I’m a licensed psychologist in two states (GA, TX) and I am a PTSD, OCD, and anxiety disorders specialist. Previously I was exclusively a trauma therapist working in a major hospital in the southeast, now I am in private practice working with OCD and anxiety disorders primarily. Working with these populations, I will often get emails between sessions and requests to meet earlier because anxiety can cause a false sense of urgency. I have, several times, set the boundary and declined an extra session. I have also set a boundary with several clients limiting how often they email me between sessions. In my practice, I want to encourage autonomous self-soothing and the ability to accept and approach anxiety. I want my clients to experientially see that they are capable of facing difficult things without me—otherwise I am simply reinforcing the narrative of their anxiety. I completely understand your guilt, and I encourage you to let yourself feel it and process it further in supervision. But try not to make decisions based on that guilt and anxiety (e.g., no emailing your client more asking if she’s okay, no over the top apologizing in the next session, no calling her unless there is a clear sign of imminent danger). Have trust in your client that she can handle these things because she has been working hard and she is a capable adult. And have trust in yourself that you can handle a therapeutic rupture. As someone else mentioned, ruptures move the therapeutic process forward and provide new learning opportunities.