Skip to main content

Verified by Psychology Today


600 Ticks

What therapists do with those 10 minutes

I live a significant portion of my life in the ten minute gaps between clients. I've gotten it down to a science after a dozen years in practice:

  • "Good work today, see you next week."
  • Write session notes
  • Check voicemail
  • Check email
  • Grab keys, walk 18 paces down the hall to the restroom
  • Find sports drink/Diet Coke/lemon Arrowhead sparkling water in my refreshment drawer (bite of Power Bar optional)
  • Return urgent messages, put the others on my to-do list
  • Pull out file for next client, review previous sessions
  • Gather myself, collect my thoughts, take a deep breath
  • Listen for the waiting room door close
  • "Hi, welcome"

It looks so utilitarian in writing. The list doesn't do it justice. Those ten minutes are golden.

Don't get me wrong, I thoroughly enjoy the 50 minutes I'm on the clock - exploring uncharted territory, learning how people think and cope, sharing in "ah ha!" moments. Each work day gives me opportunities for growth, challenge and reward. But those ten minutes between the 10 and the 12 on my clock are vital.

They're my time to reflect, reset and reload.

As soon as the door closes, I'm at my desk putting into writing the gist of the past 50 minutes. Thorough yet concise, I'm summarizing and evaluating what just happened. Sometimes it's an emotional breakthrough. Other times it's gathering data or the client just needed to vent. I'm using a few moments to take stock: where did we go today and where might we go next time, and furthermore, determining how today fits into the overall case conceptualization.

I hit the commode (if nature calls), check messages and evaluate my food/liquid intake because don't want these needs to intrude upon my sessions. I don't want to be thinking how much I need to go to the bathroom when a client is grieving his lost childhood. I don't want to daydream about dinner when someone is deciding whether or not to get a divorce. During sessions, I usually have something to drink on the coaster to my right. Not that I'm dying of thirst, I just don't want the desire for something to draw away my attention. If it's there, a muscle-memory away from my right armrest, that much more of my brain can attend to the issue of the moment.

I'm resetting: allowing the last session to pass away, attending to my own needs, re-calibrating my instruments and preparing myself to enter the psychic space of another. It's like a boxer going back in the corner for some water, a pep talk and a possibly a styptic pen, getting ready for another round. Minus the violence and spit bucket.

Then I reload. I review the file for the next client. I get familiarized with our last few sessions, placing myself back in that mindset. Where are we headed? How did we leave off last time? What unresolved issues are waiting to be addressed? I've been blessed with a good memory, so a couple sentences usually trigger all the relationships, events, defenses and assets we're working on. I have an idea of what we can cover today, but it's up to the client to chart that course. I find myself eager to get started.

The waiting room door closes. I wait for the big hand to reach 12, and I'm up to open the door. I'm not sure what the next 50 minutes will bring, but I'm excited about the opportunity to reconnect with my client and curious about where we'll go.

I know some colleagues who see clients back-to-back, no break. They must know something I don't, because that would never work for me. I believe those ten minutes between sessions are essential for client care and my own mental health. Sometimes clients wonder if they can go overtime a few minutes to finish their thought, or they might want to know if I care enough to bend the rules. What they might not understand is by keeping that ten minutes sacred I am caring for them. I'm modeling good boundaries and self-care, reflecting on their session and making time for the tasks that keep my practice rolling.

Without those 600 ticks, I might not be able to help them as much.

More from Ryan Howes PhD, ABPP
More from Psychology Today