Therapy and email etiquette

It's not only a common topic around here, it's on my mind because I have to include provisions on email etiquette for my students on my syllabi.

So, whether or not your therapist allows email, what do you think the etiquette should be? How in/formal should they be? How much time should a therapist take over emails? What should clients be able to express in an email? Should therapeutic topics be allowed? Has the use of email improved or damaged your relationship with your therapist, and if so why? If you don't email your therapist, do you think it would be helpful or harmful if you could?

I only emailed Nos. 1 and 2 over administrative things like appointments. So they both obviously tended to respond briefly. No. 1 never bothered to proofread, and seemed to send them mostly from her phone. Sometimes she addressed me by name with a "Dear," sometimes not. Sometimes she signed her name, sometimes her initials, sometimes nothing at all. No. 2's emails were all grammatically correct and on the formal side (complete sentences), started "Dear ATAT," and signed, "Take care, No. 2).

No. 3 and I did do some therapy by email during the month or so I was between her and returning to No. 2, even though she doesn't normally email clients except for scheduling. I found it useful because she so clearly took time over them - they were thorough, on the long side, answered questions, responded to points, etc. I made it clear that I was writing just to get stuff out, and that I didn't need a response unless I specifically indicated one would be helpful. She always responded to those emails, and often to the ones that didn't ask for a response. There was one email towards the end that I blew up at her for sending - she admitted that she had screwed up and sent it in haste and that I was right in blowing up at her. But otherwise, it seemed to work quite well - short-term anyway, I don't think long-term would have worked at all well. She usually started, "Hi, ATAT," and ended with either her name or "Best, No. 3."

My T allows emails. I know I am the only one of her clients who does this because she was upfront with me to begin with when I asked in our first session and she explained that she wanted to speak to her supervisor about it and think about it before giving me an answer.

We email about twice a week, one after each session, but some weeks only once and some nine at all. A couple of times I have sent three a week. All of this had been fine but we have agreed that if I was to email every day then it would be too much and I would not be using my other means, such as journalling or writing emails and not sending etc. It took a few weeks but we have a system now that works. I email and if it us important to me I send a text. She replies to my texts and gives me an indication of when she will read. The text normally comes within a few hours and she reads within a day or so. She nearly always replies to my main points but I don't see it as therapy via email, more just that she has heard what I am sating and some words of support and encouragment. Thinking about it, I think I get more of this through email than in person. They are normally about 5-6 sentences though a few have been longer and this is perfectly acceptable to me. I know that she has read and taken ib what I have had to say and has presented a considered and kind response.

I am far less anxious about the wait because of her consistency around this topic. The email nearly always comes either that day or the next but because of the text I know when to expect it, not expect it etc. I try yo text no later than 7 or 8pm and she has replied by text up until just gone 10pm and emailed as early as 6.30am.

Even when I have said that my email does not need a response, she has remained consistent and replied anyway. We do try to discuss the email in session sometimes but mostly this method of communication has been so important for us because I really struggle to verbalise things and so this gives us both more understanding of what is going on.

A bit long winded maybe but I hope it helps someone maybe who is trying to sort through this with their T. I know I struggled to find anything about it when I was looking for information prior to discussing it with my T.

ETA I always address my T as Dear T but sometimes she replies with Hi or Hello. This is OK with me but I will stick to Dear T. She nearly always ends with Best Wishes wish is nice, and if I am struggling then very best wishes. The proofreading isn't always spot on but then I don't think that this is uncommon. There isn't normally more than one small spelling mistake and again, that is fine by me. There have been a few instances where I could have read them wrong but I actually know that all in all she only wants to help and wants the best for me so I am OK with things and can wait until our next session to discuss (or at least try to!)

I started using email for support and I found that unhelpful because he couldn't really offer me what I need and it didn't make me feel better. So I changed my email boundaries and now I will only email him to tell him something that can't wait, asking only for a confirmation of receipt, or can email about scheduling (normally very rare but had to do it yesterday).
I like him to be somewhere in the middle in terms of formality. He starts with "Hi [echos]" and ends with "Best wishes" or "take care" usually. Works for me.

I am allowed to email, but anything that is not just scheduling he does not respond to, with the exception of a few times.

There was once he did not respond to an email that I felt very vulnerable for sending and I just ended up blowing up. My emotional reaction was unbearable and the subsequent emails I sent really worried T and he gave me the "legally I have to tell you to call 911 or go to the ER" speech. I hated that, and he never understood the feelings I was having.

I don't email anymore unless it is strictly scheduling based. I have no interest in those bad emotions, I still haven't figured out what they are or why. Every time I start to write an email now they start. I know better than to push send now.

Emailing was his idea. He allows his students to email. He does teaching and supervision. I find ways to bring material into session without email now. I wish I could though, but the risk is too high. It is not a good idea to initiate an emotional reaction I can't control.

I don't think he allows emails except for rescheduling , but we've never discussed it. I'm not sure I would find it helpful. We did have a brief discussion about the problems that can occur which we see on here with the T not returning them and being misconstrued etc , and I said we never had those problems as we never did it. When we do e-mail or text he says " Hi Out There " and usually ends with " kind or best regards "

Current T's policy is no email or phone except for scheduling. Given the extent of my anger at her these days, that works well -- I can barely coax myself to make it to session without cancelling and so, the familiarity / intimacy of out-of-session contact is pretty much nausea-inducing now.

I've heard T's (including current T) say that they don't do email because it's not a safe form of communication -- I call bull crap on that because seriously, at least post Snowden, who in the world thinks that phone calls are secure?

In general (leaving aside my current situation), I would like a T to offer some email contact with clearly stated (and most importantly, adhered-to) boundaries early on -- so, one email per week or per fortnight and it'll be responded to; or, that the client can email but the T will only respond in session; etc. So, I would find some sort of email contact to be really helpful -- I am able to sort stuff out much better in writing when I have the time and space and (crucially) solitude to do so. In session, I am pretty much incoherent and feel really unsafe / messed-up when it comes to expressing my feelings (rather than my thoughts) -- so, it ends up being rather pointless after a while.

If a response has been offered by the T, I would like for it to be a well thought-out response. In the absence of the T being able to do that consistently (even if not every time), I would prefer to have no response at all.

I don't really care about the formality or lack thereof. Current T veers wildly (in her scheduling emails) between not starting with a salutation of any sort and just getting straight to the point; or, starting with a 'Hi AY' and either continuing with a 'Hope you're well' (if it's right on the heels of say, the 10,465th rift between us) or just plunging straight into it and then signing off with a 'Thanks, T'.

I email often, and it hasn't caused any problems other than trying to figure out to compensate financially when it's excessive (something I brought up, not my therapist). When I added an extra session per week, that helped. Mostly, emails help me strategize during bad times and sometimes just stay connected. I like it when I don't need to email, but I'm grateful that when I do, my therapist doesn't make me feel badly about it. Her replies vary--from brief to lengthy--and I'm happy with any response. The understanding is that she will reply if she is able, and if not, that's fine (but usually, she does). It's been a really good thing for me.

Both T and PrevT allow email. I am allowed to email anytime.

T normally responds to most emails but not every one. She responds to the important ones. If her answer is too involved and/or lengthy, she may elect to save it for face to face therapy time.

PrevT responds to many emails but not every one.

Sometimes it is enough (for me) to know I have mailed content to T or PrevT, knowing I have gotten the issue out away from me and that we can take the matter up another time. It helps because I find I am not mentally churning away about the issue. It is out away from me. I can rest.

I normally, i do not email much if they are on vacation. I try to give them a rest from me. T does not take her laptop with her on vacation. PrevT, on the other hand, let me know she *always* has her phone with her.

The only problem emailing T and PrevT has been *my* concerns about my emailing too much. T and PrevT both helped me relax about emailing concerns.

It's taken a while to work things out but we have a system that mostly works now.
I generally use email to provide "background info". I do a lot of independent meditation and processing and I don't like spending my sessions just "getting her up to speed" per say

So I tend to email my meditation experiences etc. She used to intermittently respond. Now she generally doesn't because she is busier ( she opened a new office and yoga studio), we text more, and we have started having 2 hour sessions 1-2 times a month to allow more time for working on stuff.

My T ALWAYS reads what I write carefully ( I used to be suspicious of this but she will pull out a quote from something a wrote a few weeks ago etc). She feels it is too difficult for her to properly address my intense feelings on email. I am hard to read even in person.

*I* have also gotten more comfortable with calling if I need to. She is VERY comfortable talking on the phone with me, and always tells me to call.if I need something . now if I have big intense emotions I am.more likely to call

We sometimes discuss my emails in session but its just as common these days for me to.say something along the line of "I assume you read my emails? OK then, building on that idea" is we just continue on working off a shared knowledge base.

i think email works well for us. When.I am in am active change period I often have way more going on than sessions allow time for. But if I expected answers to each on that would pry burn my T out.

I don't tend to think about what a therapist "allows" or not. I do not see a therapist as having the ability to allow or prohibit me from doing anything. I will write a therapist if I want to do so. Whether the therapist reads what I write is up to them. I will send things by regular mail if I don't know the email address.
I don't usually write in order to have a response - in fact - the therapist is no better at making sense or getting the point in responding when I write than she is in person - I would just as soon (and I usually say not to respond) that she did not bother responding. In my opinion, if a therapist puts an email address on their cards or website, a client gets to use it.

I think a lot of email consternation from both sides could be resolved if the therapist simply charged in 10ths of an hour like I do for my work.

My T reads my emails but doesn't respond. Though she always brings them up in session. i have a feeling that email isn't her favorite, but she's never asked me to stop. It hasn't been a problem for me.

Both PrevT and current T allow email. I've only been with current T for 5 months and I've only used email for some administration stuff.
They both have an emailadress for work and both only read and reply to emails during their work times.

PrevT was the first T with email. When I started with her I was very anxious and I didn't talk much during sessions. She suggested I could write it in an email to her if that would be easier for me and then we could talk about it in session. I haven't used email a lot. It wasn't weekly. I usually used it if I wanted to tell her something, but I was too anxious to do it in session. She usually responded to most of what I wrote and we would also discuss it in session. The emails are informal. It's the same as how she is in session. I think it has helped me to open up to her and helped me to talk more in sessions.

There hasn't really been problems. Only one time I had sent her an email on Thursday. At the end of her workday on Friday I got an email saying she didn't had time to read my email and she would reply to it on Tuesday (she doesn't work on Mondays). I never said this to her, but it made me feel unimportant. And nothing. She wouldn't even take a few minutes past her official worktime to read my email and respond to it. It wouldn't have taken long. The reply I got on Tuesday also wasn't long.

I don't know what the ''rules'' are for emailing. Neither PrevT or current T has said anything about that.

With T, I didn't really e-mail in the first couple years I saw her, then started gradually e-mailing, to the point that I was sending 1 or 2 lengthy (like multiple pages if you printed it) e-mails a week. Generally without expectation of a response, but with the expectation that she would have read it before our next session (assuming I sent it a reasonable amount of time beforehand). She told me that she understood I used e-mail to process things from session (both from her and with my marriage counselor--I often e-mailed her after sessions with him) and that one of her other clients did that, so she understood.

She started responding to them at times (mostly to say things like "good insight! Let's discuss more next week"). Then a few months ago, I sent a few e-mails within one day where I was really stressing/upset about something. And I figured she'd respond to one of those. But nothing. My session with her that day had been kind of awkward, too, so her lack of response especially bothered me. I texted her about it a few days later, and she was just like, "I don't always respond to e-mails, so nothing different there." Which...well, it felt different to me. Then there were a few times where she either "accidentally deleted" my e-mail and couldn't retrieve it or didn't get it at all or didn't have time to read it before session. I finally asked her about it about a month ago because it seemed like she had changed how she interacted with my e-mails. And she said she didn't know if e-mail was helpful to me anymore. Which bothered me because she was thinking that (and seemed to be almost passive aggressive about it, with not reading/responding to e-mails) but she didn't share it until I brought it up. Like, if she didn't think it was helpful to me anymore, why not discuss it with me and see what I thought? That, along with some stuff she said when I wanted to talk more about it the next session, led to a bit of a rupture, which we've since mostly worked out.

But now I don't e-mail her anymore. (I tend to post on here instead if I want to process a session). She suggested I could just type it up on my computer, then figure out before next session which things I wanted to talk about. Which is less helpful to me for whatever reason--it's like I wanted to share my insights with someone (even if I assumed she wouldn't respond). Hence my posting on here, though I was doing that some anyways. I did e-mail her recently about scheduling, and after she responded, I included a brief note about something that had happened in session with MC, saying I hoped it was OK that I'd shared that. She said that of course it was OK, which seemed to conflict with what she said before. I just feel like our relationship has changed, like it's not the same anymore now that I feel like I can't e-mail her about stuff. I mean, I'm managing OK without it, but I feel more distanced from her. Maybe that was her point, and she feels like she's been successful in making me less needy or dependent or whatever. But it feels more like a negative step in our relationship. I mean, maybe this is her trying to prepare me for life outside of therapy. But I also feel like I'm intentionally distancing myself from her, both outside of session and in session. And not necessarily in a good way, more like a wall has gone back up (after she and I took some time knocking it down...)

Will post later about MC and e-mail, because that's a somewhat different situation.

This! This is what helps me. You explained it better than I could have. It's not just about typing it out for me, but sort of passing it along to someone else.

MC (marriage counselor) has said before that with e-mail, maybe I'm looking for connection with him, particularly when I've said that I'd like him to just let me know he's read it. T has said something like that, too. And yes, there's probably some element of that there. When I told MC that, yeah, it's probably in part a desire for connection, he said that was fine, and natural--it was more that he was making me aware of that being part of the motivation. (T has seemed a bit less accepting about that desire to connect.)

It's just hard sometimes to have a therapy session where you expose all this stuff about yourself, how you're feeling scared or unhappy or self-hating or whatever. And/or talked about something that happened in the past that's had a profound impact on your life, that maybe you haven't talked about with anyone before. And then it's like, you're just supposed to walk out of there and be OK until the next session a week later. To me, it's a completely natural thing to want that connection. To maybe share some other thoughts you had on the topic. To kinda be like, "Hey, you're still there, right? Still caring? Don't think I'm pathetic/disgusting/etc.?" I wish T's could understand that more, the need sometimes for out-of-session contact. I mean, some do. In my case, MC certainly does, to some extent. Allowing out-of-session contact makes me feel like more of a person and less of a job, I guess. Maybe not using it all the time, but just knowing it's there when I need it (and not just in an emergency situation).

Neither my T nor my pdoc use email for communication which is perfectly okay with me. If I need to contact them, I can simply call and leave a message and they get back to me that same day. Scheduling is done through their office.

My current T has never offered email as an option. She called me once from her cell phone, and I have texted her a few times. She has initiated a text in the past, so I felt okay about texting her.

My old T offered her email address to me so that I could write my thoughts between sessions. I had mentioned that I didn't feel that "journaling" to myself was helpful - I felt that knowing my words "went somewhere" made it feel more useful. However, I always felt guilty about emailing because I worried about taking up her time outside of sessions.

Now, it seems okay for me to just journal on my own. I often share key things with my current T, but only during our session. Part of me wishes my current T would allow emails, but part of me would feel guilty if she did. I guess it's just best that we keep our contact outside of session to a minimum.

My T allows email but I don't email very often and never lengthy emails. Usually I will email to share an article or similar resource and my thoughts on how it applies to my situation. She does the same.

She does respond to emails, usually the same day it was sent. They're brief but not just an acknowledgment of receipt. I've been impressed by how insightful they are at times.

She doesn't use salutations of any kind, just begins with MobiusPsyche and ends with T. I do the same, because she does it that way.

I do lots of processing between sessions and she allows this. I can submit up to 2 pages of writing and she'll read and write comments on it. (There used to not be a limit but I was writing a LOT.... That was a difficult discussion but now I'm more focused in what I share.) I'm posting this because that's one reason some people use email.

The system works well for us but I'm sure we would renegotiate if I began using email excessively or inappropriately. I like the way it is now, because if I was having a crisis I'm sure I could email and get a thoughtful response. I wouldn't like the ability to email to be taken away, even though I don't use it that often.

Oh, here's something I forgot to mention in my initial post - what about emotica? Normally I am pro blinky things, but I disliked it when No. 1 used them, and the two times No. 3 did it was a shock, because otherwise her emails were not familiar.

I suspect No. 2 doesn't even know what an emoticon is.

Neither T nor MC has used emoticons. Which I think is a good thing! MC has used LOL, but that's a pretty common thing. And he's opened with "Hey LT" rather than "Hi LT" or "Dear LT." Much of his work is with teens, so I imagine he's more well-versed in, uh, emotica and text speak than T

My T does not allow email or text and I used to think that I was jealous of those that were able to connect with their T through either text or email. But, after reading so many posts about Ts not responding to emails or with folks waiting and waiting for T's to respond, I realized that it would drive me crazy if I emailed and had to wait and wait for a response or deal with NO RESPONSE. I think that for me, it's best that I am not allowed to email or text. There was ONE time when I really needed some reassurance from her and I left her a voicemail which she returned within a couple of hours. So, I know that if I have an EMERGENCY that she will respond and that's good enough for me.

On another note, there are LOTS of times that I write draft emails to myself with a list of things that I want to remember or discuss and that seems to help me a lot by getting my thoughts in order ahead of my appointment.

There was one time where I wanted to email and since it was not allowed, I typed up a letter, left it with the admin and left her a message to check her mail box. She said that she preferred that I didn't leave her notes but wait until session so that I was sure that what I put in the note was what I really wanted to discuss and that I was truly ready to discuss it.. I've felt remorseful after what I consider over-sharing so she thinks that I should not send her random notes and that if I'm not comfortable discussing it that I am probably not ready and shouldn't push myself.

Hope that this all makes sense.

I write a lot, journal a lot even, but I think that's easy for me to hide behind and it's more important for me to talk about things in person. So I have never emailed T about anything other than scheduling etc. and never wanted to, either.

As for email etiquette--I'd go for polite and concise, but no typos, no emoticons, nothing cutesy or overfriendly. Professional, basically.

I have not used email. I just would want consistency and the rules about it very clear upfront.

My T claims she was HAPPY when I began texting her between sessions.
This was about two years in. I guess she interpreted it to mean that I was comfortable enough to reach out. I guess so.....I was going through tough times and thought a few check in texts would help. They did.

I see her weekly and will usually text once between sessions. She responds briefly, usually within hours.
Email is available but I choose not to use it. I jot notes and bring them to session.

I would have to fire any therapist who used blinky things.
I consider allowing one of them to use exclamation points to be an indulgence.

I'm OK with one exclamation point if the use is judicious, but when there's two in a row...*shudders*