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I totally agree with you that it's very important to have a cancellation policy and to stick to it. If we don't value our professional time, then how can we expect our clients to respect it? If a client fails to show up for an appointment, that hour of time is gone and cannot be replaced.
I have surveyed therapists where I work (Ontario, Canada) and almost everyone does have a cancellation policy. The most common one I see is "24 hours notice or pay full fee". Therapists tend to enforce it with discretion. If a long-standing, reliable client cancels at the last minute due to a legitimate emergency, most therapists will forgive it. However, the policy is there to help deal with repeat offenders or clients who just don't respect the therapist's professional time.
Like you, I make my policy clear on the first visit. It's posted on my fee schedule as well as on my health history and the client signs that they have read and understood it.
I emphasize to new clients that if they are not able to keep their appointment, another of my clients would like to have it and I must have enough advance notice so that I can call another client to offer them the appointment. People do seem to understand this.
The only therapists I have talked to who do NOT enforce a cancellation policy, are new therapists working in areas where there is a lot of competition. They are afraid that if they charge a cancellation fee, the client will just book elsewhere and they will lose this client completely.
My feeling is that "repeat offenders" who fail to show or who cancel without notice, are no loss to my practice.
So Julie, what's your take on me not having enforced my cancellation policy with this client of mine yet? Aside from the one where she didn't have transportation and didn't want to walk in the rain, the other short notice cancellations seemed like unforseeable circumstances... Maybe I should've cracked down with the no transportation one. ?