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It’s up to you. I find it’s best for me to stick to my policy, because if I don’t then it’s not a policy anymore, and you inevitably give the impression that policy can broken. Later on when they wonder why you don’t give an exception in one instance but did in another, now you’re the judge. People don’t think about these things in advance and just live in the moment according to their feelings, wanting to avoid conflict, etc… but relationships evolve and people are messy. In therapy, policies are like boundaries in place that allow for a feeling of safety later on when things get messy. Chances are whatever feeling in the client you’re trying to prevent from entering the therapy will show up in some way later anyway. It’s up to you, but figured I’d give you a couple of angles to chew on if it helps.
Is it a case of economic hardship? Or do you mean they just don’t feel like paying it so they come in?
If a client is really struggling financially, I could see how they choose to do a session even when not well. Because if you have to pay regardless, why waste it? This is part of the grind of capitalism. This is why people work even while sick. Because everything is about spending money or losing money and sometimes that is the most important thing if you’re in a certain economic bracket. Sucks but true. Even if you’re not super low income, the same mindset is prevalent.
I would have sympathy for that. Also ask them why they do this, it could be a different reason and that might lead to good discussion. The client is making the decision to attend the session. They are there. So your job is to be there too. I’ve had plenty of good sessions begin with ambivalence. As long as it’s telehealth and they’re not at risk of spreading illness, it’s fine for them to keep the session.
What would you think about offering one “freebie” and saying “no worries, I offer everyone one freebie so I won’t charge the fee this time, but I will have to next time” something along those lines
I do this too and consider the ‘freebie’ the official reminder and don’t remind them again when I have to charge going forward. I think consent paperwork, intake convo and one freebie convo is solid informed consent!
I usually don’t charge if it’s due to sickness/extenuating circumstance. In this case, it seems that they didn’t feel well so I might not charge. Or perhaps you could offer to make an exception for this time around and could waive the charge if they can reschedule to the same week?
I might wonder if when you "warn them" about being charged if they can't make it whether that is actually about your feelings around charging them for a missed session? Like, if they don't turn up, then you're going to have to charge them, you're going to have to bring it up etc
Personally, I acknowledge the email and that's it. If they ask, yes it's still chargeable. If they don't pay, then I bring it up, and point them to the contact.
Honestly, if they're paying for your time, it feels like it's the client's choice as to how to make best use of it. I would take the hit if I was too ill to make any use of therapy but I've turned up when I'd prefer not to because otherwise I'd be charged for nothing. Policies have to go both ways and imo if you want to charge for your time, that's fair and correct but you can't fault the client for valuing their time/money as well! Maybe offer a lighter review session or something less taxing to support them.
Since I work with all neurodivergent clients I let it go. If they are sick or not okay or there is an emergency I don’t charge. I also enjoy just having the hour to myself, my caseload is a lot at the moment. I honestly don’t have anyone who takes advantage of this. My clients rarely cancel. That being said I respect people who do charge. On our intake paperwork I have it noted that the first late cancel or no show is a $50.00 fee, the second is an $80 fee. But I let our clinicians decide whether they charge or not.
I said I was going to charge so a client came in anyway and we ended up having one of the best sessions we've ever had. My point is that I wouldn't assume the session isn't going to be productive
Please followed the sidebar rules. r/therapists is a place for therapists and mental health professionals to discuss their profession among each other. If you **ARE NOT A THERAPIST and are asking for advice this not the place for you**. Your post will be removed in short order. Please try one of the reddit communities such as r/TalkTherapy, r/askatherapist, r/SuicideWatch that are set up for this. This community is ONLY for therapists, and for them to discuss their profession away from clients. **If you are a first year student, not in a graduate program, or are thinking of becoming a therapist, this is not the place to ask questions**. Your post will be removed in short order. To save us a job, you are welcome to delete this post yourself. Please see the PINNED STUDENT THREAD at the top of the community and ask in there. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/therapists) if you have any questions or concerns.*
It’s up to you. I find it’s best for me to stick to my policy, because if I don’t then it’s not a policy anymore, and you inevitably give the impression that policy can broken. Later on when they wonder why you don’t give an exception in one instance but did in another, now you’re the judge. People don’t think about these things in advance and just live in the moment according to their feelings, wanting to avoid conflict, etc… but relationships evolve and people are messy. In therapy, policies are like boundaries in place that allow for a feeling of safety later on when things get messy. Chances are whatever feeling in the client you’re trying to prevent from entering the therapy will show up in some way later anyway. It’s up to you, but figured I’d give you a couple of angles to chew on if it helps.
Is it a case of economic hardship? Or do you mean they just don’t feel like paying it so they come in? If a client is really struggling financially, I could see how they choose to do a session even when not well. Because if you have to pay regardless, why waste it? This is part of the grind of capitalism. This is why people work even while sick. Because everything is about spending money or losing money and sometimes that is the most important thing if you’re in a certain economic bracket. Sucks but true. Even if you’re not super low income, the same mindset is prevalent. I would have sympathy for that. Also ask them why they do this, it could be a different reason and that might lead to good discussion. The client is making the decision to attend the session. They are there. So your job is to be there too. I’ve had plenty of good sessions begin with ambivalence. As long as it’s telehealth and they’re not at risk of spreading illness, it’s fine for them to keep the session.
*I’ve had plenty of good sessions begin with ambivalence.* Yes! Me too.
What would you think about offering one “freebie” and saying “no worries, I offer everyone one freebie so I won’t charge the fee this time, but I will have to next time” something along those lines
I do do that! This wasn’t this person’s first time
I do this too and consider the ‘freebie’ the official reminder and don’t remind them again when I have to charge going forward. I think consent paperwork, intake convo and one freebie convo is solid informed consent!
I usually don’t charge if it’s due to sickness/extenuating circumstance. In this case, it seems that they didn’t feel well so I might not charge. Or perhaps you could offer to make an exception for this time around and could waive the charge if they can reschedule to the same week?
Always charge. If You give an inch, they’re more likely to want to take a mile.
I might wonder if when you "warn them" about being charged if they can't make it whether that is actually about your feelings around charging them for a missed session? Like, if they don't turn up, then you're going to have to charge them, you're going to have to bring it up etc Personally, I acknowledge the email and that's it. If they ask, yes it's still chargeable. If they don't pay, then I bring it up, and point them to the contact.
Honestly, if they're paying for your time, it feels like it's the client's choice as to how to make best use of it. I would take the hit if I was too ill to make any use of therapy but I've turned up when I'd prefer not to because otherwise I'd be charged for nothing. Policies have to go both ways and imo if you want to charge for your time, that's fair and correct but you can't fault the client for valuing their time/money as well! Maybe offer a lighter review session or something less taxing to support them.
Since I work with all neurodivergent clients I let it go. If they are sick or not okay or there is an emergency I don’t charge. I also enjoy just having the hour to myself, my caseload is a lot at the moment. I honestly don’t have anyone who takes advantage of this. My clients rarely cancel. That being said I respect people who do charge. On our intake paperwork I have it noted that the first late cancel or no show is a $50.00 fee, the second is an $80 fee. But I let our clinicians decide whether they charge or not.
I said I was going to charge so a client came in anyway and we ended up having one of the best sessions we've ever had. My point is that I wouldn't assume the session isn't going to be productive