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Psychotherapy Appointment Time

Mailbag: Time to get the most from your therapist

Um, how long is this session, Dr. Escher?

Should you start your day with introspection? Break up your workday with a therapeutic diversion? Spend the dinner hour feasting on internal conflicts? When is the best time of day for therapy? Is your therapy dollar better spent morning, noon, or night?

My inbox is filled with interesting email from people around the world who want to get the most from their therapy. Once again, we have a disguised and distorted letter from an unidentifiable and possibly fictional reader:

When is the best time to schedule a standing therapy appointment? Afternoons so that I don't have to take the fallout back to work? Last appointment for a therapist who may be less focused at that time of day? Mornings when we both may be more focused/energized but fallout at work may be a factor? How different do appointment times feel/work from the therapist's perspective? Does your mind wander more at certain times of day, etc.?

This question is great Mailbag material. Is there an optimal time of day for a therapy session? Are freshly caffeinated morning therapists the top choice, or do we shrinks take a while to warm up? Do we reach our peak around quitting time, or are we on overload after sundown? The root desire is perfectly reasonable: you want your therapist at their very best. So the question logically follows – is there a time of day when therapists perform at their best? But I must add, is that the whole question?

These birds are APA members

Let’s tackle the time of day issue first. Some people are early birds and others are night owls, including therapists. There are therapists in my building who have 6am appointments, and others offer 10pm spots. Some people are bright eyed and energized in the morning, others take half a day and a few cups of coffee to get up to speed, just like any other profession. I would assume that therapists who have some control of their schedule will skew their hours to times when they perform at their best, and some will manage their energy with strategic caffeine or an energizing workout. Essentially, therapists probably try to play to their strengths, or strengthen their weakness. Those who don’t can be called out, you're their boss after all.

If there’s a question about your therapists’ energy, you should probably just ask (because you can ask anything) about time of day or any other factors that make her seem disconnected. A question like: “Sometimes it seems like you have lower energy when we talk, what can we do about that?” should kickstart the conversation. I think an honest, authentic therapist will be able to talk about their energy levels with their clients and make appropriate adjustments if necessary.

But Fictional Reader (FR) raised a few other topics, as well. FR talked about the impact of having a session and then returning to work emotionally raw. I know this happens, and I think it's possible to minimize the negative effects through something we call "containment." This could be something like stopping the emotional work of the session five minutes before the end and organizing it intellectually through a summary or making an action plan. It could be taking a few minutes to journal what happened in session, then putting the journal aside until the end of work, where you can revisit the material. It could be taking a walk to clear your mind so you aren't so abruptly going from therapy to work. Or it could mean scheduling your appointment at the end of the day. This emotional rawness is good stuff to talk about with your therapist, as he may be able to help structure the session so it is more manageable for you.

Back to the optimum time to meet with a therapist to achieve the best results. What I said about night owls and early birds does have some bearing on the quality of our work, but I don’t actually believe time of day and tiredness levels is the most important factor when it comes to getting the most out of your therapist:

It’s about your connection with your emotions and your connection with your therapist.

I feel most energized when I feel a connection with my client, I sense their emotional openness, and I know they're ready to work. It makes me want to work hard, too. The time of day doesn’t make a difference. Give me a resistant, "I'm fine, there's nothing to talk about" client or "let me give you a recap of my whole week, hour by hour" client at any time and I'm prone to fade. My mind wanders when I feel my client is talking at me rather than with me, or when it feels like they're not really present. But give me a client who is ready to dive into deep emotional issues and take me with her and I’ll feel energized no matter what the clock says. Even after a big lunch when part of me wants a nap.

So along with “what time is it?” I challenge FR to ask a deeper question: “what am I not talking about?” Is there something else, some secret you don’t want to share, some issue that seems insignificant, perhaps something about the therapeutic relationship that you’re trying not to discuss? Maybe that’s just the caffeine your therapy needs. When you’re engaged with your story or issue, you’ll typically find that your therapist is, too. Even at 6am.


The visiting hours for my website and facebook page have just expanded to 24/7, so you can explore them whenever you have the energy. For more tips about therapy, check this out.