The Therapeutic Hour
The Therapeutic Hour is, traditionally, 50 minutes. There are both straight forward and complex reasons why this is so. Sigmund Freud used this model and in the psychoanalytic and psychodynamic traditions it has stuck.
There are practical reasons ‐ most simply, 10 minutes are used between appointments for the therapist to write notes and get ready for the next client. But there are psychological reasons too: the clear time frame offers a boundary, a sense of containment, allowing the client to take control of what is brought and when.
It is not uncommon for something particularly difficult or painful to be spoken in the last five minutes, giving the client a sense of ‘get-out’, or perhaps setting up a familiar sense of not getting enough back. It is important to know when time is up, however one chooses to manage it. In my work with clients, boundaries are fundamental and a key aspect of the overall process and therefore, so is consideration of this framework.
In recent years I have found myself holding to the sense of this therapeutic 50-minute hour whilst also allowing the 10 minutes extra to take place with the client where necessary ‐ this may be to allow for rescheduling or payment or other admin tasks. It may also allow for extra care and attention to closing the session. I therefore ask that clients allow 50 minutes for the therapeutic hour, whilst allowing for those extra minutes together when necessary.