Most practitioners who text do it for scheduling only, and most who refuse do so for reasons that are about the relationship rather than about privacy.

The refusal case is stated crisply by one therapist: no texting at all, because it casualises the therapeutic relationship, sets unrealistic expectations for contact, and blurs ethical boundaries. That's three distinct objections and each of them is real.

The case for is more practical. Some clients will not answer a phone call or open an email, and for a subset — teenagers especially — text is the only channel that reliably reaches them. A practitioner describing exactly that situation says the only way to get hold of a couple of their adolescent clients is text.

So the useful question isn't whether texting is acceptable in general. It's whether the specific things you'd use it for are things texting is good at. Scheduling and logistics: yes, with structure. Clinical content: almost nobody recommends it. Crisis: no, and the arrangement should say so explicitly.

If you do text, three things need to exist first — a number that isn't your personal one, written consent, and somewhere for those messages to live as part of the record.

What are the objections, exactly?

It casualises the relationship. The strongest version and the least discussed. Texting is the register people use with friends. Some of what's therapeutic about the frame comes from it being a frame, and a channel that feels like friendship quietly rewrites it. Practitioners who've watched a scheduling thread become supplemental therapy describe this happening gradually rather than in one step.

It sets an expectation you can't meet. Text implies now. A client who sends one at ten and hears nothing by eleven is having an experience you didn't intend to create.

It creates decisions at bad times. Once a message can arrive at any hour, you face a judgement about urgency every time your phone lights up.

The record problem. Text about a client belongs in the record somehow, and threads scattered across a consumer messaging app are the hardest possible version of that to satisfy later.

Privacy, which is less decisive than people expect. Plain SMS is not a protected channel. But one therapist's warning about this conversation is worth holding: ask twenty clinicians whether phone texting is acceptable and ten say yes and ten say no, and searching it produces the same split. The honest position is that the channel is what it is, the client should be told plainly what it is, and the decision should be made with that on the table.

What's the case for texting?

It reaches people other channels don't. Not everyone answers unknown calls. Not everyone opens email. Almost everyone reads a text.

It doesn't require the client to install or log into anything. This is the practical failure of the portal-based alternative — the security depends on the client authenticating, and a meaningful share of clients won't. The question gets asked in almost exactly those words: is there a way to message clients securely without requiring them to sign into an account?

It reduces phone tag. A confirmed appointment change by text takes twelve seconds and no callbacks.

It's asynchronous in a way that helps. A client can answer a scheduling question without a conversation, which some find much easier than a call.

How do I decide for my own practice?

Ask what you'd actually use it for, and be specific.

If the answer is "confirming and moving appointments", texting is well-suited and the objections are manageable with a written agreement and a separate number.

If the answer is "so clients can check in between sessions", stop and think harder. That's a clinical decision about the frame, not a communications one, and it's the version that most often turns into the problems the refusers describe.

If the answer is "because a particular client won't respond any other way", that is a legitimate reason and it's worth handling as a specific arrangement with that client rather than a general policy for everyone.

If I do it, what has to be in place first?

A number that isn't your personal one. Non-negotiable, and the cheapest version is fine.

Written consent, before the first message. What the channel is for, what it isn't for, how fast you reply, what to do in an emergency, and a plain statement of what the channel is and isn't secure for. Some practitioners send a version of this as the first text to every new client; a signed form is better.

A decision about the record. Where these messages live, and what gets a note.

The published standards are clearer on this than most people expect, and they ask for roughly those same three things.

The psychotherapy College ties consent to the medium — registrants "obtain informed consent from clients regarding the use of electronic communication media in the provision of services" — and where a practice involves written communication, registrants "include copies of correspondence and treatment-related communication in the clinical record." Its commentary adds what the client has to be told: clients "should be made aware of any potential risks, particularly an inability to ensure security and confidentiality, that could arise from the use of the technology" (CRPO Professional Practice Standards, Standard 3.4).

The social work College names the channel outright. Its published definition of electronic communication is "texting, email, video chat platforms, social media platforms, websites, faxes or other types of online communication," and registrants using online platforms are to explain "the limits of confidentiality" before or during the first online meeting "and document this conversation" (OCSWSSW, Interpretations 5.3.1 and 5.3.3).

The privacy regulator, notably, has published nothing addressed to texting. Its guidance is about email, and the closest it comes is the line that "similar rules should apply to communicating personal health information by secure messaging" — where secure messaging describes a system clients are "registered through" and that "authenticates their identity before accessing their messages" (IPC, privacy and security considerations for virtual health care visits). Ordinary texting is not that. Which is the honest state of it: the two Colleges most of this audience answers to name texting explicitly; the privacy regulator has not, and no amount of reading will turn that absence into permission or a prohibition.

The short version

Texting for scheduling, with a separate number, written consent, and a place for the messages to live — that's the setup most practitioners who text end up with, and it holds.

Texting as a general channel between sessions is a different decision with different consequences, and the therapists who refuse it outright are not being precious. They're describing something they watched happen.

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