In Therapy

A user's guide to psychotherapy

Therapist Waiting Room Etiquette

The Golden Rule of therapy waiting rooms

Yeah, that's my waiting room. Featuring early 00's Ikea.

The waiting room is more than a showcase of your therapist's interior design skills (or lack thereof).* It's more than a place to sample muzak or white noise. It's more than a room to wait.

It's the emotional airlock between the chaos of the outside world and the sanctuary of the therapy office. It's public yet private, a shared place of solitude. It's a space to transition and collect your breath as well as your thoughts and feelings while entering introspection mode (the reason I suggest people show up 10 minutes early). This transition can stir up eagerness, anxiety or even dread. Small talk with strangers, phone apps and magazines (yes, the ones that we leave for you) distract you from these feelings, but also the preparation. Today I offer one simple and flexible guideline for the waiting room:

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Please be quiet and respect the privacy of others.

It's a request with many implications. A faithful and inspirational reader (Therapist Pet Phrases was also her idea) granted me permission to use her email to elaborate on this point. She writes:

"My therapist is in a group of independent therapists who share a fairly small waiting room. There is a couch and several chairs. Lately, there seems to always be somebody laying on the couch, oblivious to the fact that other people might like to sit down..."

If you want to lay down on the couch in my office, go ahead. If you want to sprawl out on your couch at home, knock yourself out. But a therapist's waiting room isn't the place to kick up your heels, no matter how loud your dogs are barking. Others might want/need to sit there, and a supine stranger in a confined space makes people uncomfortable. Relax, yes. Lounge, no.

"A couple of weeks ago I was politely ending a business call as I walked in to the waiting room when someone started yelling at me to get off of the phone. This man was actually talking on his own cell! He told his caller to hold on while he yelled at me. People sit there and yak on their phones like they're at home or something. I never do that..."

I've said my piece about phones in therapy, but phones in the waiting room are a different story. The research has spoken (here and here): cell phones are annoying. It's easy to knock someone out of their zen-like preparation with an overheard half-conversation. Take it outside.

"Another time, someone else started talking to me from across the room, got up and came over to sit next to me, and then actually grabbed my arm while she was talking. This woman was going on about a TV show I don't watch and I almost panicked when she grabbed my arm. I'm not a big fan of the close-talkers or the touchy-feely ones...."

We all like making new friends, and when we're sitting in a therapist's waiting room together we already have something in common, so why not use the time to get to know your neighbor? As I said above, waiting rooms can raise anxiety. Some people get chatty when they're anxious, others prefer to be quiet. I tend to lean toward the preference of the quiet people. Their silence isn't intrusive, but your talking is bothering them.

"There is also a therapist there who sees a lot of kids. She has decided to come out into the waiting room, have a seat with the parent and go over issues and scheduling. This bothers me the most. Not just because it's irritating, but I think the kids deserve the same level of respect and confidentiality as any other client. She would never do that to an adult, what makes the kids deserve any less? I can't imagine my therapist coming out to the waiting room to schedule appointments and discuss issues..."
 
Therapists, waiting room etiquette applies to you too. Don't hold conversations with clients in the waiting room when other people are around. This crosses a boundary of confidentiality whether it's a child or an adult. You have an office for these conversations. Also, don't walk into the waiting room for a first appointment and announce "Jane Doe? Is there a Jane Doe here?" or come in and say "John, I'm ready to see you now." You've just told a bunch of strangers the name of someone coming for therapy. You wouldn't say this name in a public place, would you? Instead try "Is anyone here to see Dr. Smith?" or if you know the client, just look at them and say "come on back."

"If I was your client, would you want to know what goes on in the waiting room or is it something that you can't do anything about anyway, especially if a colleague is part of the problem?"

You bet I'd want to know. Especially if a colleague is part of the problem. I'd want to have a discussion to help her educate her clients or herself about guideline #1. Why? My faithful reader says it best:
 
"If I didn't have such a good relationship with my therapist, I might not go back because of the waiting room drama."
 
A bad waiting room experience can prematurely end good therapy. Providing a safe, comfortable waiting room is part of good ethics, good client care and good business.

There's flexibility here, too. Like many of the proclamations I make in this blog, I drape a big "it depends" over the top. A polite "hi" isn't going to hurt anyone. A sentence or two of small talk probably won't cause any harm. If you see someone you know, it might be more awkward not to say something. But generally speaking, being quiet and respecting others' privacy is the best policy. Flex your social muscles elsewhere.

* I don't have time to coordinate it, but how about a Therapist's Waiting Room Project? Clients around the world could submit a picture of their therapist's waiting room taken with their phone (no people, please) and add their thoughts about therapy or the room or tell a waiting room story. From posh Park Avenue offices to the realities of impoverished communities and all those quirky shrink spaces in between. We could make a PostSecret-style blog and/or a strange and interesting coffee table book. If someone wants to take the lead let me know. Or maybe I'm the only one who would be fascinated by this. That's possible.

 

If you just can't keep your fingers off your iPhone in the waiting room, at least you could read more therapy musings on my facebook page.

Ryan Howes, Ph.D., is a clinical psychologist, writer, musician and professor at Fuller Graduate School of Psychology in Pasadena, California.

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