Although we consider the therapy hour to be sacred, life sometimes gets in the way of counseling appointments, both for clients and therapists. Therefore, it’s important to establish a cancellation policy.
When Clients Late Cancel or No Show
Although we try to be compassionate, if we don’t establish and maintain office policies about cancellation we may be teaching clients to disrespect us. Also, many clients struggle with personal responsibility, so holding them accountable for their behavior is actually helping them.
In reading the Psychology Today forums, it appears most therapists charge their clients when they cancel within 24 hours of their appointment time. Some will charge for cancellations within 48 hours.
However, therapist cancellation policies are often dependent on the reason that clients cancel. More specifically, most therapists make exceptions for emergencies. But how is “emergency” defined?
Common reasons clients late cancel appointments:
- Illness: either they are sick or their child is sick and they have to stay home.
- Work: client had to work late, or their boss wouldn’t give them the time off.
- Problems with child care: the babysitter didn’t show up or had to cancel.
- Client forgot they had an appointment.
- Client did not give a reason.
- Client or a family member was suddenly hospitalized.
- Client had a death in the family
- Client got into car accident.
Which of these do you consider emergencies? It’s a good idea to think about this ahead of time, because when you are on the phone with a client it may be difficult for you to make a decision on the spot. For example, you may consider a sick child an emergency, but what about the third time in a month? Is it still an emergency?
What Should the Penalty Be?
For non-emergencies, most therapists appear to charge half the appointment fee when clients cancel late, but some charge the full fee. Some waive the fee if the client reschedules in the same week. Others give clients a “freebie,” that is one penalty-free late cancel or no show. I personally do not think this is a good idea, unless you have been seeing the client for some time and have an established relationship. In my experience, when I am overly flexible too early in the relationship I end up regretting it.
For emergencies, most therapists do not impose a penalty. In these cases, I suggest still requiring the client to reschedule within a reasonable amount of time.
It’s also important to note that most EAPs and some insurance plans prohibit counselors from charging for late cancels or no shows.
When Therapists Cancel
Life happens to us, too. Sometimes we become suddenly ill or have a family emergency. In these cases, most therapists simply explain this to the client, apologize, and reschedule the client. A few therapists offer the client a free session. Again, I don’t think this is a good idea. If we don’t penalize clients for emergencies, we shouldn’t penalize ourselves.
Yours in the Joy of Knowledge,
Dr. Barb LoFrisco
