This is for you River! I remember you asking once if the setup of therapy was randon or why it had to be done the way its done. My T and I were talking about the fact that my relationship with him is all about my needs. Which it wasn't when I was a child, so that's the reparative part of therapy. Having a place where you can express all yours needs and feelings because you don't have to worry about the other person. I was thinking about it later in the day, and processing alot of stuff from the seesion (it was an intense one) and I had an "aha" moment where I understood but understood in my gut. And this is what I figured out:

The therapeutic relationship needs to be about only the client’s needs. But all human beings have needs, including therapists (I’m going to give them the benefit of the doubt and assume they're human. J ) The best they can do is put aside their own needs during sessions and any contact with clients. To get to know someone is to get to know their needs. Therefore, if a client gets to know the therapist, the client gets to know a therapist’s needs and the relationship is no longer only about the client’s needs. That would be the end of therapy.

And it follows that no one can live a healthy life continually ignoring their own needs so a therapist has to have time when he is not in contact with his clients to attend to his own needs, hence the limitations on contact.

I know myself well enought to know that this probably doesn’t mean I’ll never get frustrated or angry about the boundaries again, but this is the first time they’ve made emotional sense. I understood the need for boundaries but not why those boundaries in particular were the ones that you needed for the work to be effective and for both parties to be safe. Now it makes sense.

I would love to hear other people's thoughts.

AG

Thanks AG, I do get your point. This is the same reason why our T's take vacations and are unreachable. (You've been in my thoughts JM ) They need breaks and personal time just like everyone else.

One of my questions was why 45 minutes? I feel like I am running out of things that I can talk about in 45 minutes or less. The time can go by so fast I often get frustrated.

But I guess I understand the schedule as more of an economic necessity. Some T's practices aren't as lucrative as others since they are trying to keep their fees within a reasonable range. (Thank goodness because I couldn't go otherwise.) Plus the expenses of malpractice insurance, continuing ed, office space, etc. To keep their practice open they have to see as many clients in a day as possible. I do have a good understanding of this because I worked for a dentist for several years and it is much the same (except way more overhead.) Any appt time you can't fill or any appt a patient cancels last minute or doesn't show up for is negative income. There was always an emphasis to accommodate as many patients as possible and to fill any cancellations as quickly as possible. Yes, they do make good money, but aren't the good ones worth it? It is certainly work I could never do!

So, if a T works an average eight hour day they can either see 7 or 8 patients for 60 min ea (depending on how they schedule their lunch)or 9 or 10 patients for 45 min each. I guess it benefits them both ways. The schedule helps maintain crucial boundaries and helps keep their practice in the black. Plus they don't get any sick time or paid vacations. Such are the ways of the self-employed and every T I've met so far is self-employed.

they also have time between clients to eat and go pee lol, if people all came and went on the hour they wouldn't have a moment to reflect, take notes, listen to their phone calls, etc.

i know our T does these in her 10-15 min. between apointments. she also does a lot of reading and takes a lot of outside workshops to continue to learn.

it's pricey for sure!

scott/antoni