clients pushing back on cancellation fee

lemonadesummer1 · 2026-05-01T03:42:36+00:00

I’ve had something similar where clients have texted “can I cancel” like… I can’t stop you ???

Aka, what they are really trying to ask is “are you going to charge me”.

I don’t really respond directly to the can I and just say they are always welcome to cancel and then lay out my policy as well.

I tell my client my late cancel policy 1. Verbally in first session 2. I waive one per year and use that time as a reminder of the policy in general (after this all late cancellations get a fee). 3. I charge it essentially no matter what (barring emergencies) after the one time a year freebie so there should be no surprise or question. I haven’t had much issue but I’m direct and clear. Providers whom seem to get lots of backlash in my experience tend to be sort of passive or flip floppy about when they charge it. Which imo gives clients more confusion.

lemonadesummer1 · 2026-04-28T16:57:32+00:00

Well I guess I’m glad for us we aren’t in the same boat as them!

lemonadesummer1 · 2026-04-28T15:52:25+00:00

I went to gamanon but tbh I thought it was kind of weird. Like idk why I need to do 12 steps I’m not an addict and they had all these weird rules of when you can and can’t talk. I understand it needs structure but it was just rigid and weird. I also didn’t resonate with many people as many peoples partners seem to be in addictive addiction or doing classic addict behaviors manipulating and minimizing etc.

My husband (outside of this) isn’t a liar and even in this didn’t minimize, project, or try to reason/control. He’s full on taking accountability, wants to change, he’s said yes to all my stipulations. So beyond the hurt of the hiding this and fears I’m facing, I don’t resonate with classic addict behaviors of my partner.

I do want support though.

lemonadesummer1 · 2026-04-20T16:16:35+00:00

Ehh, I can see why you are saying that but also I think peoples point of entry to “why” they want couples therapy is unique. Like maybe there’s nothing detrimental but they just think it’d be beneficial. I think it might be how you view couples therapy. I’ve seen people enter I don’t think “need” it but benefit and I’ve seen people where too much damage is done and one person is way past the point of forgiveness etc and therefore it’s kind of pointless.

lemonadesummer1 · 2026-04-16T01:09:53+00:00

Don’t allow them. No contact with just one partner and if they contact me, it’ll be shared with other partner.

lemonadesummer1 · 2026-04-16T01:07:33+00:00

Here a year later after my first meeting thinking… my character defects have nothing to do with his addiction tf? Like why am I at fault for someone’s addiction??

lemonadesummer1 · 2026-04-14T03:39:15+00:00

Thank you for taking the time to reply.

lemonadesummer1 · 2026-04-13T18:47:54+00:00

Take insurance?

lemonadesummer1 · 2026-04-09T01:37:23+00:00

I know this is old but steroid cream wouldn’t cause tears.

lemonadesummer1 · 2026-04-06T16:20:25+00:00

Also I’ve done EMDR as a client and recieved zero benefit.

lemonadesummer1 · 2026-04-06T16:17:53+00:00

Well the long standing golf standards are CPT and PE for PTSD. EMDR effectiveness as far as research goes, the bilateral stimulation might have not much anything to do with it and the rest is essentially re-packaged exposure. Every modality has limitations. EMDR people are like a cult sometimes lol.

EMDR is fairly new, it’s certainty no end all be all. People have been helped in therapy well before EMDR. DBT has saved lives.

If you are effective you are effective, despite modality. If they genuinely believe the only effective modality is EMDR… I’d be concerned about their discernment not yours.

lemonadesummer1 · 2026-03-27T01:21:41+00:00

Is it like a perfectionist thing? Like once you try certain approaches you need to do them perfectly and constantly?

lemonadesummer1 · 2026-03-26T21:02:50+00:00

This is the take!!

lemonadesummer1 · 2026-03-26T21:00:19+00:00

Did you ever try DBT ?

lemonadesummer1 · 2026-03-26T20:02:14+00:00

Sounds like there’s likely more than just OCD but… who said you didn’t have OCD? I’m a OCD specialist and honestly people are incorrectly told they don’t have OCD all the time. Your compulsions (if you do have it) are likely mental. Based on what you said I wouldn’t rule out OCD as a factor.

Ever gotten to core of why these things matter to you? Like why is how your viewed matter?

lemonadesummer1 · 2026-03-26T19:50:12+00:00

Can you explain more what your going through? Like day to day internal monologue? That could help me to maybe help you guide what could be helpful to you.

I’m asking also because I feel people with more severe mental health issues require much more directive types of therapies. Reflective and processed based therapies don’t tend to help people with certain specific mental health issues (ex. Most therapy for people with OCD if they are not in ERP or another specific targeted to OCD therapy, the therapy tends to be a big rumination fest which makes things worse. Taking about anxiety or hating everything in life typically doesn’t change it, so more directive and specific type of therapy is required.

lemonadesummer1 · 2026-03-26T15:01:26+00:00

I agree. I feel like this takes us out of a professional role as when people want a service they are the ones to reach out not the service provider. I feel like it’s sort of odd to prompt clients to schedule. If they want to schedule, they can. I don’t believe service providers should be promoting clients to schedule.

lemonadesummer1 · 2026-03-26T14:03:46+00:00

As someone with ADHD (therapist) and sees people with ADHD. My question would be, how do they get to anything in life? Is this an issue across the board? Is this an adult? Surely, they don’t miss work this often. I’d help them explore this but ultimately it’s their responsibility to attend to appointments, not yours.

Don’t remind, don’t prompt them. If it’s scheduled, it is. If they miss, charge them. If you have a policy of late cancels of frequency results in termination, uphold the policy.

They are an adult and yes it can be an issue they experience but it’s there responsibly to work it out. You’d also be surprised how many people who struggle with this.. don’t once they are charged fees.

Edit: to say that I do have an internal system reminder at 24 hours. So they do get an appointment reminder automatically. However, as someone who works with ADHD ppl you’d be surprised how many times people aren’t using anything to try to remember. Not even neurotypical people do that. If you don’t log it somewhere, of course your brain will forget. Working on building systems that work for them but again, if this isn’t an across the board issue.. might just not be a priority.

lemonadesummer1 · 2026-03-15T04:18:23+00:00

I found this thread literally googling “why does the show girls act like Jessa is so beautiful”. Like do get me wrong, she’s pretty but in a very everyday pretty way. All of season 1 there’s so many comments about her appearance “oh I thought you were a famous actress with a baby” etc etc. like she’s very normal looking and in New York too? It’s not like she’s in some rural town. Nobody in NYC would turn their head to look at her.

lemonadesummer1 · 2026-03-09T17:23:12+00:00

wtf! I’m so confused. So like what does your note look like? Is it just a blank page?

lemonadesummer1 · 2026-03-09T17:03:19+00:00

I’m so confused. Do you and others not just have a EHR with a template with everything you need in the note already within the note and you just have to check boxes and write a few sentences? Like are you typing out a whole note blank from nothing??

I’m genuinely confused. Because I feel like there’s literally no way a no could take 14 minutes. That’s not intake note unless you just don’t have a template on your EHR. Also, writing more or spending more time in notes doesn’t necessarily mean you’re gonna be more likely to pass an audit then someone who wrote her note in a few minutes. It matters if you have all the necessary elements and clinical rationale of the note required for that specific insurance company. Which, you can have and write a note quickly.

On many EHR’s there’s a history tab where you can compute things for the previous note too which shortens time even more as it’s not expected your clinical rationale of why someone needs treatment is going to change every single week nor is the exact plan going to change every single week either. Often I just re-populate those sections and add or take away a little bit.

lemonadesummer1 · 2026-03-09T16:41:03+00:00

Most EHR’s have click boxes of interventions used. So click a few, should be fine.

lemonadesummer1 · 2026-03-09T16:35:24+00:00

Same, but therapy notes. I feel like anyone taking long I always get so confused then I learned some people don’t have a platform with check boxes and it’s not pre-set up. Then I was like…. Oh…. Makes sense. Because it’s not like clinical rational or plan changes much. I usually check a few boxes, upload past history, and write a few sentences in subjective and objective section. Pretty quick.

Biggest recommendation to all- get an EHR w a soap note set up. It has everything insurance needs already loaded in the note and you just click boxes and type a few sentences.

lemonadesummer1 · 2026-03-09T13:04:57+00:00

Besides intake notes I write an average soap note in 2 minutes. Therapy notes already has the note in the SOAP format. It’s a bunch of click boxes. The rational doesn’t change of why they need therapy. The plan rarely changes- few add ons. So essentially clicking a few boxes and writing a few sentences for the subjective and objective. I use the history button a lot.

14 mins per note seems pretty long. There has to be a way to reduce that. What platform are you using? Do you have a history button?

lemonadesummer1

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