I think having frequent outside of session contact with one's T tends to cause more harm than good. At first, it makes the client feel cared about and it seems like it's helping. Then, the client texts/e-mails more and more in order to seek reassurance, to express their thoughts to T right away, to try and get a response from T, and/or to "do therapy" via text/email. It becomes excessive. It becomes a way to get out of "sitting with" the hard feelings. It becomes a way of depending on T for reassurance rather than using coping skills and becoming more independent. The client feels like T is more of a "friend" than a therapist. The boundaries become too blurred. And, when the T can't (or won't) respond to all of these texts/emails, or doesn't respond quickly, or doesn't respond in the way the client wanted-- the client feels rejected and obsesses about T's response (or lack thereof). I think it's safe to say that a good 1/3 of the posts in the Psychotherapy forum are about distress over e-mailing T. I think the issue here is that clients *want* to e-mail T. They say that it helps because they want to be able to continue e-mailing and/or receiving e-mails from T. They don't want to lose that outside of session contact. But, in my opinion, that contact is actually not in the client's best interests. It feeds into and increases transference and an insecure attachment to T. It creates this whole drama around the T-client relationship (outside of the therapy room) which detracts from the client actually working on their presenting issues. Some transference in the T relationship is normal or even beneficial-- but I think increasing that transference (and dependency) through e-mail is a hinderance to the therapeutic process.

My T allows calls, texts, and e-mails, but I do not use them on any kind of a regular basis. I use them almost exclusive for scheduling purposes. I've e-mailed T 3 times in 3 years and have texted her maybe 10-12 times in 3 years. I certainly think it's okay to let T know if the client is in crisis, to ask for an additional session, to get truly time-sensitive information to T, or something of that nature. I think it becomes "too much" when it is once a week or more, outside of session. I should also point out that I'm referring to clients who are functioning satisfactorily in their daily lives, and are going to therapy on a voluntary basis. If a client is in-patient treatment or in a day program, I'm sure the rules and needs are different.

(I'm sure some will disagree with me; this is purely my opinion. However, I think a lot of Ts are adopting this opinion as technology (email/text) becomes a bigger part of our lives. A lot of Ts who previously gave out their cell numbers and e-mail addresses have since changed their accounts, and no longer give that information to clients. I think there is a reason why this is happening more and more frequently. My T said that she has had a problem with clients "abusing" their text/e-mail privileges and she has taken them away. She says she wants to keep those lines open for clients who are truly in crisis, but she does not want regular contact from clients).

ETA: I think it is helpful, though, to bring in things I have written to discuss in person. It's like e-mail, except it is brought into the session and discussed then-and-there so that I can get T's response in real time, there's no misunderstanding, and it does not create dependency.