What’s your T’s cancelation policy?

I actually don’t disagree with your view of payment to my T for missing a session since I’m canceling for therapy-related issues. I also think you are correct when you say that I want to see how he will handle the situation. What I believe will happen is that he will bill me for it and I will be forced to just blindly accept it or confront him which I’m not sure I can do.

This is exactly what happened. When I first started to see him I didn’t have enough experience with therapy to understand the significance of a 14 day cancelation policy. Now, 13 months later, it feels like an issue.

My T has a 1 business day notice policy, which means that since I see her on Mondays I need to let her know by Friday.

In practice, I've never had to pay for a missed session. I think the policy is in place for people who push the boundary and miss often. She's cut me slack when I've had meetings at work come up that prevent me from leaving, and even one time when I missed a make-up appointment because I thought it was at 1.30 (my usual time) when it was actually at 12.30.

I would have a hard time with a 14 day cancellation policy with no wiggle room. Life doesn't work like that. I understand that they don't get paid if we don't come, and they want us to have some skin in the game... but that's excessive.

My T doesn't have a policy that I'm aware of (but is also psychoanalytic). I have not missed very many sessions over the years, but when I did have to reschedule, he didn't charge me. There may have been 1 time where I had 14 days' notice.

There were about 3 times when I had ambivalence about showing up and ended up cancelling either at the last minute or the day before. I didn't ask him about his policy but paid him for the 2 last minute cancellations. That was so I didn't have to have renumerating thoughts/anxiety about it like you are experiencing now...

I understand wanting to deter cancellations with penalties, but 14 days is ridiculous. The point of a cancellation fee is to make up for lost income, so I think billing 2 different clients for the same session is ridiculous and ethically questionable. I think it would be ok if he didn't use the slot and could do other things such as review notes, read related articles or cases, etc.

I'm curious to know if your T is solidly booked or routinely has availability. I am also curious if he gives you 14 days' notice for cancellations. What if he gets sick without 2 weeks' notice?

It is an old school psychoanalytic tradition to have to pay whether or you show up, but the tradition doesn't involve scheduling another client in your slot. Paying for the slot means you own that day and time. It's part of containment and the frame, which is why I'd be ok with it-but not if someone was put in the slot.

I have a regular appointment time but if I cancel t puts someone else in that time and I'm fine with that

My T doesn’t have a policy. I think if an emergency came up and I needed to change he would. He no showed me last week and I made him give me a free session for wasting my time. I also said in my email to him that if I no showed him or cancelled on short notice I would fully expect to pay him.

I’m assuming he’s fairly solidly booked from what I’ve been able to tell. He has always given me 2-3 months notice for his vacations and has never been sick in the 13 months that I’ve known him. I haven’t discussed his policy with him and it really hasn’t come up as an issue until now. I’ve cancelled my appointment for this week and have given him 60 hours notice so we’ll see what happens with the billing. I still haven’t decided if I should push him a little if he does bill me for missing this week.

Maybe you should discuss this with him regardless. It may feel confrontational, but perhaps you need the experience of confronting him.

My therapist told me sort of reluctantly at our first appointment that he'd have to charge me if I cancelled without 24 hours notice, but it seems kind of comical now as I could never imagine him charging me (or anyone else). Mainly because he's so soft-hearted, but also because he gets sick a lot more often than I do and has had to suddenly cancel on me several times.

I'm not very well read in psychoanalysis, but I feel like maybe that's the point. There's a reason this is more complicated than it needs to be

Funny you should say that. My therapist is a psychiatrist, and I've wondered on occasion if his relatively flexible attitude towards scheduling and cancellations is connected to the fact that he's a doctor, since the kinds of draconian cancellation policies some therapists have would be totally unheard of in other fields of medicine.

He's also a psychoanalyst--so while some do have very traditionally strict scheduling policies, clearly some analysts manage to maintain both their livelihood and the therapeutic frame without charging for every missed appointment.

And I'm sure if I suddenly started canceling appointments he'd be curious about that and bring it up in therapy when relevant.

My understanding based on your recent posts is that you are actually working towards being able to confront him. You seem to have many valid questions about how all this work when you would miss your session or want to reschedule and whether there was double payment when you were rescheduled to a slot that someone else missed.

Why do you think you couldn't confront him? Confrontation is good and it is definitely part of good therapy.

It used to be a strict 24-hours in advance cancellation policy, but, at least for me, day of appointment is okay if I'm sick or there was some kind of emergency during the 24 hours preceding the appointment, which kept me from calling earlier.

Have you spoken to him about this yet?

No, I see him this Wednesday so will likely bring it up then when he gives me the bill for the previous month. I looked once again at his policy which clearly states that you’ll be billed in full for anything less than 14 days notice, so I’m relatively sure he’ll charge me. I can accept that, but I plan to ask a few questions about what he’d do if I called in sick at the last minute and if I cancelled would he give my spot to someone else? He’s given me someone else’s canceled spot before, so was he billing both of us for the same appointment? I’m nervous about being confrontational 😬

I think mine is like 24 hours. Unless it’s an emergency. I know in the past when I had both Medicaid and Medicare I would cancel the same day and I never got charged. I wouldn’t do that now though.