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Encounters in the waiting room.

Article Excerpt
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The waiting room is a fact of life for most therapists. We provide a space for our clients to sit and relax (or not) before their sessions and to collect themselves if they need to before returning to the everyday world. We often pass by them if we use our time between sessions to visit the bathroom or the kitchen or to check the mailbox. Patients see each other weekly in the few minutes between appointments, sometimes for years. But we rarely think much about the waiting room, unless something happens there to call our attention to it.

This article was prompted by an interaction in my waiting room between two patients of mine who have adjacent session times. When I was made aware of it, I began to think about boundary issues and guidelines in regard to that situation. I thought perhaps I might find some references, articles about events in the waiting room, experiences of other therapists, or the like. Yet, after a long and thorough search, I found almost nothing in the literature about either the structure of the waiting room or the interactions that may occur there.

The Office Setup

Several basic introductory texts on private practice devote a few lines to the physical setup of the office and the waiting area. Typical of these is Wolberg (1977) who says, "The furnishings of the waiting room should be simple, consisting of a few chairs, coffee table, ashtrays, and selected magazines." Clearly this was written before the changed attitude toward smoking. Most waiting rooms today have no ashtrays, and many have signs specifically prohibiting smoking.

Wolberg also mentions that patients may make judgments about the therapist based on the kind of magazines provided in the waiting area. A psychologist with whom I used to share office space didn't want to put Rolling Stone in the waiting room (although we had received a complimentary subscription) because of the image associated with that magazine in his mind. One of my first supervisors had stacks of Time Magazine in his waiting room, but not one was more recent than 2 years old. I'm not sure why he thought anyone would want to read such old news, but that's what he provided.

To my knowledge, only Langs (1982) writes extensively about the physical setup of the therapist's office and waiting room. Langs insists that the only proper arrangement is to have a consultation room with two doors, an entrance and a separate exit that bypasses the waiting room completely. This arrangement tries to ensure that patients with adjacent sessions never meet each other.

We know from Jones (1953) that Freud's office had "a small waiting room giving on to the garden" with "an oblong substantial table down the middle, and the room itself was decorated with various antiquities from Freud's collection." Jones tells us that "an alteration was made to enable a patient to leave at the end of the hour without returning to the waiting room,...

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