[Alishia88]

So I´ve been trying out a new therapist to go to after my sessions run out with my current T.

I went there 3 times and the 4th session now I had to cancel because I was out sick. I didn´t feel bad 2 days in advance so it was a sort of short notice cancellation.

She wrote me an email and said if I missed a therapy sessions for being sick in future she will need a doctor´s note about it.

I found that quite odd. Does any of your Ts do demand that?

I have heard about Ts making you pay for the session if you don´t abide the cancellation policy which I get, but a doctor´s note?

I feel like I´m back in school with that arrangement and MOST important,
I expect my therapist to "believe" me what I tell him and also when I tell him that I am sick. If he´s making me pay for the session, okay, but demanding doctor´s note? I think its weird and sort of in the way of having a trusting relationship, like otherwise I´d cancel for no reason at all. Which I would never do with therapy.....

But what do you think...?

[stopdog]

I would never go back to that therapist again. I rarely give reasons for cancelling in the first place, but there is no way I would provide evidence to the therapist about being ill or not. Perhaps a few tomes of the therapist catching strep throat or colds would cure them of such nonesense.

[NowhereUSA]

It seems a bit odd. If I have a bad cold, I'm not going to go to the doctor (what a waste of time). I would bring it up. Maybe this new T isn't going to be a good fit?

[msxyz]

You have got to be kidding me...

[ThisWayOut]

That's pretty weird. Did you have a history of cancelling and running away from therapy? Even so, it's your right. I would definitely ask T why she requires this, but start looking for another T because that would really bother me.

[wotchermuggle]

What the heck.....completely stupid. Maybe ask for the reasoning behind it?

[Ididitmyway]

Not only it is weird, it's inappropriate. A commitment to the therapy work is the obligation one makes to oneself only, not to the therapist. You have no obligations to your therapist and she has no right to demand a doctor's note. If she feels that she cannot be effective if you miss sessions, that's a different issue, but the cancellation policy should be clearly outlined in her informed consent. If the doctor's note wasn't mentioned as a requirement prior to your initial appointment and if you didn't agree to comply with this before seeing her, she has no right to impose this rule right now. In any case, this is a very stupid rule for a therapist to have and certainly not consistent with the purpose of therapy. When the client says she was sick, this should be accepted without a prove. If skipping session becomes a regular pattern, then the therapist may address it by asking if this is a good time for the client to be in therapy at all. But to treat therapy as if it was a full time job where you have to show up regularly is dumb and counterproductive.

[RedSun]

If you're paying through insurance, maybe t needs it for that? I don't really understand how insurance works (being in UK) but it sounds plausible? I'd definitely ask the reason before thinking on it further, it might be quite straightforward. Hopefully.

[Petra5ed]

Id have to ask her more about this, my first thought was WTF, you're not in high school?

[Mike_J]

I have been charged a cancellation fee from my psychiatrist, and that I didn't mind because it was 100% my fault, I totally left it off my calendar and failed to show up or call.

My therapist would never charge me for a missed appointment if I was ill. Heck she wouldn't if it was something I forgot if it was a one time thing, when I started with her she did warn me that if there was repeated missed appointments without notice there might be a missed appointment fee.

Just wait until your therapist is ill and then you can ask for a doctor's note.

[IndestructibleGirl]

Oh this would piss me off. The therapist is not your boss. YOU employ them, at the end of the day. I can understand needing to pay if you cancel on the day, etc, but a sick note? They can do one.

[unaluna]

the t is insane.

[JaneTennison1]

Where I live they charge for a dr's note but my work (who demands a note) pays me back. Would your T pay you back?

Regardless this seems wrong.

[geis]

That would be a big fat NOPE.

I would be okay paying for the cancellation if there was a pre-existing policy, but there's absolutely no reason a therapist should be asking for a doctor's note. I mean, there are plenty of times when I'm too ill to get to an appointment but not ill enough to bother going to see my doctor. Even if I go see a doctor, that's really not something my therapist should need proof of. I mean, trust is such a basic component of the therapeutic relationship, and that demand would indicate to me that the therapist didn't believe me. Plus, as others have pointed out, you employ the therapist, not the other way around. It's your right to cancel for whatever reason you want. You shouldn't be asked to justify that.

[SnakeCharmer]

What kind of therapy is this that you're doing? More specifically, are you court-mandated to go to therapy or is it a condition of keeping a job or staying in school or keeping custody of your kids?

If it's any of the the above, or something similar, then you're out of luck because that's how mandated therapy works. In fact, allowing you to get a doctor's note is quite a liberal policy if you're mandated.

But if you're voluntarily seeking therapy, it's downright strange.

I'm exceedingly tolerant of the eccentricities of Ts and medical providers. Very few weird things bother me much or feel unacceptable to me. But that would be unacceptable to me. I have great insurance but I still have a $15 co-pay. I'd have to go sit in an Urgent Care Clinic for 2-3 hours because I can't get in to my regular doctor that quickly. All that just to satisfy the T I wasn't lying. I wouldn't do it. I'd tell them no. And why and ask them what their problem was. (If I was a voluntary client, not a mandated one.)

I don't give reasons if I have to cancel an appointment, unless it's very last minute. So far, I've never been charged, not even for an appointment I spaced and showed up on the wrong day.

I love directive therapy, I've done the type of therapy where the T pushes and it's really helped me, but we agree on that first. I don't like demands and a demand for a doctor's note is an eccentricity I wouldn't tolerate.

I hope you can get this figured out with your T and if not, that you can find another T, one that doesn't put you in such a one-down position. But then again, if you've been mandated, you are in a one-down position. That's the reality. But if you're voluntary, now is a good time to work up the courage to say no.

I wish you the best.

[missbella]

So the authority figure disbelieves her clients minus corroboration from another authority figure? How infantilizing and invalidating. Does she believe anything her clients says, or is every client account untrustworthy and suspect?

I like stopdog's idea. Show up to your appt sick and cough/hack/wipe your hands over everything. OR, get another therapist if she is so disbelieving.

[Xenon]

Originally Posted by Petra5ed

Id have to ask her more about this, my first thought was WTF, you're not in high school?

That was also my first thought. What the hell.

Did she say what would happen otherwise? Would she charge you the session fee? Terminate? What?

[amandalouise]

I have never had a therapist require a doctors note for any of my missed therapy sessions but I do know some therapists that have started adding this to their guidelines amd at the crisis center where I work this is now the rule, also when I went to my last seminar there were many treatment providers considering doing this because of the long waiting lists treatment providers in America now have.

short version is here in the USA we now have a law that says every american must have health insurance that covers the basics of mental physical and dental health. as a result of this law going into affect millions of american's are now able to get the health care they need for their mental problems. the result of this is many is that many mental health agencies are now crammed full and have waiting lists. In order to help all these new clients mental health agencies have to review and set new guidelines for their agency and those that seek help with them. one way to ensure mental health agencies can help all these people is to ensure their therapists are not blocking up their caseload with people who tend to be habitual skippers of sessions.

here at the crisis center where I work we now have a rule saying if you skip more than two appointments due to a health problem then yes a doctors note is needed. that way we know to not place that persons file in the pile of habitual skippers.our clients get notified of this right from their first session so they know from the get go what to expect and if they want to continue to receive services from the crisis center they need to be reliable with their appointments.

granted many people who call saying they have to miss due to illness or doctor appointment may be on the up and up but a huge percentage of the time lost on missed sessions usually if not always turns up to not be an illness, when you think about it how many of us just knew it was going to be a session where we would be working on something we wanted to avoid so we "called in sick" I know I have done it in the past and I know others who have.

this new way of requiring all the clients in an agency to produce a doctors statement is just some agency and treatment providers ways to cut down on the habitual skippers and make room for all those in waiting, without discriminating against any one client...

my suggestion talk with your treatment provider. ask her about this new rule, when it went into affect and whether there are any other new rules you need to be aware of. And maybe ask that if any other new rules come into affect that you be notified, this way you wont get blindsided again like this.

[sunrise]

There are therapists where I work and it is written in the guidelines the patient signs at the outset that if they cancel with less than 24 hrs notice, they either have to pay a cancelation fee OR they can bring a doctor's note and be excused from paying the fee. I have never heard of anyone bringing a doctor's note, though. I guess it is left up to each therapist's discretion. The policy is made by the administration, not the therapists.

[ThisWayOut]

This Canadian doctor wrote a fantastic response to employers who demand medical notes for employee's sick days. | Doctors | Happy Place

I think it's one thing to make someone either bring a note or pay a fee. But demanding a note just for the sake of satisfying their hurt ego? That would be a dealbreaker for me. If I'm lying in bed with the stomach flu, there's no reason to see a doctor as long as I'm not vomiting so much that it causes dehydration.

[StressedMess]

I always preface my call with "boss, I'm doing you and the office a favor by staying home today." Viruses spread like wildfire, we're all touching the same things and breathing the same air, three days from now I'm working alone because the other members of my team caught my virus and stayed home.

And my provider encourages me to skip session if I have a communicable disease, for the same reasons. Imagine every client in the waiting room, and every office employee, and T catching the virus.

This request sounds like bunk to me!

[geis]

^
As someone who's immune-suppressed, I appreciate when sick people stay at home. Insisting people with minor illnesses get a doctor's note puts other people like me in the doctor's office at risk, and what's minor for someone in good health can be life-threatening for someone whose immune system doesn't work properly. Seriously, the last cold I got ended up requiring three doctors' appointments and an ER trip.

[Xenon]

Originally Posted by ThisWayOut

This Canadian doctor wrote a fantastic response to employers who demand medical notes for employee's sick days. | Doctors | Happy Place

That is awesome.

I've seen signs in walk-in clinics saying they charge the patient for doctor's notes for work, etc. I think this guy's right on in charging the employer instead.