Getting Cancelled On.. Twice

[Biz]

Can y'all hear out my crazy and help me organize my thoughts? I know I'm not the only one triggered by being cancelled on by a therapist, but being so early in to working with her it makes me question a lot.

I recently started with a new therapist. I saw my past one for almost a year and a half, and I like her but I needed other things. I've seen the new one 3x including an intro session. We haven't really much gotten in to things. I like her, and I tend to be picky, but I write all this to say, I don't really know her that well.

I had an appointment scheduled for Thursday of last week. The evening before, she emailed me to cancel because she's sick. I have attachment issues and a lot of distrust of other people. I definitely had a reaction to being cancelled on angry, paranoid (is this a test or something?), disappointed (that was a really hard week and I would've wanted the support/help) and generally distrustful (Is this something she does a lot?). My previous therapist cancelled on me 1x; her husband was in a motorcycle accident. She apologized and was tentative about scheduling another until she knew more about what she'd need to do for him. That said, I thought about all this, felt these things, and decided to let it go. Plus, a good friend of mine was very sick that weekend too so I wondered if something is going around.

New therapist emails this morning, my appointment for tomorrow is cancelled, and asks about rescheduling for next week. Emotions and thoughts now. -- More anger: f*** this there's 100's of therapist in my city and perhaps one of them would feel more reliable. -- More distrust: Is this something I should expect from you, because I don't know you? Are you sick or are you over this right now? Are you tired of listening to people and their pain? Do you do this a lot (because now we're 2/5 of you cancelling, that's nearly half). Should I expect one of these cancellations every month? Every 3? -- More paranoia: Is this a game? Are you measuring my reaction? Are you expecting me to respond in a certain way or talk about this next time? (She knows I have attachment stuff; it'd be guessable that this might bother me). -- Ridiculousness: I kind of want to be like "no." -- Uncertainty: I'm doing okay, really good last week, and if I schedule with her again it'll be three weeks between appointments. If I'm okay with three weeks between, I might not need therapy right now. -- A dual between the desire to be helped and the fear/anger associated with all this.

She offered me next Monday; I'm uncertain if I will schedule. What do you think? Obviously I'm sensitive but 2/5 appointments cancelled seems somewhat unreliable. Is it?

 

[joeylittle]

I had an appointment scheduled for Thursday of last week. The evening before, she emailed me to cancel because she's sick.

New therapist emails this morning, my appointment for tomorrow is cancelled, and asks about rescheduling for next week.

She offered me next Monday; I'm uncertain if I will schedule. What do you think? Obviously I'm sensitive but 2/5 appointments cancelled seems somewhat unreliable. Is it?

Super-unreliable. I would say, don't re-book; if she had to cancel you back-to-back, then for whatever reason, she's got too much of a client load. Just as a matter of good business she should have either

• Told you Thursday that she anticipated being out on Monday also, apologized, and set a time for another week out.
• Moved heaven and earth to not cancel on you twice in a row - let another client take the hit, if you must.

I don't think ANY of it is you. She just sounds overwhelmed.

Edit to add: If you want to give her another chance, tell her that you want and value consistency in your therapy, and ask if she will be capable of that, or if things are too up-in-the-air for her right now. If she says she can do it, and you want to give it another go, decide if you want to wait a week - otherwise, push back about getting in sooner.

 

[Biz]

Wow! @joeylittle, I'm kind of surprised to be agreed with; that makes me feel a lot calmer. Thanks.

I thought about that too, like why didn't she bump someone to offer me some time slot this week? (I mean it sucks for the other person but cancelling on one client twice in a row sucks too, especially when you don't have much relationship with that client). It's funny though because I have the impression from the times she and I scheduled for that her caseload is not that big since she has at least a few open evening slots. I could be wrong though.

 

[digger]

New therapist emails this morning, my appointment for tomorrow is cancelled

Did she say why? Is it because she is still sick or did she give a different reason? If it's a different reason, I think I'd be inclined to look for someone else. If it's because she's still sick (which from Thursday to Sunday is feasible and could just be she was expecting to be better by Monday but isn't) then I'd probably give her another chance if you were feeling like she was someone you'd be able to work with in the few sessions you've had.

 

[scout86]

I have my own business and it involves making and keeping appointments. If I'm out sick or something, it rarely affects one person, it usually affects a bunch of people. My deal is a bit different because I don't see the same people every week, but if this week is messed up, next week will probably be somewhat messed up as well, while I try to fit everyone in. So, chances are you aren't the only person she cancelled on back to back. And, who knows what the other clients are dealing with? (Well, she does, I guess.)

But, I also think you have legitimate concerns and, if I had had to do something like that with a new client, it wouldn't surprise me at all if they asked me how common such things were. (In my case, pretty uncommon, but I can easily see it happening.) In fact, I'd hasten to assure them that such things are unusual and do my best to accommodate their schedule for the next appointment, even if it wasn't convenient for me. So, I sure don't think you'd be at all out of line in asking how often this sort of thing happens and discussing it with her.

 

[Biz]

@digger. She said she's still sick. I understand that people get sick, and sometimes it takes them a while to feel better, but I don't have a base w/ her at all or a lens through which to know 'well she's reliable she just got sick this week' or 'she's unreliable and this is a great example of why I shouldn't bother with her.'

I also am struggling because I could see working with her; it surprises how close I've felt at different times when we still don't know each other and I still haven't really talked with her about much (that wasn't something I started feeling with my previous therapist for a while, although I'm wondering if this ability to feel more is built from new neural connections and is because I'm just more generally able to feel close).

 

[digger]

She said she's still sick. I understand that people get sick, and sometimes it takes them a while to feel better, but I don't have a base w/ her at all or a lens through which to know 'well she's reliable she just got sick this week' or 'she's unreliable and this is a great example of why I shouldn't bother with her.

In that case, personally I think I'd reschedule so I could have the face to face conversation with her about whether this is likely to be a recurring issue or whether it's something unusual for her. I think it's fine to lay it out for her that you need someone consistent and reliable and that, if she foresees having to cancel often, then you would rather find someone else before you get in too deep with her.

 

[Biz]

@scout86, that's helpful. It would make sense that both weeks are off if one is. Now that you say that I realize that happens with my work clients too (I meet with each monthly). It's helpful too to think that I'm not the only one cancelled back to back because to some degree I do feel singled out.

Thanks for the reassurance about it being legit to question the commonness of this. If I was working with her more long term, I would totally email her back immediately to say "I feel like this....", but not having much of a therapeutic dynamic yet I'm hesitant to open up that conversation. But I think I will at least ask if this is common before I reschedule. The other thing is, if I was doing trauma work with her (and I will be hopefully if all goes well), being cancelled on twice would not only trigger the h*** out of me but also leave me generally freaking out. Maybe her other clients are doing trauma work right now and she's trying not to double cancel on them. I'm kind of surprised she didn't apologize much or do some reassurance.

 

[Biz]

Now to draft this email. It'll probably take a couple hours. PS 2/5 is 40%; 40% of the appointments we've scheduled, she's cancelled the day before. That's a pretty high probability of cancelling.

Also, she has a one week in advance cancellation policy for clients.

 

[digger]

That's a pretty high probability of cancelling.

Keep in mind that it could just be lousy timing though...if it had happened some way in to your working with her the percentages and probabilities would look very different, six months down the line, a year down the line, you could be lucky enough to have a therapist that's only had to cancel twice. :) Hope it works out for you either way.

 

[Biz]

:) @digger. Thanks.

 

[joeylittle]

she has a one week in advance cancellation policy for clients.

For real? Wow. I hate to be so blunt, but she's allowed to get sick, her clients aren't? Or rather, they will get charged anyway? That's just odd, in my opinion. It totally sounds like you have a plan. I still believe that when your business is any kind of health care, you need to anticipate more thoroughly the potential scheduling dominoes. My message on Wednesday night would have been "I am so sorry, I have to cancel, I've taken ill. It is likely to affect your Monday appointment as well - I'd like to cancel that one now; if it turns out I get better faster than I expect, would you like me to get in touch?" And then make sure I got something on the books for the week following.

It is better to give mental health clients a situation where they know what's happening, not a play-by-play kind of thing. (I think). But I'm also really persnickety about this, because cancellations rock my world, and I know how I need to deal with them - which involves the therapist really working hard to be realistic with me about what's going on. (Also, what I'm outlining above is how I handle my cancellations with students....which is probably my main bias).