Communication/therapy between traditional in-person sessions.

Hello! I know therapists as well as clients that communicate actively between traditional in-person sessions (through WhatsApp, Viber, audio calls etc).

They are not necessarily clients suffering from panic attacks or having symptoms demanding an instantaneous response from the therapist. Therapists practice it because it helps to speed up the process of building relationships, therapeutic alliance, increase healthy attachment. Also, it helps to gather insight, keep an emotional journal, etc. On the other side, therapists should be careful in order to avoid clients becoming dependant on them. Also, therapists usually don't get paid for doing such extra work.

A strong argument of therapists practicing this methodology is that this is much more effective if done right.

What are your thoughts about such therapy?

Hi. I've only had one T that has communicated with me outside of session in any media (in her case she allowed, texts, calls, and emails) but the other three I saw did not allow any of that to happen between session. With the T that allowed it, it definitely helped me heal some of my wounds because I just could not bring myself to say them out loud. I helped build the relationship as well. I think though it also fostered dependence (a year out from seeing her and I'm still devastated by the loss) and attachment. I guess just buyer beware. It feels good at the time but it's a pain in the rear later when the relationship ends.

The problem is the clients brain gets used to that as a support source and fosters attachment/dependency but the therapist can not keep it up with their schedule and then cut the client off from that life line. That is so damaging.

My T doesn't do 'therapy' via text but she does allow some text contact. This is because she's keen to make clear the relationship isn't limited to 50 minutes one day a week, it's something that continues throughout the week. She puts boundaries around the contact so I know where I stand with it, and she limits her replies to acknowledging how I'm feeling and that it is okay. I've also been in therapy with a therapist who didn't allow any in between contact at all, and for me the contact is definitely more helpful and gives me a sense of being 'held' all the time. I can't actually say I feel more dependent with the contact compared to without; I was very dependent on the T who didn't allow contact and used to write to her constantly during the week, but just not sent anything to her. I feel the contact with current T allows me to say things I really can't say which definitely moves the therapy forward for me as I receive her care and acceptance which I can then internalise. All in all, I would say my attachment is much more secure with this T, and the contact is a part of that.

**repeats
, it doesn't create dependency if done right. It builds you stronger inside each time your need is responded to that you can do it yourself over time**!

*sighs*
Is the word dependency the new black?

Yes this is pretty much my experience. It's very difficult to retain a sense of Ts caring in just a short time of face to face contact during the week, at least imo. For me the text contact shows that T is there and is responsive during the week, that our relationship is consistent even when I'm not in the room. A T who disallows any contact and frowns on having anything of mine to read during the week (as an ex T did) doesn't give me a sense of being cared for and I remained anxious within the relationship and desperate to work out how to get her to respond to me. My current T just does. And it's the safest I've ever felt with a T. I don't feel dependent on her because I know she is there and I'm starting to trust that.

I'm not saying that in between contact is always necessary and perhaps many people can build solid relationships with a T who doesn't allow it, but for me it has certainly helped me shift from being anxious to trusting T. I do think dependency is seen as bad or wrong, but it shouldn't be as along as it is allowed to transform into a secure kind of attachment that can then be internalised.

Yes.
Plus the longings are there. Dis seen as 'the bigger thing' to just stuck it up.

Unless one gets expenence of being responded too they're is no way you can 'do it alone'. You can build walls. You can big yourself up. But thsts not the way of courage.

My last T even says on his website that he encourages communication between sessions. I think it really depends on the individual client and how it is done whether this is helpful or counterproductive. In my case, I already had a bad habit for several years of interacting with people way too much online, and then I was just doing the same with Ts as well. I used it as a distraction/avoidance from dealing with far more important things. I definitely got to sharing much more about myself with the extra but it was also feeding that habit. He realized that later (I told him also) and then he always remained very minimalistic in his responses or often did not respond at all - that served me much better. My first T was very erratic in handling between session communication, all over the map, I think he had more issues around that than myself.

These things had nothing to do with attachment or dependency for me, I did not experience either with Ts really. But it was an avoidance mechanism and habit, I would do it with anyone interesting and engaged enough, it was not person-specific at all.

The second woman encouraged calling her. I tried it a couple of times and did not find it useful. It did not have a negative effect, but it didn't really do anything positive either. I found writing and mailing it off more useful.
I think like most things in therapy - it depends.People don't all hire therapists for the same reasons. Some people are helped, some are harmed and some are neutral. None of those states makes anyone bigger or lesser - there is no need to judge what someone else's experience with it is.

Yes it's so incredibly powerful have these longings heard and understood. Being emotionally vulnerable is so hard but it's what heals...being accepted for exactly where we are and knowing it's ok.

I don't have any between-session contact with my therapist other than for scheduling issues. For me, at least, the feeling of connection to another person only really happens face-to-face, and emails, etc., are a way to try to replicate that feeling but they just aren't the same, so they're always going to be frustrating and disappointing. Anecdotally from what I've seen on this board, emailing can lead to a lot of misunderstandings and anxiety, like people want a response immediately or a longer or different response, and feel very hurt or rejected when the response doesn't come or isn't what they hoped. Sometimes I think it's that same frustration and disappointment because they want to feel connected but emails and texts just can't do it, so people end up feeling hurt and angry.

Plus I think between-session contact can sort of blur the lines between therapist/friend and lead to unnecessary confusion.

So, to me it seems like between-session contact can raise more problems than it helps sometimes. But I know there are people here who feel like they really benefit from it so it's probably just a matter of it working in some cases and not in others.

My T offers me the option to have a phone call on the days he works. It's not just a spontaneous 'I need T right now, call right away' thing, we usually schedule it over text and he offers me a time some hours later. There were two times where it was pretty much right away, but that was more of a 'it fits with his/my other things' than me just needing it to be instantaneous.
It's also not to speed up building the relationship. It's a way to get some light support. We don't do therapy during it, T might remind me of some things I can do that might help, I can get reassurance that we'll have our usual session. Often it's also to ease stress caused by something he said or that happened recently.
My T charges his usual fee for these calls (and I have to call so I pay the phone bill as well).

I think the way it's set up for me is pretty nice and helpful. I know that if I need to talk to my T sooner than usual, I can. It's nothing like actual therapy sessions though.
I think to just have access to your T most of the time and get an immediate response would not be helpful to most clients (in most situations, of course sometimes I'd be good, like if you are actively suicidal or something like that). One of the points of therapy is to be able to sit or cope with emotions on your own. If there's constant immediate access to somebody who helps, that sounds like it fosters way too much dependence.

I had frequent email contact with one therapist. It served no purpose, but to fuel my preoccupation with therapy and therapist.

Given what was going on at the time, having no contact outside sessions would have been equally detrimental.

Either way, it was a ridiculous model. The basic relationship consists of a one hour meeting per week, and this is supposed to be the basis for trust and a secure "attachment". And then as a bonus the client might be thrown a few crumbs between sessions, in the form of email responses given in boilerplate language... "I honor your authentic feelings" or some other patronizing thing.

I have been on both sides. I had a T who welcomed outside contact by either email or phone calls. We emailed frequently. It did create some dependency but it was needed. I needed to be able to have the consistency and closer bond so that I could trust her with information had never shared with anybody.

EMDR T doesn't do email but welcomes phone and text contact. She warned me She isn't great at checking her work phone especially on her days off. When she receives them she is wonderful about responding. Unfortunately, there have been times where she hasn't received my message for a few days. That was hard. I dont contact her nearly as much. For me, it is difficult not knowing if she will respond or not. I find it is harder to go go deep and be vulnerable in my appointments because it frequently leaves me triggered. I cant just walk in see here for about 70 mi utes and walk out and put everything on the shelf so I have a fear of opening up to much at once.

One problem with this whole outside contact thing is that often the Ts handle it in very inconsistent, erratic ways over time. That can cause extra stress to the client - so many stories like that here, it is a recurring topic on this forum.

My view on the relationship building is that it is often overemphasized and overdone by Ts, coming from those ideas that it is the relationship that therapy is all about, and everything is about relationships. IMO, building of a healthy, secure relationship in life is usually more a consequence of a good. satisfying, constructive interaction between people, not the primary purpose. It builds naturally when it is positive and won't build much if it is not. But forcing it the way many Ts do, for its own sake... is kinda twisted even as a concept, in my view at least. Again, I am talking about truly positive, fulfilling, secure relationships... which is clearly not always the case in therapy.

I think this depends on individual clients so she be individualized treatment. For somebody like me with severe attachment and trust issues, the outside contact has been an important part of creating attachment (which for me is necessary for me to trust enough to open up. It is also helpful for me to have somebody who understands my situation and help me calm down when triggered. My husband is a wonderful loving husband who had a wonderful happy childhood. He understands depression but nothing about abuse and trauma. When I am triggered and try to talk to him, he unfortunately usually makes and worse or at least totally missed the mark. That is where outside contact comes into play.

I guess I will go against the grain here once again. I am avoidant, I do not trust anyone including for the most part my T although I do share most things with him. Although he allows me to send emails ( usually only do this when I have a long letter to send stating my feelings and issues when I am particularly struggling with something because I can't say it in person). I only send an email maybe once every 2-3 months. He does not respond except to thank me for sharing and that it is was helpful to him. He then prints it out and responds to the entire email at the next session so I don't have to bring anything up or even discuss if I choose not too. I would never email on a regular basis because I am avoidant and do not want to get close to him. I also have no idea what he would do if I did. I do not think he would respond on a regular basis outside of session. He is however very goal oriented and always encouraging me to work on my skills so I can self-regulate.

I guess what I am saying is that we do not have the close "connection" or "relationship" that everyone talks about. I am still not even sure what a "connection" means. However, even without all of that I have made tremendous progress in therapy. This is due to his boundaries and consistent pushing me gently out of my comfort zone each session. He is always asking for my feedback on how the session was for me which I have told him not to ask on the same day because I do not know and have to process. He suggested and encourages me to record each session so I can listen back as I am extremely dissociative and check out a lot during sessions. This also helps me make progress.

Maybe it is just me or maybe it is just my T (he does not allow me to just chit chat about the week or vent for more than 10 minutes per session without typing it into how things make me "feel" and working on strategies to improve the situation going forward). It is annoying at times but it works and I am improving. I know everyone is different but I don't feel the outside contact is necessary for progress. From my observations on this site it does seem to be a huge source of distress and dependency for those who are allowed to use it consistently.

I am glad my T does not encourage it or I may fall into the trap as well. I like making progress without all the "relationship" baggage.

I'm so old that with my first two therapists, texting and emailing wasn't a thing. LOL! If I needed to contact them, it was pick up the phone and call, probably leave a message, and they'd get back to me later that day. With my last therapist, it wasn't something he offered nor did I ask -- it wasn't something I felt I needed. I was fine with calling, leaving a message, and waiting for a return call. I so very rarely asked for a call that it wasn't ever an issue when I did. He knew if I was calling, I needed help.

Personally, I think having that boundary (which really wasn't a boundary--just the reality of lack of technology in the olden days), forced me to be the heck sure I really needed to speak directly with my therapist before I picked up the phone and dialed. While emails and texting are marvelous inventions, they can tend to be a source of impulsive instant gratification that can lead to regret and miscommunication at times (not just in therapy). Slowing down to think things through before making contact is often a wise move so that we don't "open mouth; insert foot".

I also preferred to speak directly with the therapist on the phone where I could hear voice inflection, ask for immediate clarification if needed, etc. So much less opportunity for misunderstandings when we actually speak to people directly rather than through the typed word on a time delay of response.

I agree with nottrustin that all this depends on the individual client, we are very diverse. I had that thing, too, of sending emails (I did email regularly) and then we discussed some of them in session. For me, it wasn't because I could not say those things directly, I had no issues talking about whatever I wanted to. More because I wanted to share more, in my own way and my own time. One issue, in my case, was that I brought up so many different things in the emails, it often derailed my therapy, it just lost focus. And I would have needed more focus because I went to get help for specific, quite practical issues, not to generally talk about my whole life or to have a supportive relationship. But I ended up using my therapy in different ways, in ways that were counterproductive for me and it all became a distraction rather than a useful endeavor. Unfortunately, the Ts I saw allowed that, even when I told them repeatedly that it wasn't very constructive and it was often an aimless, useless wandering. Surely it wasn't their responsibility to make and keep my focus, but they could have been more helpful in reminding and steering it that way. I guess they also just never got to know me well enough (I never saw one longer than a year), many clients don't care about focus and goals and more want a place to talk about their whole life. In any case, if I ever got into therapy again, I definitely would not contact them outside of session other than for practical things like scheduling and if I really need their feedback on something relevant to my goals. For me, distinguished efforts for relationship building would not be relevant as it is not hard for me to trust someone that I feel qualified... but when it is violated, it cannot be compensated just by being available and supportive.

My last T was actually quite smart with handling the outside contact question. I asked him about it upfront, in my first session, and he said he generally encourages it because he thinks it is often helpful, but the nature, quantity etc of that communication will be formed by how a specific therapy with a client is going. I did not like that responsive much at the time - it sounded like refusing to answer my question - but I can see now how that is probably the wisest approach, including not making promises he would not keep later (he still made others).

When I first started therapy out of session contact was a very big thing for me. I used to find coping with the weekends super hard. My T wasn't a fan though but he gave in to me after around 9 months, on the condition that it was for emergencies. But I didn't stick with it.I think I got to this point where I was emailing 3-4 times a week others 1 email each week and when I was really angry at him I would send him several just to irritate him.

We had agreed a two day response time, but I used to get so hung up on that- we increased the reply limit to 5 days. He also never previously let me have email contact during the holidays either, but changed his policy on that. Whilst he was away it would only be 1 email just to say "hi" with a smiley face.

He used to say that it was actually hard to tell what I needed from my emails he told me to make them long using feelings.

He recently started letting me text him which I thought was a very big deal, and I haven't abused that. Where I am now I actually feel like I don't need to contact him as much, and I don't because I've learnt that he "is there". My last email was 9 days ago and just about arranging a session.

I just think a T should be flexible depending on each clients needs.