While psychotherapist alertness is essential for effective psychotherapy, many therapists have anecdotally reported that sleepiness during psychotherapy sessions is problematic. To assess the extent of the problem, and the effectiveness of various coping strategies, I surveyed a random sample of clinical psychologists in New Jersey, USA and received responses from 165 participants about their experiences with maintaining wakefulness and alertness while seeing patients. Fifty-two percent sometimes or often have trouble with sleepiness, 32 percent sometimes or often struggle to stay awake, 52 percent have almost fallen asleep and 13 percent have fallen asleep during a session. Two-thirds of the participants believe that their alertness difficulties interfere with their therapeutic effectiveness.
Respondents reported that peak alertness levels appear to be highest in the morning and lowest in the mid afternoon. 63% attribute their sleepiness during sessions to lack of sleep, 61% to biorhythms, and 65% to feeling bored during a session.
These psychologists also found remedies for their daytime sleepiness that was most likely to occur in the afternoon, such as getting more sleep, short naps, walking with patients outdoors or just walking around the room, more physical exercise in general, becoming more engaged by talking to the patient, and the use of caffeinated beverages.
What can you do if you are the patient and your therapist is sleepy? First of all, talk to your practitioner about the problem you observe. Ask if they are morning, afternoon or evening people and schedule your appointment accordingly, if possible. Allow your therapist to provide you feedback. Engage your therapist more by asking questions.