⚖️Therapist's Unconscious and the Missed Session

This is final post in the 4 part series on Understanding and Responding to missed sessions. Read Part 1 Missed session- business or a therapeutic issue? , Part 2 Making sense of the missed session and Part 3 Responding to the missed session.

A therapist’s response to a missed session can be shaped by various factors beyond conscious awareness. This makes it essential to recognize and examine these influences to ensure that the client’s best therapeutic interests remain the priority.

For those in solo private practice, navigating this issue can be particularly challenging due to the personal financial stakes involved. Here is a (non-exhaustive) list of factors that might affect your meaning-making and decision-making processes, potentially steering you away from responses that best support therapeutic progress:

• Transference or countertransference: can lead to responses that are either too lenient or overly rigid, depending on the emotions and biases at play.

• Relationship with money: A therapist's financial attitudes and beliefs may create biases that influence their decisions.

• Financial Pressure: Economic difficulties or a low caseload may prompt a therapist to strictly enforce cancellation policies, driven by the need to secure consistent income.

• Overburdened Schedule: A therapist with a demanding schedule might feel relieved by a canceled session and choose to waive the associated fee out of gratitude. 

• Unexamined Role Models: We may unconsciously replicate the practices of our therapists, supervisors, or mentors without critically reflecting on their suitability.

Supervision and personal therapy can provide valuable spaces for exploring these responses and ensuring they align with the client’s therapeutic needs.

Until next week,
Suvrita