Why is my Therapist Charging a Cancelation Fee?

Published on July 18, 2022

Are you struggling to get to your therapy sessions consistently?

It is common for busy people, or just everyday people, to miss therapy from time to time. Sometimes it’s a child’s game or event, double-booking for doctors appointments, or you have no energy to engage that day, there are many reasons why therapy may need to be canceled. 

You may have noticed that even when you cancel your appointment you continue to be charged, even though you were not seen. Is this normal or should you be worried?

Is It Normal to Charge For Canceled Therapy Sessions?

Yes! It is completely normal and common practice for therapists to charge the full session cost if an appointment is missed. 

If you are being charged a late cancelation fee, it is likely because you canceled your session on short notice. For us here at Long Island EMDR, we consider “short notice” anything less than 24 hours in advance. This is common practice for most therapy offices and other medical professionals . We list this policy in our intake paperwork in multiple locations and do our best to review with you during your initial session.

You may be thinking “Okay I get it you charge but why do you charge”? Below I will go over some of the main reasons why we charge for missed appointments.

Your Progress in Therapy Slows

Canceling your sessions can slow your progress to a snails pace.

The number one reason we charge is because client’s ultimately lose out when they are not showing up consistently to their appointments. Therapy is not easy- it takes commitment and hard-work. As a practice that specializes in trauma and anxiety, I can tell you avoiding therapy will only serve to maintain your current anxiety and trauma symptoms.

The truth is- the more you avoid facing your difficulties the worse your symptoms will get. We charge to motivate you to face those fears. We believe in the power of therapy and in your ability to overcome your challenges. You deserve to feel better. 

As someone who has been in therapy, I know all too well there are many reasons to cancel your session. While your reasons for canceling may be entirely valid, the truth is something can always come up. Many of our client’s late cancel because they are in a bad place emotionally, or are “too drained/anxious/overwhelmed” to deal right now. Canceling really just keeps you stuck in that cycle. Underlying your cancelation is likely a feeling that not attending is the easier option in that moment- and it may be easier in that moment- but it is not what is best for you long term.

Showing up even when it is uncomfortable allows you to work through those difficult feelings and ultimately receive the help you need to reach your goals. Therapy provides you with the support you need to feel better about your life and begin to make changes. Avoiding your sessions will only serve to make your anxiety about attending worse- not better.

Our goal is to help give you every excuse to make your mental health a priority.

We strive to make being consistent with therapy as easy as possible (which is why we always offer to switch to virtual for the day) and to make neglecting your mental health or placing it at the bottom of your priority list more difficult. This is because we believe in your ability to grow and change. Because we know you deserve to make progress towards your goals so you can start living the life you want. 

We charge a cancelation fee for the session, because we want you to come. Not just for us- but for you. Because there is a reason you chose to enter into therapy and sometimes in our busy lives we forget that our needs and priorities are important too. Consistently attending ensures you get the most out of your treatment, you are honoring your needs and feelings and you are putting yourself first! Showing up is an investment in you and your future- and we want to encourage that.

Note for Trauma Clients...

Long Island EMDR is known for trauma counseling. Clients seek us out specifically because we specialize in EMDR and are truly trauma-informed clinicians. I founded Long Island EMDR because as a trauma kid I know what the struggle is like. That one cannot simply just “stop being anxious” and that you may not fully understand why certain things trigger you- they just do.

Staff are trained continuously so you can move from past to present. A present unencumbered by the bombardment of triggers and negative self-talk that can take over your life. To help you end that constant “whack-a-mole” of thoughts popping up in your head even though you know they are not rational- which is so very emotionally draining. I believe so deeply in the work that we do and in our client’s ability to find relief- because I have seen therapy work over and over again. Our work and the results and relief we get with our wonderful, truly awe-inspiring clients is what continues to motivate me as a therapist and as the owner of Long Island EMDR.


But as trauma specialists- we also tend to push our client’s out of their comfort zones. We are not “uh huh” or “how was your week” therapists. We really dive deep into underlying issues that cause our clients to feel stuck and work through old patterns and make lasting change!

This can make wanting to come to therapy really hard at times. It can bring up unwanted memories, thoughts and feelings. It is oh so easy to just say- I don’t want to do it any more. Many client’s want to quit therapy at some point- because it often gets worse before it gets better. These feelings, thoughts, unwanted memories, flashbacks and nightmares- may very well trigger you to avoid coming to your sessions. 

Trauma kids are really great at problem-solving and avoiding pain. So your brain will very easily come up with tons of reason to cancel. They are all likely valid. What is also valid is the need for you to face your trauma and anxiety head on so your past stops replaying in your present. And to do this you need to come to therapy- consistently. 

For EMDR Clients

EMDR clients in particular. Avoiding an EMDR session on an uncompleted memory or “target” is not going to make all the thoughts and feelings that came up with that target go away. You cannot just push it back down- it’s not likely to work. Finishing processing of that target/memory, however will. The more you do it the more memories you work through. And the less true those thoughts of “I’m unlovable” “I’m not good enough” “I’m responsible” will feel. And, the less distressing the memory and its associated triggers will be. 

That is why, we are doing you a disservice by not holding you accountable when you late-cancel. Every time you cancel late and we do not charge a cancelation fee, your brain gets a wave of release. Because you successfully avoided the anxiety that week. This makes it more likely you will come up with more excuses in the future. By charging the fee, we are holding you accountable (for my neglected folx this is even more important.) And we are saying to you that your mental health matters. Hopefully this will help you to avoid the avoidance and come consistently. Research shows us consistency will truly help when you are being treated for trauma. 

It Affects Your Therapist

For our fee-for-service therapist, if you do not show and are not charged they just lost out on income for that week. If you give them notice, they may be able to move you to another time during the week and not lose out on that income, as well as ensure your consistency.   If the practice does not get paid, we cannot pay those therapists. These therapists do rely on you coming consistently to pay their bills. 

Most of our therapists are full-time salaried W-2 employees. In order to maintain full-time status they need to meet certain quotas and when clients cancel their appointment it puts those numbers in jeopardy. Though it may not affect their weekly paycheck, if they lose full-time status it does mean they lose all the benefits associated with that- including health insurance and retirement plan. While we would love to offer health insurance and other benefits to all our clinicians, the cost associated with doing so is just not possible unless they meet certain minimum standards. 

We understand that most clients are not thinking of how their cancellations affect their therapist. But when client’s consistently miss appointments it is not just employees pay that can be affected- but their lives outside of work as well. 

Late-Cancelations Affect Other Clients

As stated above, most of our clinicians are full-time. Many clinicians have little flexibility, especially after school hours to move appointments. If client’s need an additional parent session, couples session, or emergency session and we have notice you won’t be there- we can offer your time slot to those clients. When we have less than 24-hours notice there is not enough time to schedule in those clients who really could’ve used that time-slot that week.

When you just have to Cancel…

We understand there are just some times you will just need to cancel. Maybe it’s a family vacation, a night out with friends, or a big exam. That’s okay. We understand entirely.

We do however need to know in advance. As soon as you know you cannot make it- let your therapist or the front office staff know. We won’t make you feel bad or encourage you to change your plans. We will likely just offer you whatever other time-slots (if we have any) that are available that week. 

If you cancel before the 24 hour mark, we will not charge you a cancelation fee. You won’t be hurting us or other clients. And hopefully we can squeeze you in some other time so it’s not interfering with your progress either. As long as you are coming consistently, canceling when absolutely necessary is okay.

If you do cancel within less than 24 hours, we will charge you a cancelation fee of the full fee. For all the reasons I stated above. Please still let your therapist know so they do not worry about you. Hopefully we can reschedule your appointment to another time and waive the fee. But this is not a guarantee as most of our therapists have very full schedules.

Looking for a Therapist?

Our counselors at Long Island EMDR would love to help you on your journey. We have clinicians with a variety of specialties including trauma, EMDR, TF-CBT, LGBTQIA+ issues, grief & loss, teen counseling, caregiver issues, anxiety & depression. Contact our office today to schedule with a therapist and take the first step towards wellness. 

Sending Love & Light,

-Jamie Vollmoeller, LCSW

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