[AmysJourney]

I know, this topic has probably been discussed thousands of times. But I still feel compelled to make this a new thread again because I have a very strong opinion about it.

I see my Therapist twice a week. That is more than my rent, my car payments, my health isurance, what I pay for food every month and so on. I pay that with gratitude and I believe it's the best money I have ever spent on anything. But I do expect value for that money - as I would if I would spend it on buying anything else. If my therapist would tell me to not call, text or email out of session, I would feel like merely a wallet filler and not a cared for client. That doesn't mean I email every day or text or call, but when I need to, I do.

Therapy doesn't just happen in the hour you are in the office with a T, it's an ongoing process that keeps happening when you leave the office, when you are at home, when you are with friends or family or when you are alone. A good T will even encourage out of session contact when the client really feels the need to because I believe it can show the process a client is in and also that a client is able to reach out if he needs to.

That's not to say you should call or email your T every day or multiple times a day. I know and understand how that can cross important boundaries.
But when I go to a session, I pour out my heart, share my deepest emotions and fears and how could that suddenly be completely resolved when I close the therapist's office door behind me? I usually text my T the same day I had a session. Either with a message of gratitude (which I believe is important!) or a message about how I feel. Sometimes I email when I struggle with certain things that came up during a session. Not once has she asked me not to do this. Not once has she ever given me the feeling that I am doing something wrong.

It hurts me to read all the struggles that some people have. I read a post on here where someone was so anxious about sending a very valid email to her T and about her T's reaction. That really made me mad. A T is entitled to their own boundaries but I think sending an email with what we feel is not crossing any boundary. She can read it in her work time, she can respond when she has time. I sometimes tell my T that I would be fine if she would charge me for out of session contact - and I really would be. But I never want to feel like I am doing something wrong or that I am somehow inconveniencing her by seeking contact out of session.

Some of you have probably read that I am fighting cancer at the moment. My oncologist calls me several times a week just to ask me how I am. When I am in chemo and struggle, he makes an effort to see me and he has held my hand or stroked my back when I was puking my heart out. That doctor is someone I can respect, trust and value. Because he truly defines what a doctor represents. I can call him when I need to, I can email him with my questions etc.
The same goes for my therapist. I respect her because she doesn't make me feel like a case file. She is as real to me in this relationship as she is ethically allowed to be. And she goes above and beyond for her clients and that makes her a great and much sought after therapist. She works in a building with another therapist, whose office is almost always empty. I know that the other therapist is struggling to get clients, when my therapist is unable to take any new clients. The difference between my T and the the other is that the other has implemented incredibly strict boundaries. No emails, no calls, no physical touch whatsoever, no multiple sessions in one week etc. I talked to her a few times while I was waiting for my T to finish a session with another client and I would never chose her as my T.

Long story short, I really think that out of session contact should not be such a huge deal for therapists. And it should not make us as clients feel ashamed or of less value than those clients who stay strictly to the only in-session contact.
I know this might be a controversial topic, but I am interested in how you think about this.

Amelia

[stopdog]

I am a lawyer and when I practiced full time, people would call me at non-regular office hour times. That is fine with me because I billed for that time.
For whatever reason, I personally blame the medical model, therapists don't just build it into their K that they bill for time (other than scheduling or short technical stuff). I think that would go far in solving a lot of this. I do not believe it is because they can't "do therapy" in email or phone calls.

[AmysJourney]

Originally Posted by stopdog

I am a lawyer and when I practiced full time, people would call me at non-regular office hour times. That is fine with me because I billed for that time.
For whatever reason, I personally blame the medical model, therapists don't just build it into their K that they bill for time (other than scheduling or short technical stuff). I think that would go far in solving a lot of this. I do not believe it is because they can't "do therapy" in email or phone calls.

I think you are right. I believe they can and a lot of good ones do. I would be fine with paying extra for out of session contact because I understand it is a service they provide for me. I just don't like when it's apparently about "boundaries" which I don't believe most of the time.

[Petra5ed]

I can second Stopdog, my clients call me and email me at all times and feel entitled to a piece of my life... so why am I not entitled to contact my T?

I agree that zero touch out of session contact sounds cold and not very therapeutic. Every person is different, so saying that someone like you or I cant contact out of session because there's someone out there that's stalking their therapist is absurd.

It seems almost pathological in my case that I cant contact out of session even though my T allows it and I desperately want to. I just feel like such, a, loser... I wanted to email my T all week to say that my dad told me he is proud of me, and then I realized, why would my T care about this? Why am I such a loser that this is a big deal to me? And I didn't even believe it. I guess it is pathological, I feel like such a burden that I assume every contact I have with people is annoying to them. All the reminders, I pay for therapy, I'm not supposed to bother the poor bastard out of the hour... really feeds into my core belief that I'm not worth anyone's time. No wonder I feel like such a mistake. Sorry for my long selfish rant!!

[feralkittymom]

For the sort of issues that you apparently bring to therapy, there is no problem with how you use out of session contact. But if your T has another client whose best interests would not be served by unrestricted contact, and so she instituted boundaries for that client, would that make your T not a good T?

There are poor Ts who make blanket stupid policies about outside contact; there are good Ts that make policies appropriate for each client about outside contact. There are bad reasons for forbidding contact and good reasons for forbidding contact. It isn't about customer service, it's about psychological treatment.

[stopdog]

I don't agree that therapists know what is good or bad for someone and i don't see it as psychological treatment (I doubt anyone will be surprised I disagree with the notion of psychological treatment). I have no trouble with the notion that someone does not want to be contacted after hours because they have a life. I just don't believe and I find it insulting when they blame their choice as being in a client's ?best interest? = something I will never believe they know.

[AmysJourney]

Originally Posted by Petra5ed

I can second Stopdog, my clients call me and email me at all times and feel entitled to a piece of my life... so why am I not entitled to contact my T?

I agree that zero touch out of session contact sounds cold and not very therapeutic. Every person is different, so saying that someone like you or I cant contact out of session because there's someone out there that's stalking their therapist is absurd.

It seems almost pathological in my case that I cant contact out of session even though my T allows it and I desperately want to. I just feel like such, a, loser... I wanted to email my T all week to say that my dad told me he is proud of me, and then I realized, why would my T care about this? Why am I such a loser that this is a big deal to me? And I didn't even believe it. I guess it is pathological, I feel like such a burden that I assume every contact I have with people is annoying to them. All the reminders, I pay for therapy, I'm not supposed to bother the poor bastard out of the hour... really feeds into my core belief that I'm not worth anyone's time. No wonder I feel like such a mistake. Sorry for my long selfish rant!!

This feeling you are talking about is exactly what I mean! YOU feel like a mistake, YOU feel like you are bothering your therapist, YOU feel like a burden. What good does that do you for your own life, for the progress you wish to make in therapy? Nothing.. it only prolongs the suffering, worsens the suffering and it makes you feel like less of a person. Writing that email (which I guess would report of something positive) should not be burdened with such a negative feeling..

[feralkittymom]

Well, no, I'm not surprised you don't accept the existence of psychological treatment! On the contrary, I do have a problem with people choosing to practice, especially in a private practice rather than institutional setting, yet maintaining an across the board 9-5 mentality. I think it's unethical to engage in treatment of people as their sole support, yet refuse to respond to crisis (or not provide some other alternative in the event of crisis.) Because sometimes, it is a matter of life and death.

But when it isn't life and death is when situations get thorny.

[AmysJourney]

Originally Posted by stopdog

I don't agree that therapists know what is good or bad for someone and i don't see it as psychological treatment (I doubt anyone will be surprised I disagree with the notion of psychological treatment). I have no trouble with the notion that someone does not want to be contacted after hours because they have a life. I just don't believe and I find it insulting when they blame their choice as being in a client's ?best interest? = something I will never believe they know.

I agree with you, stopdog! Saying it's in the client's best interest is like being the judge over someone's feelings and emotions or struggles etc. A T can set boundaries, and I agree with most of them. But making it a boundary to not be contacted out of sessions is usually and in most cases more harmful to a client than doing any good. We as clients don't go to Therapy because we need to be treated like we have been all our lives. We go because we need help and therapy is not like taking a drug and waiting for it to work. It's an active and dynamic process.

And yes, Ts have their own personal lives. And so they should. Making it a rule to not read emails or answering phone calls after a certain hour seems a good thing to do. But if it is within a usual work day, I see nothing wrong with it unless it causes the T to lose money or neglect other patients. But charging a little extra for it seems a solution to that.

I'm allowed outside contact. But there have been times when it became almost damaging. I was in a traumatic flashback & T couldn't keep me safe in that way so suggested we 'hold it' till session.

[Asiablue]

I could never go to a therapist that doesn't allow some form of contact outside of session, like you say the majority of therapy goes on outside that 1 hour in session. I really need that support the few days after.

I don't think it's something we can or should ever make therapists do. There would be no point in outside contact with a T who wholly resented it. I think Therapists should be able to choose what's best for them, what they can cope with comfortably. But equally a client can vote with their feet. If they don't like a "no outside contact rule" then go find a therapist who does offer it.

Therapists generally do need to set some parameters around contact, and it seems that many have found ways to individualize those parameters. While the vast majority of clients use that contact with respect for the therapists' time and life, there is that minority who would abuse the privilege resulting in additional stress for themselves.

I've seen right here on PC posters who spoke of spamming their therapist with literally dozens of texts or emails in a day. Full outside contact clearly wasn't working to help the client nor the therapeutic relationship which inevitably became highly strained. These instances are probably fairly unusual, but they demonstrate that therapists do have to have some reasonable parameters they work within and the ability to individualize them for clients as they learn more about them.

[Leah123]

Thanks for this thread! I am having a stressful morning and was quite ready to be upset by someone ranting that clients shouldn't bother therapists out of session. How nice to read the opposite perspective.

I've definitely benefitted from out of session contact. I contact my therapist frequently, however, I do pay for all her time, which I think helps keep the relationship fairly well balanced, if intense. I do worry about bothering her too much, but I must trust that after 20 years in the business, if I was, she would set a boundary or say so, when in contrast, she had told me that she never tires of reading my replies and that I do not wear her out, I am not too much for her. So... that's a relief.

I credit the close work we've done with helping me make significant behavioral and other changes in a relatively short period of time. The ability to give her real time, detailed updates gives us both greater insight. I'm very pleased to be working with a therapist who welcomes this type of relationship, and again, she is compensated for the time, so I need not feel as if I'm taking advantage.

[AmysJourney]

Originally Posted by Leah123

Thanks for this thread! I am having a stressful morning and was quite ready to be upset by someone ranting that clients shouldn't bother therapists out of session. How nice to read the opposite perspective.

I've definitely benefitted from out of session contact. I contact my therapist frequently, however, I do pay for all her time, which I think helps keep the relationship fairly well balanced, if intense. I do worry about bothering her too much, but I must trust that after 20 years in the business, if I was, she would set a boundary or say so, when in contrast, she had told me that she never tires of reading my replies and that I do not wear her out, I am not too much for her. So... that's a relief.

I credit the close work we've done with helping me make significant behavioral and other changes in a relatively short period of time. The ability to give her real time, detailed updates gives us both greater insight. I'm very pleased to be working with a therapist who welcomes this type of relationship, and again, she is compensated for the time, so I need not feel as if I'm taking advantage.

Thank you Leah! I think this is a great example of how appropriate out of session contact can indeed be very helpful. And your T sounds a lot like mine and I am very grateful. This relationship that goes beyond the hour in the office has played a huge part in who I am now as opposed to who I was when I started therapy. And I believe having a slight feeling of not wanting to "bother" the T too much is healthy and even kind and it shows we can have respectful contact. It's a healthy part in us or one that has been healed.

[someone321]

When I started seeing my current T, I told her that one thing which I didn't like in previous T was that I wasn't supposed to contact him between sessions. My current T said that if I am in a crisis I can text her so she could give me a short reassurance (but I would never text her). I also can e-mail her; however, she said that probably she won't be able to answer these e-mails but she will read them, print and bring for the next session. I would be really okay with it; however, she actually does respond to my mails... And I am still not so sure if I am happy with it... Sometimes I send something to get rid of my thoughts, even to forget about the topic till the next session and then I get the response which usually is different from this what I would expect/want and instead of forgetting the topic I start thinking why she wrote that and what it means... Mails can be interpreted in hundreds ways so I can imagine why some Ts do not like them and prefer discussing hard topics during sessions...

[Yearning0723]

Originally Posted by stopdog

I am a lawyer and when I practiced full time, people would call me at non-regular office hour times. That is fine with me because I billed for that time.
For whatever reason, I personally blame the medical model, therapists don't just build it into their K that they bill for time (other than scheduling or short technical stuff). I think that would go far in solving a lot of this. I do not believe it is because they can't "do therapy" in email or phone calls.

That's actually an interesting way of thinking about it. My father owns a business and gets calls at all hours from clients, and I email my professors occasionally when I have a question or when I need something and I don't think twice about it. There's one professor that I probably email a couple times a week to run ideas by or to clarify assignments or to comment on the readings or to share something I think she might find interesting, and she doesn't mind at all. (It's also a small class of 18 students, so I get that if she had 300 students, she might not appreciate it as much.)

But I don't worry with her about being a bother or crossing a boundary, and she responds when she responds, which is not always right away, and occasionally she doesn't respond, and I'm fine with that. And she likes that I'm engaging so well with the class material, so it isn't an issue. So why does this paradigm not work with therapists, who should be glad you're engaging so well with the session on your own time? And I don't mean calling the therapist every single day, but occasionally, if you really need to or even if you just feel like it would be helpful.

I had a previous T (ED T) who not only let me email her, but emailed me first to ask how I was doing the day after a session or halfway through the week. It was lovely, and I never abused the privilege. It just made me feel very cared about and helped me trust her. Knowing that emailing her was an option was a comfort.

This T doesn't allow emails/calls/anything. I'm trying to find another T that will, but also worried that stating my needs upfront might make that person not want to take me on as a client because they might worry about not being able to meet that need or me being too high-maintenance...I don't know. It's not like I would email/call every day, but having that option would be really nice.

[AmysJourney]

Originally Posted by Yearning0723

This T doesn't allow emails/calls/anything. I'm trying to find another T that will, but also worried that stating my needs upfront might make that person not want to take me on as a client because they might worry about not being able to meet that need or me being too high-maintenance...I don't know. It's not like I would email/call every day, but having that option would be really nice.

It makes me sad that we even have to call it a "need". Calling it that automatically labels us as needy or needier than others. It's not a need, it's a valid desire to be able to process thoughts or fears or even joy and communicate that. And I am not talking about calling or emailing the T with every little thing we have on our minds. But when we feel it could help just to write things down or for them to know what is going on, then why call it a "need" or "crossing boundaries"? My out of session contact is just as important to me as the time I spend with my T in the office. And it doesn't make me a needy person, it just makes me a human who is in the process of getting help and healing. I hope you find a T who is more open to the process.

[PeeJay]

Originally Posted by Amelia112

I know, this topic has probably been discussed thousands of times. But I still feel compelled to make this a new thread again because I have a very strong opinion about it.

I see my Therapist twice a week. That is more than my rent, my car payments, my health isurance, what I pay for food every month and so on. I pay that with gratitude and I believe it's the best money I have ever spent on anything. But I do expect value for that money - as I would if I would spend it on buying anything else. If my therapist would tell me to not call, text or email out of session, I would feel like merely a wallet filler and not a cared for client. That doesn't mean I email every day or text or call, but when I need to, I do.

Therapy doesn't just happen in the hour you are in the office with a T, it's an ongoing process that keeps happening when you leave the office, when you are at home, when you are with friends or family or when you are alone. A good T will even encourage out of session contact when the client really feels the need to because I believe it can show the process a client is in and also that a client is able to reach out if he needs to.

That's not to say you should call or email your T every day or multiple times a day. I know and understand how that can cross important boundaries.
But when I go to a session, I pour out my heart, share my deepest emotions and fears and how could that suddenly be completely resolved when I close the therapist's office door behind me? I usually text my T the same day I had a session. Either with a message of gratitude (which I believe is important!) or a message about how I feel. Sometimes I email when I struggle with certain things that came up during a session. Not once has she asked me not to do this. Not once has she ever given me the feeling that I am doing something wrong.

Can I give you a standing ovation?

Yes!! I so agree with this!

I am not a therapist but I have paying clients in an entirely different profession. And they contact me all the time. And I try to respond. And not just about scheduling. I try to write thoughtful email responses and I try to respond to voicemails as soon as possible, and I apologize if I take more than 24 hours to respond.

That some therapists are so rigid about this just feels like laziness to me. Or an overt fear of being manipulated by clients.

Finally, I one time wrote a very long email to my T. It was like a novel. And I offered to pay T for the time, and T was offended.

I think T should not have been offended. I'd rather pay double my normal rate, and have more email interaction. And I know T needs to make a living. So I'd say, "Don't take on another client. Instead, spend an hour reading my emails and responding, and I'll pay you what another client would pay."

Ok that sounds arrogant and I don't mean it so harshly, but that's my take. I'd rather spend a bit extra and have extra contact. And my reward for not having contact is that I save money, not that I supposedly honored T's boundaries.

[feralkittymom]

Yearning, the comparison to a professor isn't a fair one because there is no legal obligation of care between professor and student the way there is between T and client. And your class may have 18 students, but what is her total student load across classes? I carry a load of 350-400 students, and if I had even 6 students e-mailing me as much as you say you do, that would add hours of work to my day. Just having students e-mail and neglect to put their name or topic in the header, causes 10-30 minutes of extra time that I usually don't have in my workday.

Leah, forgive me, but you have a thread agonizing about being way over your therapy budget because of unlimited contact with your T. It appears that neither of you exercise the kind of control necessary to avoid creating this problem. I don't see that as benign.

[Leah123]

Originally Posted by feralkittymom

Yearning, the comparison to a professor isn't a fair one because there is no legal obligation of care between professor and student the way there is between T and client. And your class may have 18 students, but what is her total student load across classes? I carry a load of 350-400 students, and if I had even 6 students e-mailing me as much as you say you do, that would add hours of work to my day. Just having students e-mail and neglect to put their name or topic in the header, causes 10-30 minutes of extra time that I usually don't have in my workday.

Leah, forgive me, but you have a thread agonizing about being way over your therapy budget because of unlimited contact with your T. It appears that neither of you exercise the kind of control necessary to avoid creating this problem. I don't see that as benign.

Yes, it is a struggle to find balance between progress, desire for connection, and expense. But it's also been extremely rewarding in terms of seeing significant change in my life, and since January, when I resolved to cut back, I cut the expense 30% last month, and have a plan going forward with her to improve the balance.

Everything is blessing and bane Feralkittymom- you know it's not black and white. Therapy is a better investment than many other things I've spent money on, and while I have been cutting back and need to, I don't regret 90% of the spending I did on it last year.

We can agonize over things without it meaning they're wrong or meritless. I have student loan too. I agonize about it at times also, but it's less controversial, partly because it's more common.

[feralkittymom]

Yes--boundaries have positive and negative consequences, regardless of how they are defined. So I'm just saying, let's not consider Ts with no boundaries as saints, and those who have boundaries as sinners.

[Yearning0723]

Originally Posted by feralkittymom

Yearning, the comparison to a professor isn't a fair one because there is no legal obligation of care between professor and student the way there is between T and client. And your class may have 18 students, but what is her total student load across classes? I carry a load of 350-400 students, and if I had even 6 students e-mailing me as much as you say you do, that would add hours of work to my day. Just having students e-mail and neglect to put their name or topic in the header, causes 10-30 minutes of extra time that I usually don't have in my workday.

Leah, forgive me, but you have a thread agonizing about being way over your therapy budget because of unlimited contact with your T. It appears that neither of you exercise the kind of control necessary to avoid creating this problem. I don't see that as benign.

She only teaches one class (this one), so it works for her - she told us all at the beginning of the year to please email her if we have any questions or if we have ideas for the next class or want to share something. It's a really interactive seminar course, so if a student sends her a short video clip related to the topic we're discussing, she'll show it in our next class or she'll email it out to all the students.

I think it's different in a small setting like that when you know all your students; like in my one class with 1500 people, you email the professor when you need his permission to reschedule a test with test and exam services, and you put your name and the topic in the subject heading, and you wait 4-5 days for a response. That's standard.

[stopdog]

I do think it is important to get expectations lined up. I am personally not a huge fan of email for things other than scheduling or to get something away from me due to the sense of immediacy I think it instills. I don't want a response.
Also, for example, I tell students I will respond to emails within 48 hours and that I don't check email on the weekend. That way the student knows it is not about them, but about how I operate. I also will sometimes tell a student they need to see me in person - that I do not believe I can respond by email for their issue.
I don't text with my students. I would not text with a therapist.
If it works for both parties, then great, just not something I would do.

[Lauliza]

I'm in school for my Masters to become a T, and this is something that is brought up often. I've never heard a professor say that it's against the client's best interest to contact their T outside of session. What they've said is that it is important to let your client's know up front what your policies are regarding contact. If a client becomes too demanding you need to address this in session and explain what your boundaries and expectations are regarding contact. Obviously no one shouldn't give out personal cell numbers or emails, but then I've heard about T's that do, which baffles me.

I think the problem with some Ts are afraid of getting in a situation where a client goes overboard and is dependent on contact like Sierra pointed out. They are afraid to have the conversation if a client goes overboard with the contact so instead they go to extremes. They set rigid blanket policies about no contact at all or are overly permissive and allow too much. All people have boundaries, friends, family, co-workers, etc., and there are many people who don't respect them. So it is important in therapy for a T to be warm and flexible with some contact, but also be firm so that clients who may struggle with boundaries can perhaps learn from it. Therapy really isn't the one place where we can do anything we want, when we want. That's not reflective of real life and I isn't treating clients as responsible adults.

[stopdog]

I strongly oppose the medical model as the correct way to view therapists.
I don't actually think it works for mds, but I really think it wrong for therapists.