Therapist resource: When on-call therapy creates dependency and burnout

With the large-scale shift from the therapy office to virtual sessions, it can sometimes feel like therapists are expected to be online and available 24/7.

While that may sound ideal from a client perspective, as therapists, we know the work we do is more than just an outlet when someone is having a bad day. Sure, we want to be there for our clients, but that doesn’t mean making ourselves into a quick-fix emotional support. Our goal is to help clients become more independent, not dependent on us for every bump in the road. 

So, how do we strike that balance — being available when it matters while also fostering client growth — in a world where technology makes us technically accessible all the time? Striking the right balance can protect us from burnout and guide our clients toward real growth instead of reliance.

Why staying in touch matters

One of the key ingredients to successful therapy is building a solid foundation of trust. And let’s face it, trust doesn’t just happen overnight — it’s something that’s built through consistent availability and showing up for our clients when they need us. Being there, especially in those crucial moments, helps to create a sense of continuity in the therapeutic relationship. It reassures clients that they’re not alone in this journey, even when they’re between sessions.

Different ways therapists can stay connected to clients

But here’s the thing: Staying in touch doesn’t always have to mean being available 24/7 for real-time interaction. There are plenty of ways to keep that connection strong without sacrificing your own boundaries. There’s a spectrum of contact options, including:

• Self-help tools: Providing resources that clients can access anytime they need extra support.

• Automated messages: Pre-scheduled appointment reminders or therapeutic measures for clients to keep track of how they’re doing.

• Open inbox policy: Letting clients who do not have a history of risk or safety issues know that while you may not respond, they’re welcome to email you about anything, and you can discuss it during their next appointment. This is a touchy subject due to any potential liability that may arise if a person is in crisis and a therapist does not respond. It’s important to clarify which topics are appropriate for outside-of-session issues with your clients.

• Scheduled check-in calls or texts: Brief, scheduled check-ins between sessions. This could be a 10-minute phone call or a quick text.

• Crisis support availability: Crisis support might involve being available for urgent situations that require immediate attention. This could mean providing clients with a dedicated emergency number or setting specific hours when they can reach out if they’re in distress.

5 things to consider when establishing connection norms

You get to decide what works best for your practice, for your clients, and for your own work/life balance – but there are some things you have to keep in mind.

1. What therapy modalities you’re using

Not all therapeutic approaches are created equal when it comes to between-session contact. Some modalities, like dialectical behavior therapy (DBT), actively encourage between-session communication as part of the treatment process, especially in the treatment of borderline personality disorder (BPD).

DBT relies on clients reaching out to therapists in the moment for help applying the skills they’ve learned in therapy, especially during a crisis. Contact like this is crucial to the success of the therapy and teaches clients how to cope in real life.

On the other hand, some modalities may not call for (or even recommend) any significant level of between-session interaction. If your approach doesn’t typically involve this kind of contact, make sure you set clear boundaries and communicate these expectations to your clients at the beginning of your work together.

2. Talk about crisis support expectations

One of the trickiest aspects of being “on call” is managing crisis situations. It’s natural to want to be there for your clients when they’re in distress, but it’s equally important to avoid becoming their sole source of support. Eventually, you’re going to be in the bathroom when they call, or speaking with another client, and not able to respond right away.

It’s helpful to set clear guidelines with your clients about what actually counts as a crisis and when it’s okay to reach out to you. You can work together to create a crisis plan that lays out the steps they can take when things get tough — like trying certain coping strategies or knowing when to call emergency services. This way, you’re protecting your own boundaries and also giving your clients the tools they need to handle crises on their own

3. Remember that self-care is important for therapists, too

As therapists, we’re often so focused on caring for others that we neglect our own needs. Sure, we learn about self-care in graduate school, but who has time for it in real life? The truth is that taking care of yourself is the only way to stay effective in your role. Constant availability can lead to burnout, which makes it hard to provide the best care.

Setting boundaries around your availability means protecting your time, your energy, and your own mental health. When you implement practices that support your well-being, like regular self-care routines, setting aside time for rest, and getting supervision or peer support to handle tough client interactions, you’re better equipped to help your clients in the long run

Ask yourself: How much time do I need to be “unplugged” from my work? What is the real mental load of being “on call?” And give yourself permission to change your policies and practices until you find an approach that’s sustainable for you.

4. Laws and ethics compliance

When deciding how available to be for your clients, you have to consider the legal and ethical guidelines that govern your practice. Every state and country has different regulations around therapist availability, especially when it comes to crisis management and confidentiality.

Not only are there legal requirements, but ethical guidelines are set by professional organizations, such as the American Psychological Association (APA) or the National Association of Social Workers (NASW). Ethical Codes might provide a framework for defining appropriate boundaries. Make sure you familiarize yourself with these guidelines and align your policies with them.

5. Balancing sufficient support with the risk of dependency

It’s important to strike the right balance between offering support and fostering independence. We want to be there for our clients, but the ultimate goal of therapy is to help them build the skills and resilience they need to handle life’s challenges on their own. If we’re too available, there’s a risk they might start relying on us too much to solve their problems.

To avoid this, it’s a good idea to encourage clients to use the tools and strategies they’ve learned in therapy on their own (and to make sure those tools fit the client). Therapists can still offer guidance and support when needed, but clients need to understand that the goal of therapy is for them to develop their own coping mechanisms. That means helping them grow and keeping healthy therapeutic boundaries all at the same time.

You can be there for clients without getting burnt out

Thanks to technology, almost everything is instantly accessible, but our role isn’t to be constantly available for every challenge clients face. Clients might seek immediate support, but our role is to help them develop the resilience and tools they need to manage on their own. Therapy is about building something stronger than just a relationship — we want our clients to take away something that lasts the rest of their lives.

Remember, it’s okay to be there for your clients when they need you, but it’s just as important to give them the space to grow (and yourself the space to thrive). After all, the best kind of support is the kind that eventually makes you unnecessary.

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