[Gazelle98]

So I have been seeing my t for over 2 years. I arrive on time, pay in time, cancel in time if I have a work issue or am going on vacation, I never contact her between sessions. Her policy is 48 hours cancellation or she charges the full fee. Recently I was ill and had to cancel (within 48 hours but more than 24 hours notice) and she charged me for the missed appointment. Now on one hand she is entitled to do that, it is her policy etc. and I get that. But a part of me feels annoyed and disappointed with her – I feel like she could have cut me some slack as this is the first time this has happened and I am very reliable. Should I discuss this with her? I don’t know whether I should suck it up and not say anything because I’m being irrational and over-reacting or if it’s worth talking about. Thoughts please?

I think you are being irrational and I think you are over reacting, and this is why this is a perfect topic to discuss in therapy.

[awkwardlyyours]

I don’t think you’re being irrational or over-reacting.

In your place, I may still be okay with being charged (the money as such wouldn’t bother me) but after seeing a T for two years with the sort of perfect record that you’ve mentioned having, it would really bother me if she did it without talking to me first....in a lot of depth.

I broke up with my hair stylist for similar reasons — I expect far more from my therapist!

ETA: Sorry, I missed the part where you said you cancelled because you were sick (thought it was just a random cancellation). Then it’s really not okay that she did that.

I think it was unreasonable to charge you, especially considering you don't have a habit of cancelling at the last minute. You've already fell on hard times when you got sick, no need to penalize you.

Some will not agree, but I just wrote on another thread that I see it as unreasonable. Much like how a cop has the right to pull you over and ticket you for going 5 MPH over the speed limit, but they'd be an *** hole if they pulled everyone over every time. We've all gotten a break here and there, and it seems like the humane thing to do. The world is a better place.

Yes, you should discuss with your T for the mere fact that your reaction is bothering you. She may have not realized she was being over the top. Or she may reinforce the concept that no one should get a break, if that is her belief. You just take that chance.

Otherwise, it can become an elephant in the room, which can turn into resentment.

[ruh roh]

I don't think you're overreacting. I would find it hard to have a discussion about it though, and would probably resolve to show up when sick and cough without covering mouth, blow and wipe my nose a lot, and possibly vomit during session.

[LonesomeTonight]

I also don't think you're overreacting. I know my ex-T and current marriage counselor technically have cancellation policies where they can charge for last-minute cancellations, but for the few times I/we've had to cancel, for our own or our daughter's illness, they haven't charged. And once, I was in the waiting room for ex-T, and one of MC's clients showed up--apparently half of a marriage counseling pair. She said her H wasn't coming because he was in the ER with bad back pain. MC was like, "Get out of here, go be with him." And she said she felt bad because they'd missed another appointment and thought he might charge them, and MC said, "I wouldn't charge you for this!"

I would definitely bring it up though. My current T also has a policy for charging for e-mails/texts/calls that take over a certain amount of time. I had thought he'd said occasional longer e-mails are free/that he'd warn me before charging. But then he charged me for one. I told him I was upset and about how I'd understood what he'd said. He chalked it up to a misunderstanding and removed the charge from my account. Had I not brought it up to him, I probably would have stayed annoyed for a while, which would have negatively affected the therapy. It was a good way to find out, early on, how he handles disagreements with clients.

Out of curiosity, is your T a part of a practice, where you're billed by an administrator/receptionist? If so, it's also possible that it's automatic to bill clients for late cancellations, and she may not have even been aware they were charging you. Either way, definitely talk about it.

Originally Posted by long_gone

I think you are being irrational and I think you are over reacting, and this is why this is a perfect topic to discuss in therapy.

To expand on what I said here since it is out of step with what others have said...

The terms of the therapy contract are a way of maintaining boundaries. The contract doesn't say '48 hours notice unless you usually attend and we have been working together for an extended period of time'. You have agreed to the terms and she has kept to the contract.

It seems to me that you have had a negative reaction against the boundary being enforced. That emotional response is understandable, but it is also unreasonable of you to expect extraordinary treatment. I would be reassured that she hasn't allowed exceptional circumstances for you. She appears to have been consistent and professional and I would really value that.

Sorry you were sick and I hope you feel better now!

[stopdog]

I would interview some new ones to see what their position on such a thing was. I think it's really putting form over substance on the part of the therapist. I probably wouldn't pay it

The terms of the therapy contract are a way of maintaining boundaries. The contract doesn't say '48 hours notice unless you usually attend and we have been working together for an extended period of time'. You have agreed to the terms and she has kept to the contract.

Not all therapists seem to have the intention of imposing a penalty on people through these policies. Some may use a cancellation policy as a general guide to deter cancellations, then only bill people who abuse it.

I noticed that people often interchange acting like an *** hole and imposing a boundary (not here in particular, but anywhere). Someone gets in a car accident on the way to therapy and gets a bill in the mail for no-showing, or someone can't make it to session because a loved one died..then gets a bill in the mail. That would be incredibly callous, which is much different than upholding some kind of healthy boundary. This behavior can be very harmful to someone; anyone.

Healthy boundaries are often flexible, not rigid and unforgiving.

[SummerTime12]

I think it’s totally reasonable for you to feel upset. On the one hand, that’s the therapist’s policy, so I guess they have a right to charge for it. On the other hand, I think human decency would cause many professionals to throw out the fee since you’ve been so reliable and you obviously can’t control getting sick. I’ve had to cancel the day of an appointment because I woke up sick that morning, and my t never charged me his cancellation fee even though he could have since it was less than 24 hours (his policy). That happened another time with a previous t and she did not charge either. Sometimes you just wake up sick and there’s nothing you can do about it. I think only if it becomes a habit, then the t should charge because maybe the client is not actually sick then..

[stopdog]

Or next time could just go in and throw up or cough all over her office-I would be very tempted to do so

[eye2797]

maybe just oversight on T, talk to them about it. Mine does not charge for late cancel if medical. I am the same with mine been working with her for over 2 years and always cancel on time.

[Teddy Bear]

You were sick but the T still had the right to charge you. Just pay it and hope you don't get sick on therapy days

[AllHeart]

I understand this is the policy, but, I think there should always be exceptions to made-up policies. I don't blame you for being disappointed. I'd be curious to know what your t does when she wakes up sick. Does she cancel appointments with clients with less notice than 48 hours?

[WarmFuzzySocks]

It's a good idea to talk to her about it. There was no way you could have predicted your illness before the 48 hour window.

Surely your therapist doesn't want you attending a session and sharing your illness, which means she could potentially miss several client sessions.

[Out There]

I would be a bit upset about this too. I could understand if it was used to make a point if cancelling was a habit but if a client is otherwise reliable it seems off. Things aren't always under our control. I agree healthy boundaries are flexible not rigid.

[SoConfused623]

One day I woke up and barely had a voice as laryngitis was setting in but I didn't want to cancel my therapy session later that day so I went anyway. By the time I got there, I had NO Voice at all and she couldn't believe that I had come to Therapy. I told her that I came because I did not want to have to pay her cancellation feei but she said that she would never have charged me in that circumstance.

I have a new T now and am very curious about how she would be if I had to cancel last minute for a really good reason...

[growlycat]

Did your t know why you cancelled? Maybe if you explain that you were unexpectedly ill she may cut you some slack. I think it is reasonable to discuss your concern with her.

My t has a 24 hr cancellation policy but if I were genuinely ill and let him know as reasonably soon as I could I don’t think he would charge me. Like you, I show up, rarely cancel and pay on time. Some clients may cancel as a way of acting out but you are not that client.

[winterblues17]

I have a 48hr cancellation policy, If I got sick with less than that to go I would just assume I would have to pay because it's their living. Although I may ask if they was any free openings later in the week and if there was any chance we could postpone/rearrange it, but yes I would expect to pay. Just like if I am sick at work, my company still have to pay me even though I haven't gone in.

[stopdog]

A therapist is not a salaried employee of the client. What is the situation if the therapist gets sick and cancels less than 48 hours?

[Elio]

I would bring it up. I brought up a billing item once with my T and she was unaware that her billing service processed it that way. I was ok with how it was processed and it made it easier for me to request something from her because I knew she could get paid for it.

[snowangel17]

Originally Posted by Gazelle98

So I have been seeing my t for over 2 years. I arrive on time, pay in time, cancel in time if I have a work issue or am going on vacation, I never contact her between sessions. Her policy is 48 hours cancellation or she charges the full fee. Recently I was ill and had to cancel (within 48 hours but more than 24 hours notice) and she charged me for the missed appointment. Now on one hand she is entitled to do that, it is her policy etc. and I get that. But a part of me feels annoyed and disappointed with her – I feel like she could have cut me some slack as this is the first time this has happened and I am very reliable. Should I discuss this with her? I don’t know whether I should suck it up and not say anything because I’m being irrational and over-reacting or if it’s worth talking about. Thoughts please?

I don't think you are being irrational or overreacting at all. I get that you have entered into a contract with your t and that contract states 48 hours notice is required. As someone else said though the decent human thing would be to give one free pass especially since the reason was legit, have been with her for so long and have never caused any issues before.

It will be difficult to talk about but I would bring it up in session. It hasn't happened me yet but I know that it may some day and I would react very similarly.

[LonesomeTonight]

Originally Posted by winterblues17

I have a 48hr cancellation policy, If I got sick with less than that to go I would just assume I would have to pay because it's their living. Although I may ask if they was any free openings later in the week and if there was any chance we could postpone/rearrange it, but yes I would expect to pay. Just like if I am sick at work, my company still have to pay me even though I haven't gone in.

Actually, it depends on the job. If someone is salaried and uses a sick day, then yes, they'd still get paid. But in many cases (at least in the US), if someone is an hourly employee and doesn't have a sick day to use, then they wouldn't get paid for that day.

I figure that T's (in private practice at least) set their rates with the assumption that they'll end up with some empty session slots in any given week, either due to cancellations/no-shows or just not having a full caseload.

[Wonderfalls]

I think she's being ridiculously cold-hearted and rigid about this. The cancellation rule should be in place just in case she's stuck with a client who does that regularly or doesn't show up at all. I only hope it's a routine bill sent automatically by clerical staff.

I would worry about her flexibility and even empathy as a good therapist going forward.

[Favorite Jeans]

People seem to be falling into two main camps: "she has a right to charge you" and "it's unkind to charge for circumstances beyond your control."

Both are true. Of course she reserves the right to charge you, but it seems like a total lack of compassion to do so. And the whole "but being rigid and consistent constitutes good boundaries" argument? No. I don't think so. If you rely so heavily on rigid and consistent rules cause you think that showing a bit of humanness is violating some big boundary, you probably aren't therapist material.

Talk to your T about it. If it was her oversight or you were charged by office staff, it'll be good to clear it up. If she really is that rigid and your having been sick makes no difference to her, well, that's a sad and painful thing to learn (or would be for me) but is still useful information going forward.