduct themselves as if they are being recorded.
References
Contact
If you have questions about the application of College Standards and resources, contact the Practice Resource Service: 1.800.890.6570/416.214.1177x240 or [email protected].
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