⚖️Missed session- business or therapeutic issue?

Consider this scenario: you have a clear policy in place that missed sessions without notice will be charged. This policy is communicated to the client at the start, both verbally and in writing.

Now, the client misses a session. What do you do?

Do you enforce the policy? What thoughts or feelings arise for you in that moment? Are you worried about the financial impact?

Many therapists I’ve spoken to describe experiencing guilt and grappling with the dilemma of balancing empathy for their clients with the need to protect their own financial well-being.

To implement or not to implement— is this purely a financial/business decision, or is it a therapeutic one as well?

It is both.

The policy and its communication at the outset form a mutual agreement between therapist and client. Whether the therapist chooses to enforce the policy, how they enforce it, and how the client responds all carry significant implications for the therapeutic relationship and the work itself.

Therefore, therapists need to examine their own feelings about enforcing the policy, develop a thoughtful and therapeutic response, and explore the meaning behind the client’s reaction.

Here is the article by Gans, if you’d like to read more about this thought.

Until next week,
Suvrita