My therapist has an answering service who will either connect me with an emergency on-call therapist (which I've never done), or put me into his confidential voice mail. There is a part-time receptionist sometimes during business hours, and when she is in the office I have to leave a message with her.

My experience with calling has ranged from him just taking my call right that minute (when I called and got the receptionist) to getting a call back several days later (when I called and got the receptionist but she forgot to give him the message until she was back in the office several days later). When leaving a message with the voice mail, my T usually calls back within a few hours. Although he has called back before within 10 minutes, and once waited until half way through the next day. I'm not sure if the difference is how upset I sound (or don't sound) or whether it's just about his schedule.

My T doesn't allow e-mail or text messaging (with me, at least).