Hypothetical

As a T you have a suicidal client. As part of the safety plan them calling you is right before going to the ER. So you get a call from this client but they hang up and don’t leave a message. So the T instead of calling back or sending some other means of message just waits until the next session to talk about it. Wouldn’t a hang up worry you more than if they left a message? How could the T not be concerned?

Is this really hypothetical? Was the client trying to signal the therapist? I'll be honest, if I were a therapist I might think the client accidentally butt dialed me and I might not want to embarrass them by pointing it out. I guess I would generally have to trust that if they really needed help they would ask.

As a former mental health social worker. I was trained to do diligence, do more not less. Her calling back just to verify would have made me sleep easier that night. I’d rather be embarrassed about a butt call than find out later the client was really in need of help but hung up.

I would think the T should either try calling back or, assuming a cell, text to say they saw they had missed call, is client OK? (I’d think text probably, then call if no response to text after a few minutes). I’ve also heard from a couple Ts that the universal signal that it’s important is to call, let it ring till goes to voicemail, then hang up and immediately call back. If this happened to you, I’d talk to the T about it.

It would depend on the client and whether this is a pattern of behavior.

Documenting that you have tried is the difference in winning a malpractice lawsuit and losing. If something happens to the client. The family will come after the therapist. I know I would and the therapist had better have their documentation in order.

I think if the arranged deal is to call the t before going to the ER, then the therapist trusts the client to do just that. If I were a t, I would assume that a client calling and not leaving a message would indicate a non-emergency situation. Therefore, I would not call the client back.

If the client has a safety plan as initially stated, I personally think that if they are looking for help, they need to ask for it. I don’t believe in playing games or testing my therapist. My safety plan states to just go to the er if I’m in crisis, that’s it. If a therapist requests you call first, then call, and if the T is unavailable to answer, I say leave a message saying you are in crisis and need urgent help, and if that doesn’t come quickly, call or go to emergency services. Ts aren’t mind readers, and I don’t believe they need to call back every single hang up call they get in a day. A hang up could mean so many things and they truly may not understand it is a crisis in need of a callback.

It would depend on the client. Maybe t thought the client accidentlu called the wrong number and immediately realized it and hung up. Should the T call back probably especially if the T knows the client is struggling. K once butt dialed T and had no clue. T emailed to make sure everything was play. She figured it was a butt dual as she heard me talking to a group of other people

if i received a call but they hung up and there was no message i would assume they called accidentlyor changed their mind.
if that person needed help they should have asked for it. the therapist is not a mind reader.

I'm surprised at how many people on this board have therapists they can communicate with at any time. I've never been in that situation. The therapists I've seen always have specific hours and are not available at other times. Yes, I could/can leave a message but it wouldn't be heard until the following work day.
Just something that came into my mind.

Mine are exactly the same way. I’m super jealous at times about all of those people who seem to get 24 hr access by phone, email and text.

Well, I just feel like if I had an emergency come up in which I really needed support of information from my therapist, that's not going to happen. If I cancel, she doesn't call me or anything.

I don’t know, I’m sorry, I don’t trust the “professionals” in this forest (irl) at all (with good reason) (and being told to move on does not “allow” me to explore those reasons... is it all in my mind..........

My pdoc is available during office hours only. The off-hours/weekend voice message refers patients to a 24-hour state-run crisis line or the ER. Even if I can reach him during office hours, he usually says, "I don't treat people on the phone. My recommendation is that you go to hospital intake and have them call me." There's also an implied, "If you choose to ignore my recommendation, I'm not liable, and I'll probably discharge you from my practice." I would never call my doctor and hang up, hoping he would intuit that I wanted/needed attention...the truth is that he wouldn't try to track me down.

I used to think it would be nice for my pdoc to be available during off hours, but I can see how this would foster an unhealthy dependence. I would never test him or play games with him, and he would no doubt consider it to be manipulation. I like him, but he absolutely would not tolerate that kind of behavior or even the hint of exaggeration. I'm kind of a no-nonsense type of person, so I like this.

I don't call back numbers that don't leave messages. In my work life, anyway. Granted, I'm not a therapist and people don't call me about suicidal ideation (usually...) but I can still see why a T wouldn't call back.

My thinking (and it's only my thinking - I admit there's a level of laziness in it and other people would choose to do differently) is that my people have to communicate with me. I will move heaven and earth for you if you reach out and actively communicate with me, but I'm not going to go chasing after you if you're ambivalent about my assistance. Ask me to call back and I absolutely will. But if you call and then decide it wasn't important enough to spend 2.7 seconds leaving a message, then I don't suppose it's important enough for me to spend 2.7 seconds calling you back.

Hypothetically speaking, anyway. I'm sure the day will come when I make an exception.

I don’t think a t has a responsibility to ring back if there is no message.
I once rang my t very early on a Saturday morning! I was looking at her new what’s app picture and pressed the wrong button.
About ten minutes later she rang back. I told her it was a mistake but if it was me and I was a therapist, I wouldn’t just ring back every person who rang and didn’t leave a message. Ts are not mind readers!

I don't think a hang up is a signal of anything. Could have been a butt dial. I have read on here that some people like to hear the sound of the therapist's voice on the answering machine, too. If the person expects the therapist to do something about missed calls with no message, they should have put that in the contract. If I was the therapist, I wouldn't even bring it up at the next session, to be honest.