Yes, I think it's a part of therapy in general. I don't think it's necessarily a 'central' part of therapy, but it is the responsibility of the therapist to manage communications effectively.

I can tell you that my needs and feelings about reaching out has changed substantially over time but for different reasons.

I used to be like you and afraid to need/ask for something. When I first started therapy with the first T (which was short-lived) this really young part came out that would call him and be confused. I would say I don't understand why I'm calling you but feel pangs in my belly. Lots of other stuff...

That went away. Then I started with my first-long term T and was very avoidant. I'm not a self-injurer, but oddly felt a strong need to harm myself at the mere thought of asking for help, including a simple call or email. He didn't encourage contacting him and would often not reply. That changed at one point, then I recall contacting him in between sessions.

Then we had to separate for logistical reasons; then found my current T, who also didn't encourage this, but from my experience with the last T, I think, I was over the avoidant-ness by the time I started with this t. I was really dysregulated with this one at first and contacted him a lot for both positive and distressful times. It got really bad at one point, and we had ruptures. However, I was actually being traumatized and just didn't realize it at the time.

Now, he changed his therapy approach, and I find sessions more containing so I have no need to reach out for the most part. I will, however, not hesitate to reach out if something major comes up.

I'm probably not a good example on this issue as I varied so much but wanted to share that I worked through those 'not worthy' issues, and how different the needs can be with the same person.