therapy office space

Reflections on therapy office design

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A client comes to your therapy office for the first time. What impressions does your office design suggest? What does my therapy office design say about who I am and what this therapy experience will be? In my 40 years of practice, I have provided psychotherapy in over 15 different offices. And I have no doubt that each space had an effect on the therapy.

My least favorite therapy office design

My least favorite places to see clients were in hospitals and in church basements. These rooms were, in my experience, the least aesthetically pleasing settings I ever worked in. They just did not feel warm and friendly.  

The hospital therapy rooms were totally set up with practicality as the only consideration. The walls were neutral, the lighting terrible, the seating functional and institutional. These spaces did not have a therapy office decor. But of course, we were in a medical setting where sterility is highly valued. I just didn’t like it.

Church basements were utilitarian and of course, had multiple uses. In most cases, using these spaces for therapy was an afterthought. And often we did not have the authority to decorate the spaces and make them more “homey.”

My early spaces

Fortunately for most of my career, I had the privilege of having therapy office space that I could decorate as I liked, as long as I did not paint the walls. And yet for me, it took a while for me to figure out what to do with the canvas of my office. 

Early in my career, I just used leftover furnishings from the previous tenant. I made due. The look was. . . truthfully ugly. Functional but no personality showing through. I think partly I lived with that because I did not have much money to put toward furnishings nor was I confident in my decorating skills. But there are other reasons too.

Part of my training was psychoanalytic. I think I thought that if I did not reveal much via my decor, I was providing a blank slate for my clients to project onto. But now as I look back and see that perhaps I was just hiding, afraid of being known and possibly rejected. Perhaps I feared real engagement with my clients. Maybe I was unsure about how much I wanted them to know me. I can make a pretty strong case for all these motivations. 

That has all changed now. I want clients to know me. I want to know them. If they reject me, I will be fine. Sad but fine.

What my space is like now

Eventually, I was able to upgrade my therapy office design to a real therapy office decor. I always had a full-sized couch and usually two living room chairs. Most of the time I sat in one of the chairs through there were times I ended up on the couch, especially with those competitive couples where one chose the chair. What could the other partner do but also pick a chair? I am fine sitting on the couch.

Now I try to set my room up much like a comfortable living room. I even have a neutral-colored blanket on the back of the couch for those that wanted to cover. Some like the blanket and use it. Not because they are cold but just to cover. After all, therapists are scary. We see too much. 

Balanced for couples counseling

From early in my training as a couples therapist, I was always cognizant of attempting to balance the spatial distance between me and each member of a family or couple. I learned early that physical distance affected perceptions, both for me and for my clients. This, of course, is difficult in some room arrangements but I did the best I could.

The importance of this is partly due to the need for all types of balance–spatial, time spent listening to each party, and my need for a balance in my understanding of all parties. The way we arrange a room symbolically expresses this commitment to balance.


To the degree I had control, I wanted warm colors. I’ve usually chosen “earth tones.” For the last decade or more, I designed my office with a grey/green feel. Clients often comment on how much they like the warmth of the room. I hope that carries over to the process itself.

Simple and Uncluttered 

At times in my history, I displayed a large gallery of family photos. Now I have just one picture of the family. At times I had my walls covered with degrees, certifications, and several placards showing honors I have received. All these plaques sit in a box in a closet now. These days I have gone for simple, clean, uncluttered, professional.

The books I display are either therapy or business books. Those are the two domains of my professional life and reflect some of who I am.

Below is a picture of the therapy end of my actual office. The picture at the top of this post is a section of my office looking at the desk end.

Office space

Why these choices?

Some of these choices are about my awareness of how blessed I am. These days I am more sensitive to the awareness that some of my clients and colleagues will never have happy families or have an organization give them a plaque for some professional activity. So nowadays, I wonder why do I need these on public display? I know who I am; what I have done. I guess I am more comfortable just being me. 

Final thoughts on therapy office design

We spend a lot of hours in our offices. So far in my career, I have spent about 35,000 hours providing therapy and if I tallied up all the additional non-therapy hours, the number would get pretty large.  So while space is for me, it is for my clients and colleagues too. Making all comfortable is the goal. 

For more on therapy office decor look at:

Finding your community: The location and space

8 steps to adding office space in psychotherapy practices

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  1. Tammie Houston says:

    I never thought about how the distance between you and your patient can determine a lot about how they perceive you. It would be really important to strike a balance with that. My best friend just graduated college and is asking me to help her with finding a psychotherapy suite rental so that she can practice occupational therapy. I’ll have to make sure to look for a space that can allow for a reasonable distance as well as a welcoming atmosphere like you mentioned. Hopefully, I can find the right office that my friend is looking for.

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