When is the best time to give or receive therapy?

The majority of people seeking counselling or psychotherapy need their sessions to fit in or around their busy lives, which means that early morning, evening or weekend appointments are the most sought after. But which works best?

Some people are early birds, others night owls. This applies to therapists too. If you ask some practitioners whether they would prefer to practice at 6am or 6pm the answer will be a no-brainer. They either could not contemplate thinking with a client (or thinking at all) before 10am and a generous intake of caffeine. Or they would baulk at the idea of still having energy and enough to give after teatime.

However, science seems to point at early mornings being the most effective time for therapeutic work. A recent study by the genetics department at Exeter University showed that people identifying as early birds have higher levels of happiness and are at a lower risk of depression than night owls. And a Texas University study showed that early risers have consistently higher grades than those burning the night oil.

All of this seems to show that the working therapist might be more alert and effective during early morning sessions, but what about the clients?

Our cortisol levels are highest at the start of the day, which could make the early hours the optimal time for clients with anxiety to have their appointments. Cortisol is the hormone that regulates fear and stress, and studies* have shown that our levels of it make a real difference to our ability to regulate anxiety and deal with emotional difficulties.

There is a fear though, that although clients might be more focussed in the morning, they may not be able to switch off from their reflections before work or that there might be some fallout during the working day.

Two days a week my first appointment is at 7am. As an inveterate night owl and someone who finds it hard to go to bed before, say 1am, this is something that caused a certain amount of horror and concern when I first started my private practice. However, I now really value this work. From the early morning walk through dark and silent streets to the strong coffee and a croissant held in mind as treat and reward when I finish at 10, I really enjoy this work.

It is true that clients sometimes access something painful and difficult during their sessions, but I have learned to contain and stop this emotional work a few minutes before the end of the session. This gives the client time to package things back up before they have to go and face the world again. I have also discussed the value of the client taking a few minutes to jot down some notes about what happened in the session so that they can put it aside to reflect upon later, after work. I have also raised how taking a few minutes to have a walk can buffer them a little so it doesn’t feel like such an abrupt transition from therapy to work.

On other days of the week I have clients from 2pm to 9pm, and can I honestly say I have a better connection with the morning clients? Well perhaps not. All our work with clients depends on the connection we make with them, and it is different in every case. However, I do certainly feel that with my early morning clients, we are both coming to the session as (relatively) clean slates, and in a more open and contemplative state than we might be later in the day.

If you are a private therapist and are interested in having a pre-working hours private practice at The Awareness Centre in Tooting or Clapham please call 020 8673 4545.

* published in the journal Psychoneuroendocrinology