Awkward situation with therapist

[astrasky]

I have just started seeing a private therapist for depression. She's so expensive, but I understand it's a hard job.

Anyway. I cancelled my appointment for tomorrow morning at 9pm on Monday due to work commitments. She didn't reply. So yesterday I resent the same email in the morning and in the evening and recieved no reply.

This morning I emailed the Head of the centre to say I had cancelled and recieved no reply. She then got in touch with the therapist who immediately replied saying that's fine, do you want to rebook etc., and she hopes i understand this will be charged as less than 24 hours to go til appointment... I did agree to that policy and I do think its fair, but I gave well in advance of 24 hours notice? I told her over email three times that I wouldn't be coming over 48 hrs before the appointment.

I don't want this to sour the atmosphere and I am really quite apprehensive about going back now - she quite clearly did get the emails as she replied straight away to an email her boss cced her into, so it's not like she was unable to access them.

I feel pretty down about it. I don't want to come across as rude but I am actually quite annoyed.

Aibu to tell her I won't be paying? And will I have to find a new therapist?

I think it's obvious what has happened.

Your appt was for Thursday 30th and you cancelled - for argument's sake- Tuesday morning?

SHE didn't get the email / didn't open it and only saw it when the head of the centre flagged it up by which time it was presumably less than 24 hours ahead?

One thing to bear in mind is that although you send emails on bank holidays and weekends, perhaps, he recipient is not obliged to open them or respond until it's a working day. You need to be aware of that.

I work with clients and make it my normal practise never to reply / read out of normal office hours because it suggests I am available 24/7, and encourages them to email and expect replies willy-nilly.

So in your case I'd have assumed the email sent on a bank hols would not be read till perhaps lunchtime Tuesday but that was still giving plenty of notice.

Don't pay and say they have misunderstood the timings.

Honestly, I would find a new therapist. She sounds unprofessional to me.

I would reply once more, cc'ing in the Head of the Centre, that you will not be paying as you did alert them to the cancellation well outside of the 24h notice period.
And then I would cancel all future appointments with her and find someone else.

If you can't trust her with your emails and your appointments, or to read them and pay attention, you can't trust her professionally either, in my opinion.

She then got in touch with the therapist who immediately replied saying that's fine, do you want to rebook etc., and she hopes i understand this will be charged as less than 24 hours to go til appointment

'Hi. I know that there is a policy and this is why I emailed 'whoever' at x, x and x on Monday, giving 48 hours notice.'

This is very likely a mistake on your therapist’s part, she probably didn’t check her emails on the bank holiday and has missed your earlier emails. Hopefully your email clarifying this will be all that’s needed.

You appear to have appreciated your first session with her, so it would be a shame to read too much into this.

If she still insists that you should pay, then she is being a CF and you may feel that the relationship has been soured as a result.

I’m a psychotherapist in private practice and I would say that the onus is on me to keep an eye on my inbox and voicemail regardless of whether I respond immediately or not. You have given more than 48 hours notice so you’ve done right by the policy. I have a similar policy in place but always try to be flexible and always keep in mind that someone may need to cancel because of an emergency such as a child’s illness. As someone else said upthread, to be too mercenary could damage the therapeutic relationship and as it is (or should be) a collaborative relationship a bit of give and take on both sides is important. My flexibility has never lead to micky taking with my time or repeat offenders cancelling all the time as I think committing to therapy is important to people and they generally don’t mess around. If I was to adopt a rigid adherence to the cancellation policy I think I’d lose clients and they’d feel as you describe OP.

I think you’re over reacting due to anxiety.

Your therapist has made a mistake but all you need to do is gently and politely clarify. There’s no need to overthink, analyse, or apologise. Nor is there any need to swing the other way and be rude or confrontational (not saying you are, but some people on here are suggesting it!).

There’s no need to find a new therapist! Just explain.

I'm just feeling so awkward that she hasn't replied to my last email showing the email thread this morning.

She was quick to reply about a future appointment but then didn't reply at all to my email..

I don't know, I just think at this point I'm not overreacting. Therapy is expensive enough and hard enough without a therapist who is making me doubt whether I followed rules right and won't reply to an email which just required a "oh yes sorry didn't see that"

Now I have another night of worry about whether I need to start looking for therapy again and the money.

For people who say I am overthinking it, that's pretty much the nature of my problems - I actually discuss alot in my sessions about being taken advantage of.

I don't think she did it on purpose, but maybe a more professional approach would suit me more.

You followed the procedure to the letter and gave double the required notice. You are totally in the right here and shouldn’t pay.

There has been loads of research about all the different kinds of therapy to see what is most effective. Perhaps unsurprisingly the most significant factor is the relationship with the therapist. If you don’t have faith in them, it might not be so effective. So maybe now is time to find a new therapist.

How did you feel about her/the sessions before this?

If you liked her then I'd give it a chance and discuss it when you next see her, it's not always easy to find someone you can work with. If you weren't sure about her then leave it.

I'm a therapist too and there's no way I'd charge a client in these circumstances. Hopefully it's just a misunderstanding and she'll be fair when she realises her mistake.

You gave enough notice so don't pay for session.

Whether you should continue with her or find another one is up to you - the quality of the relationship between therapist and client is the single strongest predictor of positive outcome, so if you're not comfortable, you should change.

As a side note, (and I don't know anything about your back story so this could well be completely irrelevant) there are some pretty effective treatments (both medications and/or talking therapies) for anxiety available on the NHS, which may be worth a look.

No need to feel anxious.
Go about it a different way.
All you need to do here is send the following to the head of the service...
Hi x,
I'm concerned that z isn't receiving emails from me.
I emailed to cancel on a, b, c in order to cancel before 48 hours in advance and she didn't get my emails and now I don't think she's received my emails explaining this.
I think my emails may be going into her spam folder or there's a problem with the inbox.
Would you be able to contact her for me so that she knows I've been emailing.
I've attached the previous emails so that she can see them.
Really sorry to bother you.
Thanks ever so much.

thanks for the responses ... I do think it's worth looking for a new therapist.

Those who mentioned anxiety treatment on the NHS - been there, done that. These issues I discuss are more based on a probable diagnosis of PTSD and discuss alot of abusive relationships etc., that I didn't think were addressed in CBT.

@Jiggles101

The sessions before were OK. There were some minor issues, but more just ways of doing stuff - I don't like speaking to someone when they're fiddling in their bag looking for paper for example, but at the end of the day, I know that is just a personal preference.

I feel a bit disheartened, it's hard when things like this happen because you start to think maybe you are the problem, and even people who are paid to help you don't seem to think you're trustworthy

Please don't be disheartened OP. There are lots of great therapists out there.

And no, they shouldn't be rummaging for paper when you're talking.

I was thinking it was a mistake, she didn't see your emails etc etc.

But fiddling in the bag thing when you're talking? No no no. She wouldn't be my kind of therapist either.

That said, you have to get some really shitty stuff out with a therapist - including giving them what for when you're upset with them. It's all part of the process and therapists are qualified not to take it personally. But I can understand you're not established enough to have a ding dong/share your upset and disappointment with her. Which is fair enough.

I think it would be useful if you can talk about this at your next session and tell her how you feel about it, how it has impacted on you and what this means for your relationship.

@Sunshineandeggshells the OP paying for the sessions to get help with her own personal issues she shouldn't have to use a paid for session to talk about issues she having with the therapist - issues that the therapist has actually caused!

Yeah, I think maybe time for a new therapist OP. Not because of you, but because she doesn't seem to have developed a good understanding of you, if she had she would know this is anxiety inducing for you.

For what it's worth I can't stand anxiety over unanswered e-mails either. In fact emails in general cause me huge anxiety. For this reason I try to phone people whenever I can, just to save myself the agony of interpreting people's non-replies / short replies / choice of sign-off / cc'ing etc etc

She’s ignored your emails again. It sounds more as if she’s pissed off you cancelled with short notice - ie circa 48 hours (in work hours) - but in time. I agree. Time to find a therapist, who respects you.

If you can discuss the rupture in the relationship and find a way to repair it then it is likely there will be an even better outcome in your therapy. I know it is really difficult but changing Therapists isn't always the answer unless the relationship i beyond repair. By changing you might even be avoiding the real issues you need to work on. I know it is really tough but talking about all these difficult emotions that have come up for you could be really helpful.

Yy mummyoflittledragon.

Sorry OP - therapy is brilliant when the dynamic is right, but finding it can be really hard. I'd try someone new if I were you.

Did she get back to you? Did you manage to rebook? I agree, I wouldn’t like to talk about my issues with someone who didn’t look like they were fully listening. As a professional, there should be no need to be rummaging in a bag whilst a client is talking. Everything should be in place already.

I think you need to find a new therapist because you will not feel comfortable and you can hardly talk to a counsellor who you have an unresolved issue with

I don't think she should check her emails on days off but on Tuesday morning would that not be be 48 hours notice for a Thursday appointment? If she didn't check then she is at fault.

Who needs a therapist who increases your anxiety by making you chase her to the point of contacting her boss?

No she still hasn't got back to me ....

So it looks like no therapy this week and I still don't know about the payment.

I feel really sad to be honest, I know it's pathetic. But this therapist clearly knows a lot about my personal life, and it just feels like she has taken a disliking to me.

She always replies to emails promptly about payment and appointments (usually within the hour).

I have had a prior therapist who retired, who was amazing. Obviously therapists are just human beings - he would sometimes say things I would take the wrong way - e.g. "do you want to have an appointment in two weeks?" (as opposed to the week after). Because I valued his help so much, I would bring it up briefly the next week, because I was willing to be honest with him and I knew he would respect my concerns. In fact, he would usually pick up on my body language if he said something wrong like "okay I see you're turning away, tell me about that."

If I knew I had upset someone, I would have replied very promptly.

I don't like speaking to someone when they're fiddling in their bag looking for paper for example

For the money you're paying? She can fuck off. Get someone better. It won't be hard.