I am concerned lately about the number of people who have posted that their ts start sessions late and then finish early because they have a client before and a client after. Sorry if this a trigger for anyone- I apologise
In my own experience and I believe it is mandatory here to leave at least 15 mins between clients. I can honestly say in seeing three different ts that I never seen ts next client (apart from a few weeks ago when he was 30 mins early and knocked on the door). Following that t checks the corridor after every session to make sure it is safe and her clients don't see each other because it is supposed to a privacy and confidential issue.
Also taking a 15 mins break is the law here because it is practising good self care and allowing yourself time to catch your thoughts before next session.
I am not trying to rock the boat or label anyone's t here but I would be concerned about a t who has back to back clients. I would worry about a burn out.
I suppose the laws are different in every country but here a therapist has to meet with their supervisor( a superior t) once for every 6 clients and attent their own personal therapy to protect their clients.

Originally Posted by monalisasmile

I am concerned lately about the number of people who have posted that their ts start sessions late and then finish early because they have a client before and a client after. Sorry if this a trigger for anyone- I apologise
In my own experience and I believe it is mandatory here to leave at least 15 mins between clients. I can honestly say in seeing three different ts that I never seen ts next client (apart from a few weeks ago when he was 30 mins early and knocked on the door). Following that t checks the corridor after every session to make sure it is safe and her clients don't see each other because it is supposed to a privacy and confidential issue.
Also taking a 15 mins break is the law here because it is practising good self care and allowing yourself time to catch your thoughts before next session.
I am not trying to rock the boat or label anyone's t here but I would be concerned about a t who has back to back clients. I would worry about a burn out.
I suppose the laws are different in every country but here a therapist has to meet with their supervisor( a superior t) once for every 6 clients and attent their own personal therapy to protect their clients.

So clearly you are not in the US! I would love to know what country you are in, but completely understand if you don't wish to divulge that information.

Here in the US Ts make their own schedules so they can decide if they wish to leave time between sessions or not...and I think Ts that are in the same practice have the same predetermined scheduling practices as well. I believe some Ts are much better at time management than others...the best T I have ever seen stayed on schedule to the minute and left himself 10 minutes between each session to clear his head for the next one, etc.

I am seeing two Ts right now...one of whom is always late but he runs into the next person's session time taking a few minutes for himself, so I am guessing his clients all know how he "works" by now...I think he intends to be on time, but he never ever interrupts me to tell me our time is up, and he is aware time management is not a strong point of his with all his clients. He also only works 4 days a week and never seems overly stressed.

The second T I am seeing is a LCSW, and he runs his sessions right into each other, which I have been finding a bit annoying and I mean to ask him about and probably will next session. BUT he is also the most calming presence I think I have ever been around. (Seriously, he is kind of like Buddha, lol...it's really amazing. And I am sooo high strung that he works so well as a T for me.) So maybe he is able to switch his energy from one client to another w/out it being an issue. He has never once seemed stressed; I know he takes a lunch break every day, as did my ex-T, the one who left 10 minutes between each session.

As far as supervising, I imagine that happens up to a certain point once a T becomes, well, a T (licensed) and then at some point they are on their own unless they choose to see a therapist for their own "stuff." (I have no knowledge if my current Ts do or not see Ts, and I would never, ever ask them. It seems very personal, and they seem well-balanced enough that I don't feel like I have reason to worry about their self-care.) OR if they hire a consultant (usually because of needing help in a particular area or with a particular client, like if they need help processing feelings of countertransference, for example). These people are "hired" however for this particular service and can be "fired" (so to speak) as well. Or the relationship might end when the issue is wrapped up. I think consultants are hired for short-term, specific issues vs. a therapist seeing a therapist (obvious longer term self-care).

Anyway, that's what I know about the sessions, etc. here in the U.S...I like the idea of mandatory time between sessions.

[Victoria'smom]

I go to community health my T runs thing back to back. This is so she has decompression time from morning evaluations and have an hour for calls backs before going home. I honestly don't know how those pdocs and T's handle such heavy loads. I know my t loves crisis work and takes on all the most serious cases. I'm guessing my evaluation didn't go well.

[Miswimmy1]

Actually, where I am in the US, it is the law that therapy sessions be 45 minutes long, to give the therapist a break in between and to leave room should a client run overtime, etc. Sessions used to be 50 minutes but it was recently changed to 45 a couple months ago. Some therapists have not really adopted this change, but that is the legal time allotted to each client.

Originally Posted by Miswimmy1

Actually, where I am in the US, it is the law that therapy sessions be 45 minutes long, to give the therapist a break in between and to leave room should a client run overtime, etc. Sessions used to be 50 minutes but it was recently changed to 45 a couple months ago. Some therapists have not really adopted this change, but that is the legal time allotted to each client.

That's quite interesting. I will have to inquire about that one. I wonder if it's by state? I also wonder if that is an APA rule so it wouldn't apply to LCSWs, etc. Thanks for the info!

[Raging Quiet]

I know universities and the NHS tend to organise back to back (with 10-15mins if lucky)

Most private T's I have met though have up to 30 mins, an hour or more between clients.

My T is semi retired so has a small caseload; her clients are sprinkled back to back and she usually has 30 mins between me and other clients after.

[feralkittymom]

Some insurance carriers, which are usually regulated on the state level, have decided to only reimburse based on a 45 min hour. Once the biggest carriers adopt a practice, it tends to spread. If a T doesn't accept insurance payments, they needn't be concerned.

The Univ center that my T directed scheduled appts on the alternating 1/2 hour and hour to allow for 30 minutes between clients. So a schedule might be 9AM, 10:30AM, 12PM, 1:30PM, etc. So my appts were always 60mins. He had fewer clients in his private practice and so more flexibility, so it wasn't an issue. One of his offices also had 2 entrances to protect privacy.

[sweepy62]

my t waits 10 minutes in between my session is usually 50 minutes but lately its been spilling over by 10 minutes or so but we been working on stuff i also go to a mental health community she does alot of grounding skills breathing skills during sessions so it helps both of us she seems not stressed at all

My new T says she can book back to back but chooses not to. As for the 45 minute rule, they can go over but it falls into another bracket with insurance and some companies only allow for the 45 minute bracket. Mine has talked to me over 45 minutes, but I notice she then charges my insurance for the 60 minute slot.

[tinyrabbit]

Personally, I think it's bad for the therapist AND the client if the schedule gets messed up.

I'm in the UK and my T is in private practice. He seems to leave about 15 minutes between sessions, which are 60 minutes. I would not be happy with back to back clients or sessions starting late. He has never ever started late unless *I* have turned up late.

[murray]

My T sees clients back to back and always starts late....always. It doesn't bother me now that he is in his own private practice but it did make me a bit uncomfortable when I was in a waiting room with other people and would be sitting there feeling anxious for 20-30minutes. Now that I am waiting alone it is fine. He also makes up the time at the end so I don't miss time, if anything I usually get more than 60 minutes.
As far as his ability to see people back to back, he appears to be able to easily transition from one person to the next. I suspect he must do his notes and review either before or after his work day. There was only one time in the years that I have seen him where I felt he needed a break between clients and then I was more concerned for him, and his previous client, as he seemed to be distressed than I was concerned because he wasn't immediately tuned into me.

[content30]

Originally Posted by Miswimmy1

Actually, where I am in the US, it is the law that therapy sessions be 45 minutes long, to give the therapist a break in between and to leave room should a client run overtime, etc. Sessions used to be 50 minutes but it was recently changed to 45 a couple months ago. Some therapists have not really adopted this change, but that is the legal time allotted to each client.

I do not believe this is true. There are new laws and rules governing health insurance here but not session lengths (whatever your state). You could pay a private T to see you for an 8-hour session. It would not be illegal. No health Insurance will allow that, though. There are new insurance codes for 30-minute, 45-minute, and 60-minute sessions. There are no laws governing breaks for Ts either.

[content30]

My T sees clients back-to-back. It doesn't bother me. Sometimes she is late, and, at times, she has kept me late. It's much harder on her than me. She only works three days per week, and of that, two days are only 6 hours. I don't see her becoming burnt out on that. I'm a curious person by nature and like seeing T's other clients and the other therapy clients for my T's group in the waiting area. I'm a people-person and a people-watcher. However, I know many of you find this distressing/upsetting. In that case, it's worth mentioning to your T. Most of the time, if my T is late, it's only by 5 mins or less. As far as confidentiality, others see me but do not know my name. We write our initials on a check-in clipboard, and T just opens the door and smiles at me. She does not say my name out loud. I don't even know how a T group like mine could function with that level of anonymity, each T would need a separate entrance, exit, and waiting area. There are up to 5 Ts counseling in my T's group at the same time, and they have around 10 total Ts.

Here, Ts are only supervised until they are fully licensed. After that, they consult a T under their own discretion. My T is great, though. She still goes to counseling every once and a while, and she does consult on matters she needs help with. I know she consulted a T about one of my issues. I respect her for that, as she is licensed as a supervising T, is clinical director, and has been a T for over 15 years, but she knows her limits and seeks help accordingly.

[LadyShadow]

My T sometimes sees me for an hour or more, when I make appointments I make sure he checks his calendar to try and ensure I am the only client he has on that day. I got that lucky because my T became an administrator and doesn't see that many clients anymore, only a selected few.

[purplejell]

My T is in private practice. She leaves a half hour between sessions and I really like it. When I've seen other therapists and they just finished with someone else, I felt like they were maybe still thinking about the previous person. I wanted to ask if they were OK, or needed some time. I like her to have time to shift gears between people. And I REALLY don't want to see the people before me. I find that super upsetting. She pretty much always starts on time and I'm happy about that too. My anxiety goes way up when sessions don't start on time.

[anilam]

I don't mind meeting/seeing other clients. I would ,however, mind running late. I have a very tight schedule (school/work) and cannot afford going over even 5-10 min to make up for the time lost. My T has 15 min between clients so our sessions always starts on time- though sometimes he ran over so I've seen his previous clients

[1stepatatime]

Well this post sure hit home for me...lol No worries, your post did not trigger me at all. As you know, my T has recently kept a client on more than one occasion over into my time. Yes, it bothered me and still does when I think about it. I agree that T`s should allow enough time between clients...not only for the clients sake but for theirs as well!! It must be challenging going from one clients issues to another clients issues. I live in Florida and quite honestly I do not know if there are any laws that govern how they set up their sessions,etc. although I doubt that there are. It seems like good practice to allow at LEAST ten minutes between sessions.