An appointment time is like a hotel reservation--if it's being held in your name, nobody else can have it. But sometimes schedules need to be changed! Please be courteous and call as soon as you know you need to cancel or reschedule. If a cancellation is received less than twenty-four hours before appointment time (or after Friday for a Monday appointment), or if the client fails to show for an appointment, he or she is charged for the length of time that was reserved for him/her.
Sometimes, people express the belief that being charged for a late cancellation (or no-show) is a form of punishment. This is a very unfortunate belief, as it is hurtful to the client and reflects an inaccurate understanding of this common policy. While it is true that a timely notice for cancellation makes schedule openings available to others who might need them, it is actually the rare case that a late cancellation can be filled in a therapy practice. Therapists usually work to prevent the need for emergency care as much as possible, and even people who would like to utilize the time generally find that a late cancellation doesn't give them enough notice to leave work with permission, obtain a babysitter, etc. More typically, the cancelled hour is simply lost for therapy. However, a timely cancellation does help prevent additional wasted preparation time caused by a late cancellation, and prevents needless waste of the therapist's time on the day of the appointment as the therapist waits for someone who doesn't show.
The most significant reason for the policy is the one that is almost never discussed. It addresses a primary aspect of scheduling and cancelling of appointments unique to the psychotherapist's office. Because of the nature of our work, our scheduling differs radically from that of a physician's practice. Psychotherapists must spend much greater periods of time with each client and typically see each client repeatedly, usually on a weekly basis, until therapy is concluded. Prudent therapists are very careful about maintaining a cap on the number of people they see. If a new client is added every time an existing client cancels, that is one more hour a week that must now be available not just for one week but for every week until therapy ends. Repeat this cycle with multiple cancellations across multiple weeks, and in no time at all a situation has developed in which existing clients suddenly can't be seen because there aren't enough openings for everyone, the therapist is overextended, and the quality of therapy suffers notably, while client frustration rises considerably. Needless to say, a client who is being ignored due to therapist exhaustion is not fooled into believing that he or she is receiving quality care. This is no way to conduct therapy. Being responsible for maintaining a regular schedule, and for missed appointments when they occur, protects the quality of your therapy and the availability of appointments for the duration of your therapy.
Most often, therapy ends when the client is no longer struggling with the issues for which therapy was started. The client comes in and reports repeated successful management of the problem situation on an ongoing basis, and there are fewer "glitches" in problem management. By the end of therapy, the client has expanded his or her skills sufficiently to manage these "glitches" effectively and with confidence in his or her own skills and choices. Typically, this becomes evident to therapist and client at the same time. Usually there is a tapering-off period with the end of therapy, but again this depends upon the client's needs.