Missed Appointments

An appointment was missed by the client…. Why does it happen?

If an appointment was reserved for the client but the client did not attend it it was probably for a legitimate reason.

• an accident
• serious illness
• some calamity.

It also happens that clients just forget about it. It happens.

I understand that attending a first counselling appointment can be especially hard. There are many risks involved such as:

• What is the counsellor like?
• Will I feel comfortable with her or him?
• How open should I be?
• Will I face judgment from the therapist, or even judge myself?
• Will I get what I need from the session?
• Will I need to discuss things outside of my comfort zone?
• Will I feel like an emotional mess afterwards?

These are all important questions and there is no guarantee that psychotherapy will be a comfortable experience, although screening a psychotherapist well beforehand can help ensure that psychotherapy is a helpful and worthwhile process.

Other factors which can increase missed appointments can include:

• Drinking or drug use, particularly the day before
• Relationship stress, particularly if the partner does not support the idea of counselling
• Financial instability
• Health problems
• Housing issues

Most counsellors have firm policies around missed appointments, usually charging clients the cost of the appointment. (see e.g. OPA guidelines) Why?  This time has been reserved exclusively for the client, meaning other people who could have benefitted from this appointment time, cannot use it.  Additionally, when counsellors have reserved  the time in their work schedule, they expect to be compensated for that. Most therapists will have a 24-hour cancellation policy as it’s typically hard and often impossible, to fill appointment spots on short notice. Some counsellors ask for 48 hours notice.

Counsellors themselves are not immune to missed appointments.  It is theoretically possible for the counsellor to, for example, experience an emergency before a scheduled appointment. Once I myself forgot about the appointment but luckily I was not far from the office and came to the client in 15 minutes.

What to Do

Please cancel if you need to, for whatever reason!  It’s actually OK to decide for yourself whether or not you want to participate in psychotherapy and to change your mind even if you already have an appointment set up.  Not only does it save you money, I as a psychotherapist will feel that my time is being respected and it also allows me to open up the spot for someone else who may need it.

There is another option, particularly if you trust me as your psychotherapist.  If you are cancelling your appointment to avoid something, often emotional, sometimes it can be useful to bring up your feelings or fears with me in a session.  This is not a guarantee that this conversation will go well, however, if you have trust in me as your psychotherapist, the conversation could be a pathway to addressing deeper issues. If it’s your first time trying counselling, let me know so that I will be more attuned to the fact that this is a new experience for you.

Bottom line: cancelling an appointment should be a straightforward process and is always better than just not showing up. Based on source 

If you missed your appointment and/or informed me less that 24 hours before the session there are two options:

• I will ask for late cancellation fee and I will discharge you from therapy. When you pay me the fee you will be free to be by yourself or find another psychotherapist.
• I will ask for late cancellation fee. And I will welcome you back to therapy.

The choice is yours. As always.