I knew going into private practice I would have to expect some clients to cancel or reschedule. I certainly did not account for the high amount that did. I had planned for it before opening my practice by adding a cancellation fee to my consent form and by talking to clients about it. I find this to be quite effective in and of itself. However, there are some other tips I can share with you.

First of all, why do clients cancel or reschedule last minute? Is it that life gets in the way via personal illness, personal and family emergencies, a death in the family etc.? Or is there something a bit deeper to these last minute cancellations? Some clients may cancel their first appointment for fear of the unknown; however, this type of cancellation seems, at least in my opinion, to be rare. I find that mental illness itself may impede the client from making their appointment, especially when anxiety and depression come into play. If they can barely meet their activities of daily living, like showering and getting out of bed, how can they make it to your office? Other reasons people may cancel are due to a breach of some kind of the therapeutic alliance perceived by the client, a change of financial situation, having a phobia to come in or having some form of avoidance especially when diving into deep topics etc.,

Having a cancellation policy set up in your consent form, like I mentioned above, is a great first step to avoiding or cutting down on cancellations. Clients will think twice about cancelling last minute because a cancellation fee will apply. You can always give a first time warning as well if you are worried about breaking the therapeutic alliance. I believe that if you set the boundaries early about cancellations, clients will respect that and reschedule/cancel ahead of time to respect both your time and money. It is up to you what you will charge for cancelling last minute and what time frame you set. I tell clients that I prefer a 24 hour notice by email or phone but the fee will be applied if less than 12 hour notice is given. I personally charge half of my actual fee. At first, I wrestled with this notion of charging people for last minute cancellations. Then I began to realize that it is my time and my source of income and it’s a professional courtesy. If you are new to practice and you have a last minute cancellation – you may already have gotten ready for the day and be in the office and that may have been your only client. Can you justify the fee then? Many clients may not be aware that you pay for office rent, supervision, advertising, business supplies, etc., all out of pocket. This is a business decision that you need to decide is right for you. If you do decide to have a cancellation fee, will yours be flexible in certain circumstances?

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