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No, psychologists and psychotherapists do not always work sitting behind the patient/client. The traditional image of a therapist sitting behind a client on a couch is primarily associated with psychoanalysis, which is just one of many therapeutic approaches used in psychology and psychotherapy.

Therapists use different therapeutic orientations and styles, and the arrangement of the therapeutic space can vary accordingly. Here are some common ways therapists interact with their clients:

  1. Face-to-Face: In many therapeutic settings, the therapist and client sit facing each other in a room. This setup promotes direct communication and allows for non-verbal cues to be observed and understood.

  2. Couch and Chairs: Some therapists do use a couch and chairs setup, often associated with psychoanalytic or psychodynamic therapy. However, even in these cases, therapists may not always sit behind the client; they might sit next to them or across from them.

  3. Online Therapy: With the rise of technology, online therapy or teletherapy has become more prevalent. In this format, the therapist and client interact using video conferencing software. Both parties could be sitting in various locations during these sessions.

  4. Group Therapy: In group therapy, clients typically sit in a circle or around a table, and the therapist might sit among the group or have a specific chair or spot in the room.

  5. Play Therapy: When working with children, therapists often create a playroom environment with toys and art materials, allowing the child to express themselves more freely. In these cases, the therapist may engage with the child in different ways rather than sitting behind them.

  6. Walking Therapy: Some therapists offer "walk and talk" sessions, where they walk alongside the client outdoors instead of sitting in an office. This approach can be particularly beneficial for clients who find it more comfortable to talk while engaging in physical activity.

The choice of therapeutic setup often depends on the therapeutic approach, the therapist's style, and the needs and preferences of the client. The important thing is to create a safe and comfortable space where the therapeutic relationship can flourish, regardless of the physical arrangement.

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