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. Continue Reading