For me, therapy contains enough stressors (the tough work that goes along with doing deep work, concerns over the relationship itself, sometimes difficulty returning to what I need to accomplish afterward) that I wouldn't want to add another one. Insurance doesn't cover missed appointments, which would make me so nervous to have to pay the whole thing out of pocket. With my T, though I do need to cancel 24 hours in advance, she usually has a waiting list of people wanting to get an appt--she has called me at times when other clients have cancelled. Could this mean that this T doesn't have enough clients? This would worry me some. And as jbmomg points out, what if she misses? Is the next appointment on her? I get that this is a business, but such rigidness makes me wonder if her therapeutic approach is rigid? Flexibility within healthy boundaries is an important component of therapy, in my opinion.