What’s your T’s cancelation policy?

Yep, although this has happened very rarely in reality. Strangely, after I started therapy I started to become sick much less frequently than before. In fact, I have never missed a session due to sickness. I have been sick only one week during these years and then we had phone sessions.

The only reason I have missed is due to work related travelling and yes, then I have payed for missed sessions. However, now when my T is using skype there's much less need to miss because in most cases we can find a way to do skype session instead.

My therapist clinic has cancel policy of 24hr's. I have cancelled a few hours before had due to icy roads and never got in trouble for not phoning in the 24hr limit. I think the clinic is very relax unless you cancel all the time

Wow, 14 days is extreme. I have never heard of such a thing for any professional appointment. My t has a 24 hour cancellation policy. Emergencies and illnesses aside.

Ok I think my therapist must have based his cancelation policy somewhat on this which I understand is a fairly typical policy for psychoanalysis while deciding not to go all the way. The 14 day cancelation thing seems strict, but I suppose not as strict as your T. I no-showed once about a year ago and he did bill me for it. Another time I was deposed in a legal case but gave 14 day notice and he did not bill me, but said he thought about me during our normal session time.

My new T has a 48 hour policy, but he was almost apologetic when he explained that to me because 24 tends to be the norm around here.

I personally don't even understand how a professional can put up "rules" about 1-2 weeks in advance cancellation policy or no cancellation at all for single meetings. To me, that sounds very weird and selfish and I don't think I would see someone like that because I just feel it is morally wrong. There can always be unexpected emergencies, illness, etc. And I don't think it's fair to expect someone to at least engage in phone or Skype session if they cannot or does not want to make it in person. I've never heard this type of cancellation policies in any other professional appointment contexts and I don't think therapy is so special to justify it. Maybe if a client, who has a standing appointment, cancels a lot, it would be a good idea to discuss why that happens and find a more mutually agreeable solution. But expecting someone to never have emergencies or unforeseen appointment conflicts? I personally would tell them to take a hike. Just my opinion.

My first T had a 24 hours policy - I canceled last min several times and always paid without any objection. It was never something we discussed other than knowing the 24-hour thing. 2nd did not make strong rules but I kinda expected he would change for less than 24 hours notice. I did that only once with him, he did not charge for it and offered another appointment later in the week, which I took. I think a 24-hour policy in general is fine but if it was me, I would allow occasional last minute cancellation if it was not a pattern/habit.

Wow, 14 days seems really extreme! My T's policy is 24 hours, but recently, when I had a migraine and contacted him about it the morning of the session, he said I could switch to a later slot that day (which I did) or to an opening he had the next day without a charge. I'm not sure if he would have charged me if I hadn't taken either of those times.


With ex-T and ex-MC, it was technically 24 hours, but I think both let me miss once for illness (or maybe D's illness?) but didn't charge me. I think it's a case where, because I generally am reliable and let them know even if I'll be 5 minutes late, that they may be more willing to give me a pass once in a while for illness or other last-minute thing.

The two I just finished with each had 24 hour policies. The nature of my private attorney work is such that I have things come up quickly. I would never be able to make a longer notice period work nor would I want to do so. I would not subscribe to the paying the therapist a salary notion.

I’ve been consistent with attendance over the past 13 months and my issue is that I’d like to take this Wednesday off (giving 72 hours notice ). I’m not sick, but I would just like a bit of time to process things a bit more. It seems reasonable to me that I should not have to pay with this much notice, but if I bring it up, it might seem confrontational. His policies which he handed out when we first met clearly state a 14 day cancelation policy. It hasn’t been an issue before, but it’s bothering me in this instance.

They are two separate issues, your desire for time off session to process, and payment for a session. You can proceed with things dealing with both at the same time or separately. You can give notice today and say "I'm canceling this upcoming sessions for reasons I will explain at session on ____ . " You can then address the policy directly in person at your session, or you can wait until he bills you for it, if he does. If he does, you can ask to discuss it. But, ultimately, you can decide whether you will pay for it or not. Personally I think it would be worth paying for a session if that is what will be best for you (canceling). If you go just because you have to pay for it then you're not taking care of yourself and valuing your own needs. If therapy is worth paying for, then it's worth paying to not go to session, if that's what is best for you..

Sometimes you can play chicken with someone and their own policies, as in put them in a position to defend it and request that you follow the contract. Personally I think this is a contract that too heavily favors the therapist. I'd like to see what happens if you just cancel and let him raise the contractual issue of payment.

I think your reasoning is sound. Would you be comfortable broaching the subject based on what you feel would be helpful for you rather than as a challenge to the policy? Basing it in your own thoughts about your treatment might feel a little less confrontational. Plus, I think any t worth their salt would be encouraging of self-advocacy (even if they're not willing to change the policy).

The original question...I don't even know if my t has a cancellation policy.

I'm curious- Surely your t has got some kind of illness exception?
My massage therapist just changed the 48-hour cancellation policy to state very clearly that illness is an exception and please don't bring us your germs. People were showing up quite ill to avoid paying for a missed appointment.

I never had a therapist with such crazy cancellation policy and I would never have a therapist with such policy.

I am sorry if my opinion sounds radical, but this kind of policy, in and of itself, is an abuse of power. With this policy the therapist immediately puts himself in an extremely authoritarian position on top of the natural power imbalance that already exists in the therapy relationship.

I'd seriously question the therapist's character, if they have such an outrageous, draconian policy.

all of my T's have had a 24 hour cancellation policy. i also know that if an emergency happened or i suddenly got sick, my T wouldn't charge me.

This certainly is not an issue of an emergency or anything like that. Rather, it really seems part of the therapy progress and thus it at least according to my view seems completely fair that you would pay for that session, regardless of whether you decide to go or not.

However, I also think it would make perfect sense to raise this issue with the T and pressure him a bit to see how he handles the situation. Because my guess is that's what you really want - to see how he would handle it. I doubt you would be happy if he would say that you're cancelling would be totally fine because he would just see someone else (a potentially new client) at your dedicated time slot.

I had group therapy one time where we weren't allowed to cancel at all even if we were sick or had an emergency. We were still expected to pay. However, it was only $25 a session.

With individual therapists, I've never really known their cancellation policies. I don't think I have ever been charged for canceling.

Most doctors require 24 hours notice for canceling although if they cancel nothing happens to them. My pdoc was sick the day of my last appointment and canceled the day of. I was able to see her later that week, but I know if I had been sick I would have had to pay.

I have no idea. She never mentioned a policy. If one of us needs to cancel, we just let each other know as soon as possible and then we either reschedule for another day/time that week or we skip it and pick up the following week. It’s simple and it works well.

Would you elaborate more on how a policy like that is part of therapy and how it is fair not being able to skip a session, whether it is due to emergency/sickness or just wanting a break? I can't come up with an explanation, no matter how I try to think about it, other than inappropriate reasons for the T to demand a "salary" from a client, like stopdog said. I understand the value of learning/improving discipline very well, but this is a very inappropriate way of doing that , IMO, way too far and unrealistic. I can't think of any decent occupation, engagement, school, job, whatever, that would demand this on an ongoing, long-term manner, unless it is some destructive system, dictatorship or other abuse of power. How can that be therapeutic? People can exercise and talk about discipline and responsibility without being forced into dictatorship and submission.

I see it differently. The OP wants to skip the session because of things that have come up in therapy. Not because they would have duties at school or work, or health related emergency. Yes, they want a break, for reasons related to therapy and that's why this is part of therapy. They can skip the session, no one denies that, but the session must be payed for.

It is not dictatorship or abuse of power. The OP has any time the power to decide that they are not fine with this kind of agreement and choose another therapist who has a different policy.

Also, as it has been mentioned several times, this is quite common policy among psychoanalytic therapists. The patient is given a time slot and they don't ever have to worry that someone else is ever scheduled to that time slot. But that means that if the person is not coming then the therapist really has no opportunity to do anything else and thus it seems rather logical to pay for the time anyway.

Of course, one option would be to just make the fees higher to account in for possible cancellations. However, my understanding is that many psychoanalytic therapists work with a sliding scale to make long term regular therapy affordable to people. For instance, my session fee is not a list fee but is a result of the negotiations between me and T and it is such that it was affordable to me and still acceptable to T. If I would insist that I want the opportunity to cancel then probably that would mean that the general fee has to rise.

14 days? Wow. That's a long time. A lot can happen in between. What if you get sick a week to go and need to reschedule? Sounds perfectly reasonable. Would you still be charged?

I have a boring 24 hour or you get charged the full fee in cash deal. I've gotten hit with it once or twice and it hurt, lol

It's like that with my psychiatrist — very easy going — but not my therapist. I remember I had to read some paperwork on cancelations and rescheduling. Don't remember if I had to sign anything, but probably.

I would think that canceling/missing a session are different things than rescheduling? So that if you are sick on Monday and manage to reschedule to Thursday then that is not cancelling to my mind, or what?

24 hours for non-emergencies. I try to give as much notice when cancelling. My T doesn't get paid if she doesn't see a client so I want to give her time to find someone to fill the spot if she can.

I know that OP has been considering not showing up etc due to stuff related to therapy, but that's a different question from the validity of general professional policies.

Okay, I personally still cannot and would never accept that sort of style and policy for any reason. It is true though that if they make it known from start, it is up to the client to choose whether to work with that T or not. But don't think it is that simple - one might think it would be okay start, not thinking too much of it, but experiencing not being able to skip an appointment without paying can bring the harshness of that policy more upfront. I am aware that I am reacting to this topic strongly because I cringe at authority exercised in this way. Or others controlling my time in a persistent manner. I've never even had a job like that and would not. And on a job, I am paid a salary, not the other way around. Anyhow, I certainly won't change my opinion on this although I think it is very convenient for a T if they can pull it off and clients are willing to do it.

It must be a psychoanalysis thing because even reading that — the "you thought of me during our hour" — struck me as weird. Quite weird. I guess with my therapist, I'd just assume he'd get caught up on paperwork or dictation or something. Or maybe get an extra pee break and grab a coffee or read a book. Haha.

The odd thing is that I can think of 2 times when my T saw me on a different day than scheduled due to a scheduling conflict on my part and both times he mentioned that he was able to fit me in because he just had a cancellation. That means he gave me someone else’s spot and presumably we were both paying for that spot, me because I was seeing T during that time slot, and other client because they had clearly not cancelled within 14 days. So, that doesn’t make a whole lot of sense. I should probably just have this conversation with my T, but as I said, it feels sort of confrontational.