I am lucky as I have out of session contact. It took us a while to settle on a good way to work together and out of session contact has been a tremendous help. My T allows me to email, text or call as I wish. I almost never call, only in dire emergencies. Texting is very rare as well, usually if I just have a quick note for him or a question about scheduling. Emailing is something that I do quite a lot of. Generally I send at least one email a day. It is a way for me to get things out and send them away, make sense of things, give T an idea of where I am at, let him know if something has happened and also to help me feel connected. He very rarely responds and usually if he does it is a brief note or a phone call if I sound like I need it. When I come into sessions he already has an idea of how I am doing and how my week has been and he helps lead the discussion. I know that many people don't believe in that much contact or with T leading the discussion but it has been very beneficial for me. Therapy was not progressing well at all until we found a way of doing therapy that worked well for us.