Should I quit therapy if my therapist won´t call me if I suddenly don´t show up?

Today me and my therapist briefly touched the subject on what she does if a client doesn´t show up for a session. It wasn´t a talk about our relationship per se but I talked in general about other therapy experiences I´ve had.


She said something like she would wonder where I was but it was rather obvious she wouldn´t call me. I mentioned another T I had some years ago and that she once called me when I didn´t show. She didn´t comment on that, my current therapist that is.

In a way I feel I perhaps have partly misjugded her for being more caring that she actually is. I know many T:s don´t call or check up on their clients if they don´t show but I think it´s an important thing to do.

I´ve seen this T for ten months and I´ve never cancelled nor did a no show but something could happen to me and then it seems she wouldn´t try to reach me.

Should this be a reason for ending therapy with her?

For me, personally, that wouldn't be a reason for ending therapy. But I think there is often not just one reason. Are there other things that you don't like about this therapist? Are there other ways this T could/does show you that she cares? Everyone has their own deal-breakers. This just wouldn't be mine, personally.

I dont know how things are done in your location but here in america therapists usually do not call their clients if they dont show up. here they treat adults like adults capable of making their own decisions whether they want to schedule appointments, cancel appointments or just dont show up...

that said .........sometimes on rare occasions............ if someone has a history of being on time and attending sessions regularly a therapist will do a "well check" phone call.

A "well check" not like getting deep into conversations. its a check to see if you are running late or something came up but you are doing ok, lets reschedule. and if not doing ok lets schedule sooner than your next appointment phone call.

example I have a history with my present therapist of going to every session on time and if I am late or cant make it I call in before my appointed time.

recently I had to skip a session. I had forgotten I had that session scheduled due to one of my children's schedules. since my history was not missing appointments and calling when I needed to miss, my therapist did a "well check" call to very briefly check in and reschedule. the full phone call took only about 5 minutes.

more and more insurance companies are requiring clients to call with in a 24 hour time slot of their appointments or they will bill the therapist. and a lot of times, not always but a lot, the therapist must pass on this bill for payment to the client. who must some how come up with 100- 150 dollars for skipping a scheduled session without calling in their self to reschedule or cancel.

my suggestion is talk more with your therapist and let them know whether you would like a phone call when you dont show up and possible reasons why you would not show up and what you expect from your therapist should they make that phone call. this way your therapist will understand why this is important to you and that you dont have any plans to manipulate or take advantage of this rarely used option of a phone call. (I say rarely used because sometimes even though a therapists rule is no phone calls they sometimes will make exceptions. under special boundaries/ rules for those calls)

I find not calling quite strange. I'm just a rivate tutor and I would, and have, called my students if they didn't show up.

However for me personally not calling wouldn't be a reason to quit. Maybe you could talk about your concern and explain that you would never miss a session without a notice and that you need her to check on you. I think it's something she would understand.

How are you satisfied with your T overall?

I think, you need to look at this in the context of cultural norms, which, I suspect, might be different in Sweden where you live and here, in the US.

Here, if you don't show up at your scheduled therapy session, you, in most cases, will be charged the full fee for the session. The same will happen if you cancel late. Most therapist, just like medical doctors, have a 24 or 48 hrs cancellation policy. If you don't cancel within this window of time, you'll be paying the full service fee. This is the situation in private practices. In most agencies, people also pay for services out of pocket. There are few places where people can get MH services free of charge. You have to be eligible for that and, oftentimes, those services do not resemble traditional talk therapy.

As you see, in this context, the therapist or the agency they work for would have to contact you after your no show just to retrieve the payment for the missed session, if not for any other reason. So, that's why here it'd be unusual for a therapist not to call a client who didn't show up.

In Sweden, as I've heard, many people can get psychotherapy free of charge because many professionals work for the state agencies, the are salaried employees so they don't do fee-for-service work. I don't know if this is your case or not. I think, if a therapist works for a salary and it makes no difference to them financially whether the client comes or not, then the expectations of appropriate or "normal" professional behavior might be different. I think, some therapists would still choose to call the client ( I personally would) but some wouldn't and that might not be considered an uncaring behavior. This might be perceived as a sign of respect for the client's choice.

So, I don't know what kind of settings your therapist works for and what are the general cultural norms of behavior for therapist in your country vs the US or any other place. By the way, "cultural" norms are not necessarily the same as "ethical" norms. Those two are not interchangeable.

Speaking generally, I don't know if I'd come back to see the therapist who didn't call me to check on me. It depends on many other things that were happening in therapy, so that would not be necessarily my "ultimate test" of the therapist's caring. But that might make me to pause and to reflect on what I need from a therapist. If this doesn't fit into my idea of a caring attitude given the entire context of my therapy, then yeah, I might not go back. But, as others said, this would not be just one single factor for me.

I'd like to know more, from your T, about why she wouldn't contact you, like to see if you were okay. I don't know that termination is the answer, but I would be upset, to say the least. Kramar.

Thanks. No, there are no bigger things I don´t like about her but this "policy" or what one would call it shows in a way she isn´t as caring as I thought.


Yes, she hugs me from time to time, she sits more close to me when I talk about something difficult. But this is the classical question about authenticity vs therapeutic technique.


As she wouldn´t call me in such a situation I get back to the question I often have about how much a T really cares and how much is just a technique. When knowing about the phone calls I want to distance myself from her.

Thanks. Yes, I´m mostly satisfied with her but that´s because I can´t pay for therapy and she offers a kind of combination of "therapy light" and someone to meet with during the week. That is, if I had the money to pay a therapist I might not have continued with her.

If she has a policy around phone calls I wouldn´t want her to act in another way because I asked her to. Then it wouldn´t matter to me. To not call a client who doesn´t show when he or she regularly shows is for me not to be caring.

Thanks. Yes, some therapists do what you describe, they charge for a session if a client doesn´t cancel like 24 hours before. But in my case I don´t pay my therapist and she works within church so she gets her pay anyway.


I think my T sees it that way you describe that it is to respect what the client wants. At the same time it would be rather strange if a client, like me, had attended therapy for many months and did well and then just "disappeared". As a T can´t know I think one shouldn´t hesitate on calling or e-mailing. If the client then doesn´t pick up, then it´s another thing as a T shouldn´t "run after" a client.

I think this wouldn´t be an actual reason for me to leave therapy all in all but I don´t know how to handle it if she really confirms this is her policy. (As I didn´t ask her straight out today). Spontaneously I feel I want to distance myself a bit from her if she doesn´t care if I don´t show up.

Thanks. Yes, I think as someone else said that it might be that way that she thinks it means she respects the client wish to not show up. But there can be so many other reasons to it, like an accident or similar and then it´s just uncaring to ignore the fact that the client didn´t show.


Kramar tillbaka.

Not calling to check up doesn't make her not caring. Some Ts see it as manipulation or testing and they don't want to play along. I also think most Ts assume if something bad happened, you would call or someone else would call for you. I mean, if you got into an accident, you would tell T as soon as possible, right? Plus she wouldn't go see you in the hospital anyways.

I don't think my T would call me, but I know she cares about me. I don't want to test her to find out. But she might call because I've been with her for 3.5 years, have never missed an appointment even when I don't feel like being there, and I'm always early.

Thanks. Interesting point. Yes, that´s right I would call her like next day or next week depending on what happened if there was an accident I mean. I would never expect her to visit hospital or similar though.

I agree to what you say about me calling her if something happened but in another way I find her not calling at all would deviate a lot from how she acts towards me in session. Sometimes she gives me a hug, she has sat close to me when we did a certain exercise including childhood photos and similar. Then why the “no call policy”?

If I didn’t show just to test her, I wouldn´t do that, and she suspected that was the reason then I could more of understand that she wouldn´t call me. But to see it just as “respecting a client’s will” as she seems to is to me rather ignorant. Also she hasn´t told me of this policy from the beginning but I assume she doesn´t know how important or not that specific policy will be to a client.

I am always prompt and cancel in advance when necessary. I don't play games and act out. I am in no way unstable. But recently I got caught in a traffic jam due to an accident ahead of me and was 5-6 minutes late. My T was calling my cell as I walked into the office. I found it annoying because it was treating me as an irresponsible child who need checking up on--and told her so. Would I choose to end therapy because of her singular action? No, so why would the reverse be true?

Maybe the issue is more about finding some inconsistency/inadequacy/reason to walk away.

Thanks. I agree you can see this as a singular action but to me it tells about how/on what level my T cares about me and how she looks upon our relationship.

Even if I and my T holds different positions in the relationship, and it´s partly two different situations, but if I turned up at her office (she has no colleagues who are therapists nor a reception) and she didn´t show I wouldn´t just walk away from there.

I would try at least once to call her, I´ve got her mobile number, and if she then didn´t answer I had waited a few minutes more and then probably tried once more later or tried to contact someone in the same building.

So why couldn´t a T/she do something similar?

As this tells about more than just how one acts in this very situation, I find it very important how a T choses to handle it.

I though agree that it for me is a bit like looking for inconsistency as I feel it´s difficult to on one hand accept a hug from her and at the same time know that she wouldn´t call or bother if I didn´t show anymore. I find that inconsistent and to care in one situation but not in another. Also, many T:s do call their clients in a situation like the one I described so it´s not just me reacting to this.

Calling clients isn't evidence of caring. Many psychological philosophies expressly caution against it. My suspicion is that the Ts who do so, do it not as an expression of caring for the client (unless the client is known to be in a dangerously fragile state and even then I think it's motivated as much by legal concerns), but rather out of insecurity as professionals.

You are the one characterizing it as an indication of caring; you have no way of knowing if she sees it the same way.


Your calling her if she didn't show up isn't equivalent because she has an obligation as a professional to be there at the agreed upon time. You have no such obligation as a client.

It's really a choice only you can make. I can relate as for me, it is important that a therapist try to be there for me and not just in session. Being able to email, for them to reach out if they're concerned, etc. It lets me know that they care for me as a person and don't just see me as another customer that's coming and going.

I would find it odd to not get a call if I didn't show. Even my (formerly blank slate) T would text me if I was late. It's not the same as chasing after a client or checking up on. It's a pretty common thing to do where I live-to call the other party scheduled to meet when they don't show up after some time. I do it just about every day at work as there is most always a key person missing from a meeting and you want to know if they are still coming so you can improvise or plan differently.

Your T never actually said she wouldn't-why don't you straight out ask her? Feeling alone or not cared about can provoke very painful memories if you've distanced yourself from them. It's sounds like you're becoming really attached to her (just my guess).

I actually also feel that not calling to check on a client who didn't show up after you've been seeing them for a while is odd, to say the least.

Why don't you just tell her how you feel about this? See what she says.

I absolutely understand how confusing it is when she cares in one situation but not the other. I'd definitely talk about it with her too see her philosophy.

I don't understand why the T should call when the person decides not to go to therapy session and not to notify? I mean, the client/patient is an adult human being and it is his own personal decision whether he goes to therapy or not and whether he notifies or not. It would be infantilising from the part of the T to start calling and asking why the person did not come.

I mean, when I have a dentist appointment or any other appointment and I cannot go then I obviously notify. Or if I forget then I don't really expect anyone to call me (and dentists and other people normally don't ever do it) and even if they would call then what would it accomplish? The only reason I can think of why they would be calling is that they want me to compensate them for not coming. And I imagine that this could perhaps be the only appropriate reason for a therapist to call too. Otherwise, adult people know themselves where they go and when and whether they notify or not and if they don't notify then for what reasons.

I agree with this and would then ask you to consider why you make assumptions about what other people do as an index of them caring about you? My guess is you have other people in your life for whom you have/had made assumptions that they don't care about you because they do or don't do x, y, z. In my experience raising a teenager, this is an adolescent view of relationships. How many of us when we were teenagers accused our parents, "You don't care about me!" when they refused to do something we wanted.

I think your assumption that your T doesn't care about you because of this is the real issue, not whether you should quit therapy or not. Therapy has just revealed an underlying problem with your view of social relationships.

I agree with those who suggested associating calling a no-show client with caring is not so much more than subjective projection. I personally feel that chasing a client who decided not to go to session is intrusive and it is more respectful not to interfere with that choice, especially if the client pays for the session anyway. I think when Ts call, it's probably more often for them, they want to know whether the client will still come later or needs to reschedule so that the T can adjust their own work schedule. Maybe they do worry sometimes, for example if the client exhibited suicidal thoughts or other harmful behaviors recently, but I doubt this would be the very first thought of a T in general, without reason.

I never no showed in therapy without notifying the T but one of mine was quite bad at administrative things and somehow did not register my advance cancellations three times. He would then call me at the time when the appointment was supposed to happen and it always made me a bit angry. I also did not like when he would call me on the phone out of the blue because he was upset or made completely false assumptions about me.

For me, if anything else, a sign of caring is when someone seems engaged and interested in our interactions when they happen but respect my choices when I don't want to do it and won't intrude. It is indeed interesting to think where these subjective interpretations come from. For me, very definitely at least in part having an overly anxious, often intrusive mother, who did not easily understand/accept my wanting privacy when I needed it and the only way to deal with her was boldly rejecting and avoiding her. If someone often had the opposite experience, not getting enough attention when wanted, it's no surprise that they associate it with lack of caring. But in reality, it can be caused by a lot more different things, including actually respecting the other person's privacy.

Thanks. I agree it´s not objectively a sign of caring but for me it goes hand in hand with her for example offering me a hug from time to time. I´ve asked around in another forum where therapists can be asked questions and there many of them said they would call their client if he/she was longterm and suddenly didn´t show.

I agree I have no proffessional obligation to be present at sessions but there´s an informal obligation as if I keep not showing, therapy would end.

Thanks. Yes, it can be many reasons for a therapist to call, I read that in the US therapists often call mostly because of finacial or insurance matters even if some also call just out of care of course.

Yes, I´m planning to say that I nearly cancelled our upcoming session because I feel hurt by, as it seems, she won´t call or try to reach me if I suddenly didn´t show.

I´m attached but at the same time very wary of what her actions actually mean and how much is just technique and what´s genuine caring and interest.

Thanks. Yes, I find it to be a strange way of handling this as she´s warm and caring in other situations. I´m planning to say as it is that I nearly cancelled our upcoming session because I feel hurt by the fact, as it seems, she won´t call or try to reach me if I suddenly didn´t show.


She rather often says it´s ok for me to be angry with her but I´ve noticed the gets irritated if I bring something up that happened during another session. She wants me to express things immediately which of course has advantages but often I don´t feel that strongly what went wrong until afterwards.