The thought of your therapist being unavailable can provoke anxiety. Maybe they’re only going to be gone for a week or two (hello, vacation), or perhaps it’s a few months (psychologists have babies, too!). Whatever the case, you may not know what to do in their absence.
Sometimes therapists will bring up how they handle this kind of situation at your first appointment, Beatrice Tauber Prior, Psy.D., owner of Harborside Wellbeing in Cornelius, North Carolina tells SELF. This is especially likely if they have some sort of leave coming up that makes forming a contingency plan urgent. “A therapist should clearly communicate the procedure they have in place for times they are out of town or unavailable,” Tauber Prior says.
“Psychologists have an ethical responsibility to their clients for the duration of the therapeutic relationship,” Nicole Issa, Psy.D., co-founder of The Center for Dynamic and Behavioral Therapy in New York City, tells SELF. As Issa explains, this is cited very clearly in the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct. Basically, a responsible therapist won’t just abandon you and your mental health to go traipse around a beach in Belize.
Even if you did discuss your therapist’s vacation protocol with them in general terms at some point, it’s perfectly fine if you’ve forgotten exactly what it is. Therapists typically give patients as much notice as possible before any kind of leave (unless something comes up suddenly), Issa says. At that time, you can ask as many questions as you like in order to feel comfortable before they go.
If you don’t want to go without therapy the entire time your therapist will be away…
1. Tell your therapist you’re nervous about missing therapy.
Sometimes a break from therapy can be a great thing, which we’ll dive into in a moment. But don’t be shy about speaking up if you’re worried about this prospect, Issa says. “Your therapist should understand and anticipate that you may have conflicting feelings about wanting your therapist to have the time off needed while being upset that your therapist will not be there for you,” she says.
2. Ask if they ever do telepsychology appointments.
There’s a whole slew of reasons your therapist might be unable to see you in person. Depending on the circumstances, they may be willing to do telepsychology sessions, Tauber Prior says. Your therapist might not have access to video conferencing technology or might not use it in their practice, but it’s a fair question to ask and a good option to consider if they do, she says.
3. Ask if they have a suggestion for a therapist you can see in their absence.
Let’s say your therapist is going away for months and doesn’t do telepsychology sessions or you really want to see someone in person. Find out if they can refer you to a colleague with openings in their schedule, Issa says. Then ask the administrative team at the practice if the covering therapist takes your insurance.
“It can be helpful to meet with that person prior to your therapist’s last session with you before [they] leave in order to make sure it is a good fit,” Issa says. You could also do research on the new therapist’s website or in any online reviews for insight into how they practice therapy.
Of course, it can take time to really get comfortable with a new therapist, but your gut instinct may tell you whether or not you two might be a match. If you don’t think you are, you’ll still have the support of your current therapist to help you find someone new.
4. Ask how you should handle a mental health emergency while they’re gone.
Depending on the specifics of your treatment, your therapist may be available to you all the time, says Issa. That may or may not change when they take their leave.
“Some therapists remain accessible even while on vacation or on an extended leave, others have a covering therapist in place,” Sari Chait, Ph.D., a clinical psychologist based in Newton, Massachusetts, tells SELF. Before your therapist leaves, make sure to connect with them about when and how you can contact them or who you should reach out to while they are out.
All of the above can be helpful in some moments of psychological distress, but if you ever feel in danger of harming yourself or others, you should call 911 or go to your nearest emergency room, says Issa. The free, 24/7 National Suicide Prevention Lifeline (1-800-273-8255) is also an available resource if you need support.
If you’re feeling pretty good about the idea of taking a break from therapy…
1. Discuss that possibility with your therapist.
“It is possible that you want to use the time your therapist is on leave to take your own break from therapy and consolidate the gains you have made,” says Issa. For example, it can be helpful to use your regular therapy time to reflect and journal, she says.
“People are sometimes surprised by how well they do and how much better able they are to cope with things than prior to engaging in therapy,” says Issa. “Other times, being away from therapy can help people identify areas that they are still struggling with and need to continue working on.” This can make therapy even more effective when your therapist returns, she says.
Of course, discuss this with your therapist beforehand to make sure they agree with you taking a break. Even then, it can still be helpful to talk through who you should contact if you decide you want to resume therapy before they’re back, says Issa.
2. Make a list of potential life stressors that may come up when your therapist is gone, then talk about them before they leave.
Do you have a huge work deadline? Is your partner traveling for work, so all the childcare will fall to you? Discuss how you might cope. Reviewing these strategies ahead of time with your therapist can help you be more emotionally resourceful during your therapist’s time away and give you something to reflect on upon their return, says Tauber Prior.
3. Continue to practice your psychological coping skills on your own.
Reporting your progress to your therapist is great motivation to work on your newfound skills, but you shouldn’t stop just because you’re on a break from therapy. “One of the most important things for clients to do is to continue practicing what they've learned,” Chait says. “Like learning a new sport or how to play a musical instrument, if you don't practice the skills you learn in therapy, you won't be able to apply them well when needed.”
Think back to techniques that have been effective for you in the past, Issa says. Maybe that’s deep breathing, mindful meditation, or reminding yourself it’s OK to reach out to a friend or family member when necessary, says Chait.
If you’re in a stressful mental health moment and struggling to know which coping skills might be best, Issa suggests asking yourself, “What would my therapist say?” You can also discuss potential coping skills with them before they leave and make a list to keep on hand for easy access.
4. Ask them what your plan should be if you have a mental health emergency.
They’ll likely discuss who at the practice you should reach out to depending on the severity of the emergency and remind you that you should always immediately call 911 or the National Suicide Prevention Lifeline (1-800-273-8255) if you’re having thoughts of harming yourself or others.
You should also discuss with your therapist what you should do if you’re not necessarily having harmful thoughts but are having a harder time than expected in their absence, like getting in touch with a specific therapist at their practice. You may not need to act on your plan, but it’s smart to hammer it out just in case.