I've never walked out or skipped a session or not returned, but my husband has a habit of cancelling his appointments on short notice or simply forgetting to go. It does tick t off because that is my husband running away from what is difficult (a pattern for him). T charges him full price. He gives him a good scolding. He works on the underlying reasons my husband does this, etc. My husband is a bit of a hopeless case as far as consistency with therapy goes.