No Show and Late Cancellation Fee Policy.
What Should Your Policy Be When Clients Don’t Show Or Late Cancel?
OK, true confessions. I got a late cancellation this morning. This immediately made me anxious. I hate this whole topic and I hate having to address it with clients. It just feels crummy.
But here’s the good news – at least for my anxiety this morning. The client was canceling because they were sick. My policy, I don’t charge people for late cancellations for illness or emergencies. I was able to waive the fee.
I immediately felt relieved but then my inner voice struck up a conversation with me, chiding me. It whispered, “Boy are you a wuss about this stuff. You suck at this”. I’m sure you have your own version of that voice. But today I talked back. I loudly told it, “You know what, back off! I feel very good about my policy. I LIKE being able to give people a break when they’re sick. It makes me feel like I’m putting some good into the world around me and it’s who I want to be in life. Leave me be.” It felt really good to talk back!
But here’s the deal, it felt good because my late cancellation policy is what’s right for me. That doesn’t mean it’s right for you. That’s the point. When we stay true to who we are, who we want to be in our private practice (and honestly, in the world) then it will feel good and will make it easier for us to maintain our boundaries with clients.
Figuring out your professional identity, including things like your no-show policy, is a crucial part of launching your private practice. Be purposeful about this, it will set the tone for your practice, your reputation in the community, and the types of clients that come your way. I devote an entire chapter to this in The Master Course and offer a Mini Course, Establishing Your Professional Identity, that will help you with this process.
You need to figure out what’s right for your practice before you even see your first client.
There tend to be two camps when it comes to whether to charge a no-show/late cancellation fee: therapists who charge no matter what and therapists who make exceptions.
Which is right and which one should you do?
The answer is… the one that’s right for you is the one that’s right for your practice.
The first step is to establish a policy.
This can be anything you want it to be. Seriously. There are no rules about it out there. Other than you need to have a policy in writing, and you need to be very clear with clients from the beginning what that policy is. But you get to make your own rules. Don’t want to charge anything ever for no shows and late cancels? You can do that. Want to charge a 72-hour cancellation fee with no exceptions what-so-ever? You can do that. Do what you want – but do make sure it’s what you want. Because you’re going to be the one enforcing it when your clients don’t show or cancel last minute. This is always harder than you think it’s going to be, so make a policy you are good with.
Your Office Policies and Consent for treatment need to clearly explain your policy to your clients. You can find out more in this blog post, Seven Crucial Items To Include in Private Practice Forms. I also devote an entire chapter to Private Practice forms in The Master Course and offer a Mini Course, Private Practice Forms. Both courses cover the details of what you need to include in all of your forms. It is crucial you get this correct since there are ethical and legal implications when our clients are not fully informed of our policies.
Most therapists tend to have a 24-hour cancellation fee. It seems to be evenly divided between the folks who have a ‘no exceptions’ policy and those who allow exceptions like illness and emergencies. Here are some considerations about each approach.
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The “No Exceptions” camp.
The reasoning is that the therapist should not have to judge whether a client ‘deserves’ the exception. Do you want to be the one to discern if the client is truly sick, or sick enough, or if it’s an actual emergency? A no exception policy takes that out of the equation. If the client late cancels or no-shows, they pay. Period. End of conversation. The con to this is that it can leave clients feeling understandably upset if they are genuinely ill, a family member has gotten sick or died, or they get in a car accident on the way to session. As a therapist, how will you feel when (not if, but when) you need to charge a client despite one of these things happening?
The “Exceptions” camp.
This allows the therapist to forgive late cancellations/no-shows if there is a legitimate reason. Yes, this does put you in the position of defining what is legitimate and what isn’t. In my experience I’ve not really had clients who are trying to pull one over on me. They tend to be genuine about being sick or having an emergency.
I do think that allowing exceptions makes it much harder for the therapist to maintain consistency about charging clients a late cancel/no show fee. It becomes a lot easier to just tell a client, “Hey, no worries, I understand!” rather than dealing with your discomfort around charging the client the fee. Trust me, for many of us charging the fee is hard and isn’t going to feel good no matter how justified the charge is. But we don’t do ourselves, or our clients, any favors by being unclear. It’s not a helpful therapeutic stance to model poor boundaries for our clients. If you go with the exceptions camp, you will need to be very clear what your policies are and very mindful of your own tendency to want to slide on those policies.
I like my policy and I’ve never once thought about changing it. Make sure you do what’s right for you. It will make your private practice that much less stressful.
I love helping therapists build successful private practices! For more great information like this to help you build yours, make sure to check out the Master Course and the Mini Courses. I’m here to support you and I want to help you reach your dream!
If you need some individual help with all of this, I’m here for you! I offer mentoring services for those who want some personal attention to help them build their successful private practice. Don’t hesitate to reach out to me. You can find out more on the Mentoring Groups page.
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