I can call, text or email between sessions. I only call or text if it's about scheduling, or a very rare situation. Mostly I email, but I try not to do that too much because I don't want to be a pest. She tells me that she has never experienced me that way, thankfully. Recently she told me that from a clinical standpoint, she enjoys my emails because they are showing her my process. She doesn't always respond, and when she does they are short two or three words. Usually when I email it is because it's something I don't want to forget to talk about in the next session anyway. I don't pay extra.