The Very Important Cancellation Policy

The purpose of a good cancellation policy is multi-dimensional
Therapists should value their time even when clients have other plans

It’s not uncommon these days for clients to want convenience and flexibility. Therapists are increasingly aware that modern-day clients have busy lives and committing to a weekly appointment can be challenging. Many people who seek counselling or psychotherapy expect to receive an effective service with minimal disruption to their weekly routine. They expect therapy to be available and effective, but not inconvenient.

And yet therapy only works if there is discipline and commitment to the process. So a dilemma exists.

CancelledHow do we provide therapy that meets the expectations of a commitment-avoidant society, delivering a professional therapeutic service while, at the same time, protecting ourselves from a shift in culture away from structure and personal responsibility?

We must stick to our boundaries

Boundaries in therapy have always been vital. Most of us know that an un-boundaried therapist is usually more harmful than helpful, yet when it comes to cancellation policies, many therapists in the UK are timid and accommodating. They often seem reluctant, even apologetic, when charging for missed sessions.

Cancellation policies serve many purposes

People in the UK are increasingly open to the idea of therapy as a source of support and as an avenue towards personal development, but many have not yet come to understand that therapy is different from other professional arrangements. Often clients will feel that therapy is something they can cancel or postpone for almost any reason. There is sometimes an underlying supposition that other matters can take precedence over counselling appointments.

A solid cancellation policy makes it clear that therapy involves structure. It puts a client’s ability to focus on the self, to be disciplined and to commit to another (in this case, the therapist) to the test. Working within the boundaries of a pre-agreed cancellation policy is, in itself, therapeutic.

And a good cancellation policy protects the therapist. There are only so many clients that a therapist can ‘hold’ and by taking on a client, a therapist is agreeing to be available to that client, with commitment and consistency. There is no point pretending there is no financial aspect to counselling and psychotherapy. There is. Most therapists charge for their services. A system must be in place to ensure financial compensation when clients miss appointments, and this policy should form part of the contractual agreement.

The not-so-good cancellation policies

It is well-known that charging clients for missed appointments brings up difficult feelings for many therapists. In light of this, some therapists do not have a clear cancellation policy. A review of a random selection of therapy websites in London showed nearly half make no mention of cancellation policies. Though not always the case, the absence of a published cancellation policy suggests there is no policy regarding missed appointments, and this can be misleading to the public.

For those therapists who do have cancellation policies, it’s not uncommon to see 24-hour notice periods, allowing clients to cancel without charge one day before a scheduled appointment. This very flexible cancellation policy allows unlimited cancellations with little notice, gives little structure to sessions, requires little commitment from the client and provides almost no protection to the therapist. These cancellation policies offer convenience and flexibility to the client at the expense of structure, responsibility and commitment.

Getting the policy right is not straight-forward

A therapist's cancellation policy is important for her clients.A good cancellation policy is clear and contained. It should be disclosed at the start of therapy and followed through during the course of therapy. Clients should understand their obligation to pay for missed sessions and therapists should feel confident when charging for cancelled appointments. A good phrase to remember is ‘I am here for your appointments whether you turn up or not.’

Cancellation polices should also strike a balance. They should allow an amount of flexibility to accommodate the modern-day demand for convenience while at the same time respecting the necessary structure and commitment essential to therapy. When a therapist feels the cancellation policy is fair and reasonable, charging for cancelled or missed appointments is much easier.

Ideally, therapy should have structure and inspire responsibility. The therapist’s cancellation policy plays a significant role in the outcome of therapy. Therapy that is so flexible and so convenient that it carries the underlying message: ‘You can attend sessions if you want, or you can cancel at the last minute,’ is missing a vital component of the therapeutic process right from the outset.

Therapists who do not have cancellation policies, or who have lenient or unenforced cancellation policies, are doing no favours for the profession. Counsellors and psychotherapists must feel comfortable charging for their time whether their time is used by clients or not. There is no shame in acknowledging the business side of counselling and psychotherapy. Empty chairs cost money.

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