Writing this article’s title, I cringe. I wince. I wonder: “Are you so self-centred as a counsellor that you think that clients might struggle to cope when you’re off?” Yeah, it’s kind of an embarrassing question, but one that I think bears discussing, because when therapists have taken a good chunk of time off, we know that there can be an impact on clients.

Counsellors may hear comments like:

“Wow, it’s been a while!”
“There were several times that I wanted to talk to you when you were gone!”
“It was a really hard time, really difficult.”
“Your timing wasn’t the greatest.”

And many times it’s just,

“I hope you had a great time off.”
“I’ve been doing great!”

Or counsellors themselves may be struggling with thoughts like:

“I feel guilty about having taken so much time off.”’
“This is disruptive to my clients.” etc.

And therapists would be wise to retain their humility, remembering that they are but one part in the tapestry of clients’ lives.

Client Experience

As I’ve alluded to, the experience of pausing therapy because of counsellor absence, can vary. Effects on clients can depend on several factors:

Wellbeing/Coping Levels at the Time the Therapist Left – Certainly if clients are in crisis and therapists leave for scheduled time off, it’s going to be more difficult for clients.

Availability of Alternative Supports – If things are, or become, challenging, while therapists are away, what supports are available to facilitate coping? Close relationships? Established coping strategies? Hotlines or community resources? An alternative therapist?

Where Clients Are At In Their Therapy – The impact of therapist departures can be more significant when clients are right in the midst of working on a particular issue, or if clients have just started their counselling and distress levels are still relatively high.

Life Circumstances – Sometimes something throws us for a loop when our therapist is away; clients may find themselves wishing they had counselling support. It’s bad timing! Or sometimes we know in advance that it’s going to be bad timing, such as periods of the year which are historically difficult, like as the anniversary of a loved one’s passing. Ironically, many counsellors—myself included—often take vacation time which coincides with public holidays which are notoriously hard for many folks and when extra support could be very helpful.

So, What’s a Client and Therapist to Do?

Each person will be unique in terms of their needs, and any steps taken when their therapist is away. Here are a few ways that this can play out:

• No extra client needs are identified before the therapist leaves for vacation. In this situation, the client and therapist take a pause and counselling resumes when the therapist returns.
• Therapist assigns homework so that the client can continue with their goals while the therapist is away. This often works best in situations where the client is making excellent progress and wants to continue with their momentum. Or alternatively, if the client is self-motivated to work on homework that they’ve come up with themselves.
• Therapist and client collaborate on a strategy beforehand, for when the therapist is away. This can including reviewing the client’s supports (and how they will engage with them), brainstorming how each client will soothe themselves in difficult situations, as well as other wellbeing-enhancing strategies. Additional thought may be given to putting helpful routines into place.
• Client takes initiates coping strategies independently, sometimes trying or experimenting with these new ideas when the therapist is away.
• Client documents or journals challenges that arise over the therapy break so that they can be dealt with in their next session. Benefits of documenting include remembering situations in more detail (or even remembering events at all) as well as giving the therapist a better sense of what is going on, so that the therapist can better help their client.
• Crisis planning. Therapist reviews and provides crisis resources that their client can use when the therapist is away. This generally occurs when the client is going through a very difficult time around the time that the therapist is scheduledto leave for vacation.

The Return

What happens in clients’ therapy when therapists return? There are different possibilities:

• It continues in the usual manner.
• The client brings up new issues that occurred over the break period and therapeutic work is started in these areas.
• Client and therapist process the impact of the break period—positive or negative.

Tips

Breaking a therapeutic rhythm can be difficult even if you are on-side with the importance of time off for therapists.

It’s ideal when therapist absences can be addressed proactively. Therapists bear most of the responsibility, here. This may include:

• Therapists giving clients sufficient advance notice so that clients can prepare mentally or make other practical arrangements when it comes to routines or supports.
• Therapists supporting clients in processing any negative feelings that they have about absences. And similarly, clients speaking up if they are unhappy, particularly if it seems that the therapist is unaware.
• Therapists taking the time to make a plan with any of their more vulnerable clients before they leave. Sometimes clients benefit from being referred to a temporary therapist or alternative counselling services, hotlines or community services.
• Therapists and clients, together, identifying points of client growth during therapist absences: this can build confidence.
• If therapists have an online booking schedule, ensure that they have mapped out their availability well in advance, so that clients have the chance to plan ahead and schedule a session soon after a therapist’s return—if that’s what they need—as return times can be heavily booked. Providing an advanced schedule also helps clients see where the breaks are, allowing for mental preparation.

As with anything else in therapy, I always recommend that clients speak up to their therapist if they have concerns. That in itself, when well supported by the therapist, can be hugely therapeutic in an of itself!