[Ldaniels]

I have been seeing my therapist for 3 years and it is the first time I feel like I have actually gotten somewhere with therapy. I knew I had depression, but we also discovered that I have ADD, anxiety, and PTSD. This is the only office within an hour drive that offers EMDR and it has helped me a lot. Both of my kids saw therapists in the office to deal with the death of their father (one recently stopped going due to resistance to therapy and we discharged amicably). My husband started going a few months ago and it has been really good for him.

In January they changed their no show policy. I was stupid and did not read it thoroughly. They have always charged a $100 no show fee. I have always paid it when we haven't shown up (sometimes due to my forgetfulness caused by ADD and anxiety and sometimes because I can't bring myself to leave the house or pick up the phone to call). The new policy states that individuals will be terminated after 2 no shows and families with a total of 3 will be terminated. I had 2 for me and 2 for my daughter. My husband has never had even one. And, like I said, we have paid the fee every time. I never got a warning letter because my therapist said she knew it would upset me. Last week I was told that office policy mandates that we are all terminated and we get 4 more sessions to help us through the transition.

One of my major issues is guilt. It will throw me into a tailspin of depression so I am struggling right now because I caused this to happen to the rest of my family. I haven't left the house in 4 days and have been unable to concentrate on anything because I just keep trying to figure out how to fix it. I started thinking about taking a handful of meds the night it happened, which I haven't thought about in years. And now I feel like I can't call the office if it gets worse because it will seem like I am trying to make them feel bad for this.

I know my husband will not go to another therapist again. I don't know if I will find one that will work and I know I can't find one close by to do EMDR (and we were about to start another round).
I can't stop obsessing and I don't know what to do.

[LonesomeTonight]

I'm sorry. I wonder if you could at least ask if your husband could possibly keep going, because he never missed a session? The rule for families doesn't seem fair.

[atisketatasket]

Exactly how does your therapist think a warning letter shouldn't be sent because it would upset you, when presumably termination would upset you more?

If it is standard policy for them to send warning letters and they did not in your case, that is a good basis for an argument they should give you another chance.

[Lemoncake]

I'm sorry you're going through this right now.

But I would also query up about not being sent the letter and if that would make a difference?

[Pennster]

This seems a very strange policy. It seems very unwise to terminate all family members based on the actions of only some of its members, for a start. And that's just bizarre that every member of the family wasn't given a warning letter to alert you that your therapy was at risk.

I would not want to work with an agency like this at all - they seem weirdly punitive and controlling. But I can understand the tough spot you are in- I would definitely appeal to your therapist and also have your husband talk to his about the ways the organization failed in its implementation of this policy, and the overall unfairness of it.

[ElectricManatee]

It seems like you don't have much to lose by asking. I do think it's okay to politely push back a little. I don't think you would be making them feel bad by saying that you're upset about what happened and really don't want to be terminated. (Plus it's kind of a harsh policy, so maybe they should feel bad about how it hurts people.) Obviously this is causing you a lot of distress, and I don't think that's the purpose of the policy. I wonder if you could try to explain why you have difficulty canceling when you need to and ask whether there is a different procedure you can use going forward (email or text instead of phone, etc.)

I'm also confused about the two no-show thing. Is that ever? Like if you're in therapy for six weeks or three years, you're out after your second no-show either way? It seems like a little forgiveness or flexibility is called for here...

[BudFox]

One of the hazards of mixing emotional needs with business needs.

Why can't they just charge the no-show fee and allow the therapy to continue? Are they sociopaths who rule with an iron fist?

[Myrto]

Their no show policy is just insane. If you don't show, then it's perfectly normal to pay for the missed session but being terminated?? Who ARE these people? I'm sorry you're hurting so much but really these people shouldn't be working with vulnerable people if they're going to terminate after two no-shows.

Isn't it discrimination to terminate one client because stuff (in this case: no-showing) a family member did?

[Ldaniels]

Originally Posted by LonesomeTonight

I'm sorry. I wonder if you could at least ask if your husband could possibly keep going, because he never missed a session? The rule for families doesn't seem fair.

I completely agree and I tried to argue that, but to no avail. He has an appointment tomorrow and is going to try to get them to see reason. I didn't even get a warning letter, which is also in the policy.

[Ldaniels]

Originally Posted by atisketatasket

Exactly how does your therapist think a warning letter shouldn't be sent because it would upset you, when presumably termination would upset you more?

If it is standard policy for them to send warning letters and they did not in your case, that is a good basis for an argument they should give you another chance.

My husband is going to bring that up tomorrow. It got to the point where I was crying so hard I couldn't think straight and I sounded more like I was just trying to bargain my way out of something. It was really traumatic. And I REALLY like my therapist so I don't want to be petty or make things weird if they do change their mind.

[Ldaniels]

Originally Posted by Pennster

This seems a very strange policy. It seems very unwise to terminate all family members based on the actions of only some of its members, for a start. And that's just bizarre that every member of the family wasn't given a warning letter to alert you that your therapy was at risk.

I would not want to work with an agency like this at all - they seem weirdly punitive and controlling. But I can understand the tough spot you are in- I would definitely appeal to your therapist and also have your husband talk to his about the ways the organization failed in its implementation of this policy, and the overall unfairness of it.

My therapist and my husband's own the practice and have always been very lenient about things. This year they brought on 3 new counselors and I think they made some complaints to the office manager who proposed this new policy. Even if I don't get to go back I have strongly urged them to consider changing this with a mind to how ethical it is. I seems like it is based on how regular doctors work.

[Ldaniels]

Originally Posted by ElectricManatee

It seems like you don't have much to lose by asking. I do think it's okay to politely push back a little. I don't think you would be making them feel bad by saying that you're upset about what happened and really don't want to be terminated. (Plus it's kind of a harsh policy, so maybe they should feel bad about how it hurts people.) Obviously this is causing you a lot of distress, and I don't think that's the purpose of the policy. I wonder if you could try to explain why you have difficulty canceling when you need to and ask whether there is a different procedure you can use going forward (email or text instead of phone, etc.)

I'm also confused about the two no-show thing. Is that ever? Like if you're in therapy for six weeks or three years, you're out after your second no-show either way? It seems like a little forgiveness or flexibility is called for here...

During the session I kept asking lots of questions about the policy in a way to really express why it doesn't work without it sounding like I was just mad that it happened to me. I also emailed her later with more of an explanation because I hadn't been able to for that at the time. I never told her why they happened. I am really embarrassed that I get so overwhelmed or forgetful. I will talk to her about everything, but never brought that up. That was my bad, but maybe now that I have told her she will work something out with me.

Oh, and apparently the no show policy is forever. They have only counted them since this January since that is when they started the policy, but I had 5 others from before that - though that was over a 2 year period.
I also mentioned that to her. And 3 for family! They have families that come there and all see a different therapist. If a family all had appointments at the same time and forgot only one time then they would all be gone.

[Ldaniels]

Originally Posted by BudFox

One of the hazards of mixing emotional needs with business needs.

Why can't they just charge the no-show fee and allow the therapy to continue? Are they sociopaths who rule with an iron fist?

They have been so accommodating in the past. I think that might be why this major change. Their office manager decided to put her foot down

[Ldaniels]

Originally Posted by Myrto

Their no show policy is just insane. If you don't show, then it's perfectly normal to pay for the missed session but being terminated?? Who ARE these people? I'm sorry you're hurting so much but really these people shouldn't be working with vulnerable people if they're going to terminate after two no-shows.

If I hadn't gone there so long and gotten to know my therapist so well I would think the same thing and I probably would be happy to be rid of them after this, but it has been even more emotionally distressing because it is not like them at all. It was really shocking! I feel like they hadn't thought through how this might affect their patients.
I also feel like her hands were tied at that moment. She and her husband own the practice and if she starts making exceptions for her patients then her other counselors will get pissed. I honestly think this came down to my daughter's therapist. She started seeing him last summer because her therapist moved and I the last 2 no shows were for her so I think he threw a fit.

[Ldaniels]

Originally Posted by Breadfish

Isn't it discrimination to terminate one client because stuff (in this case: no-showing) a family member did?

That's how I feel, and I haven't seen anywhere online where another office does this

[Ldaniels]

Thanks to everyone for the support. My husband is going there tomorrow to talk with them. I had an appointment, but canceled it. I have 4 more they are letting me use, but I am not ready yet. I still haven't left the house (it happened Thursday morning).

[Pennster]

This policy seems really irresponsible. It's making me angry on your behalf! And I can't get over how a consistent client can get axed because of their family members. What a way to treat struggling people.

These people really don't deserve to have any clients at all. But I get what it's like if you have been working with someone for awhile. I think you shouldn't hold back on telling your therapist about the effect of this on you- she needs to hear it. And that she didn't even give you a warning- it's galling.

[scorpiosis37]

The idea of a family policy is ridiculous-- to punish someone who never missed an appointment because a family member missed theirs. That's unethical. I do, however, understand a policy that says after missing X sessions, over Y period of time, you will be terminated. Most therapists are over booked and have waiting lists, so I can understand them wanting to give that time to a client who would show up and use those services. That said, a two absence policy-- forever-- seems ridiculous. I could understand 2 no shows per year, per person. But the policy should be sensible; your T'e policy seems overly harsh.

[childofchaos831]

I really hate that this is happening to you and your family. I hope something can be worked out.

I've had Ts in the past, with important papers or policy stuff, explain it verbally, before I sign. Not because they don't think I can understand it, but because they want to be sure that every person is aware. They explain it with everyone. A lot of places do this, too, ERs, doctors before procedures, etc. I would think if they are going to make such a big change, they would want people to understand. And not sending the warning is absurd. Yes, it may have been upsetting to get the warning, but compared to this?

Also, and this is a personal opinion and peeve of mine... Yes, Ts need to make money. That is their job. But that is what the no show fee is for. Or even a fee for not cancelling in time. They still get paid, so what is the point of terminating vulnerable people, when they pay the fee anyhow? If a person chooses to go into therapy as their profession, then they should understand that there are many reasons why some people can't always come in or pick up the phone. Anxiety, depression, fear, shame, anything. So instead, they decide to traumatize people more, by giving up on them in their weakest moments? It makes no sense to me, and if trhe business means that much to the office manager (or other couselors) then perhaps they should get out of the mental health field all together. They are only going to damage someone's psyche beyond repair at some point. So many people go to therapy for abandonment or trust issues... how would this situation feel to them? I would be completely discouraged and give up completely. It would only serve to reinforce that nobody cares.

[Ldaniels]

UPDATE:
My husband saw his therapist today and convinced him to rethink this policy.
He (the T) did not like this policy personally, but they needed something so they hired a consultant to implement this.
He says that he is not going to violate the policy for us or get rid of it, but they are going to have a meeting about how to adjust it so that it is fair and also does not create even more emotional distress.
The possible solution will be to allow people to write a letter detailing why they believe they kept missing appointments and what they will do to ensure it does not continue. That way it is therapeutic for the patient and also can contribute to the actual goal of this policy.
I see my therapist next week and we will see what ends up happening.

[atisketatasket]

A reflective letter? It's like writing, "I will not talk in class" 100 times on the blackboard.

The only thing they have to fix is a) not punish people who haven't violated the policy and b) make it less draconian, like no more than two no-shows every x months.

[ruh roh]

I have mixed feelings about this. On the one hand, this policy doesn't leave any room for unusual circumstances. On the other hand, if it's a pattern--even if it's the whole family--it hinders their ability to run a business. I think my therapist said once that she will let people go after three no shows.

I think it's totally not okay for you to not have gotten a notice or warning about this. But I wonder, if you had gotten a notice and it prevented a no show, then does that mean the no shows are preventable?

There should be some way for them to rethink the policy, like maybe offering to put habitual no show people on a cancellation/waiting list to get back on the books, rather than forcing termination. It just seems that compromise on both sides makes sense (if it's a pattern, even as a family).

[Pennster]

I think the family part is the strangest part of it. Some families are more functional than others, obviously. What if one member of the family chooses to sabotage other members of the family by racking up all the no-shows? And is a family of two treated the same as, say, a family of four or five? It's hard to see how a person who consistently attends their session can be a threat to the business simply because they are related to someone who frequently skips.

And aren't there some people who have no-shows as part of their whole progress through therapy? The rigidity of this policy doesn't really speak well of the psychological flexibility of the people instituting it - it feels pretty unhealthy to me. At least they are considering some changes. I am glad your husband was able to discuss it with his therapist.

[unaluna]

A consultant?! That explains the douchebag move! Who did they hire, the Mooch?! Badda-bing, you're out! O. M. G.