Cheryl Fuller has an excellent post on scheduling psychotherapy sessions.
Consistently beginning and ending sessions on time and avoiding back-to-back sessions are practices important for both therapist and patient. Funny she should have a post on this subject, I was planning a similar post myself. I recommend that you take a minute to check out Dr. Fuller's post before you read further.
As I arrived at my office one day earlier this week
I noticed a woman standing in the hallway at the doorway to another therapist's office in our high-rise office building. A moment later, the elevator doors opened and her therapist exited, loaded down with shopping bags and breathlessly apologizing for her lateness to the woman waiting in the hallway. I've witnessed similar scenes outside this particular therapist's office many times before.
The therapist has been working at this location for many years, but never built a waiting room. Her patients wait in the hallway where they are exposed to public view. The problem is made worse by her apparent resistance to keeping her schedule. There are other issues: the therapist is an attractive woman who dresses in extremely provocative manner that would not be permitted in any professional office-even one that allows the most casual attire.
What do patients seeing this therapist learn about managing their own lives? What do they learn about keeping commitments, respect for their own privacy and dignity and respect for the rights of others? What do they learn about manipulation and seduction, about managing impulses (not shopping when they're supposed to be working) or about saying "no" and "enough"?
The scene outside this therapist's office brought me back to my own experience as a patient with a psychotherapist I saw briefly before I saw a psychoanalyst. It was perhaps the third or fourth session and I already had serious questions about the therapist's competence. She had been late for every session, she cut me short on session time due to me and I didn't think her much of a listener.
On this particular day, my therapist arrived about 20 minutes late carrying shopping bags. She announced that she was down at Eddie Bauer (in the same building) because, as she put it, "I cannot resist a sale."
That was our final session together.
It would be impossible for me to settle into a trusting, creative exploration with a person who isn't minimally attentive to matters as basic as meeting me for a session at the time she said she would be there. Patients put themselves in an emotionally vulnerable position with their therapists and they need to know that the therapist is deserving of their trust.
If a patient can't trust the therapist to arrive on time, how does the patient trust the therapist with far more delicate matters? How does a wary patient free associate, expressing whatever comes to mind in an uncensored matter, if the patient believes (consciously or unconsciously) that the therapist isn't serious about therapy and that the therapist lacks the insight and self-discipline necessary to manage their own behavior?