It’s Monday morning and you call your therapist to tell them you are canceling this week’s appointment.  If you are being honest, perhaps one of the following reasons sounds familiar: “I have other doctor appointments this week, so I don’t have time to come to therapy,” “My expenses have been too high lately,” “I spent too much money this past week,” “I’m going on vacation next week, so let’s pick back up when I get back.”

This list of reasons is not by any means all-inclusive, but it does contain some of the common reasons I am given when an existing client cancels their appointment for the week.  However, the real underlying message being sent is one which I have written about in other blogs (“Therapy: The Modern-Day and More Effective Spa Treatment & “Getting Away from the Therapy is a Luxury Mentality“): “Therapy is not that important, certainly not as important as my other doctor appointments or the outfit or home decor I recently bought.”

In essence, the person who cancels their appointment for any of the above reasons is not only saying they don’t think therapy is that important, but they are really saying that they don’t believe their own mental well-being and functioning is a priority. If it were, they would make attending their scheduled therapy appointment just as much of a priority as going to work, going to other doctor appointments, exercising, and yes – even eating (that may sound exaggerated, but just like food helps to energize, nurture your body, and prolong life, therapy does the same).

Why Is This a Problem?

There are many problems with randomly canceling your psychotherapy appointments.  As discussed in the blog “therapy is not a luxury,” not only does haphazardly canceling your scheduled therapy appointments suggest that therapy is a luxury activity that should be viewed as optional and only on occasion when you “want to treat yourself well,” but it minimizes the perceived importance and effectiveness of therapy.  It also minimizes the importance of your own mental well-being.

When you cancel your appointments only to delay them to another week due to a frivolous excuse, it broadly and strongly suggests that your problems and life difficulties are not really all that important – which does not mean they actually are unimportant, but rather that you are not prioritizing them as such.

There are many hypotheses and theories about why patients cancel appointments in this manner, but ultimately what matters to you, the patient, is how this impacts treatment results and your life.

Consistency

You know the saying “if you keep doing the same things, you get the same results” – well, this is a quote about life.  And therapy is all about [your] life.  If you don’t actively work to make changes in your life, you honestly cannot expect for things to be different (i.e., better!).

In therapy, where you are actively working on YOUR life, this means you cannot realistically expect to attend a therapy session here or there and see significant changes in your life.  Take a more relatable example: If you are dieting and exercising to lose weight, you cannot simply commit to doing this only a few days a week while eating anything you want and not exercising on the other days – and actually expect to see results.  Most individuals’ personal experiences with dieting and exercise has demonstrated this time and again – if you skip exercise and eat anything you want the other days of the week, chances are, you’re not going to see much, if any, change.  Therapy is no different.

The key here is being consistent; if you want change, you must be consistent.  Consistency essentially means sticking to the plan and not skipping (or over-doing) something.

  • If you want to lose weight, you must be consistent with eating healthy and exercising.  Inconsistency won’t get you to your goal.
  • If you have an infection, you must take your antibiotic as prescribed in order to get rid of the infection.  Skipping doses will lead to delays in the infection clearing or perhaps cause the infection to worsen the longer it builds in your body.  (In therapy, skipping sessions leads to delays in your healing and can actually prolong and worsen your distress).
  • If you want to learn how to play a card game, play an instrument, or become really good at a particular sport, you cannot expect to do so by only practicing once every two or three weeks.
  • If you want to see actual, genuine, meaningful, and lasting changes in your life or relationship(s), you must attend therapy sessions as prescribed.  This usually means once weekly, or once biweekly.  Skipping sessions will not get you there.

Couples Therapy

Couples therapy is a specific type of treatment where consistency is key.  Since you are two people working through relationship difficulties, it is unlikely you will see much progress in your relationship if even one partner is not actively working to make changes (both in session and outside of the sessions).  Attending therapy sessions as scheduled (aka, as prescribed) is more likely to keep you and your partner accountable, which means your relationship is more likely to experience the positive and intended benefits of therapy.

Prioritizing Therapy

The idea of prioritizing therapy does not mean that your therapy sessions or therapeutic “homework” assignments have to consume your time, but it does mean that you ensure you are attending scheduled sessions and not canceling appointments due to random reasons, or yes, what are really excuses.  If you are investing your time, emotional strength and energy, and money into working with a therapist, why shortchange yourself by not fully engaging in treatment?  This would be like paying money for an exam test prep course, but only attending a few classes and not practicing the skills at home – meaning, it’s essentially a waste.

When you cancel sessions for any of the above reasons, don’t be surprised to think that therapy is “not all that helpful” or to notice not much is different in your life.  The problem with this, however, is that it is not therapy or the therapist’s lack of effectiveness; this is happening because you are not prioritizing treatment and thereby, shortchanging yourself.  Period.

The Problem with Canceling or Skipping Therapy Appointments

When you go to therapy, it is because you are seeking the assistance of a professional who is experienced and knowledgable in working with your specific problem area.  Many times, therapists will give you in-between session homework assignments aimed at helping you to develop specific skills to manage your thoughts, emotions, and behavior in a more functional manner.  Skipping sessions usually means that you fall behind in practice and that the next session is spent playing catch-up and re-reviewing the content discussed at the last session due to the lapse in time between sessions.  How much progress can really be made if you are not actively and consistently attending sessions, completing next-step homework assignments, and progressing through the skill development?  The answer: Minimal progress.

If you are not being given homework assignments, the same idea applies.  If you are meeting with a therapist for “talk therapy,” this typically means you are processing through important and perhaps deep content.  It is incredibly hard for both the therapist and patient to pick back up where you left off when you skip even one week of therapy.  The next session usually becomes about checking in with you and again, playing catch-up.  If you were learning how to play an instrument, it would not simply be enough to practice for one hour every two weeks.

Therapy is not about just checking-in and you describing what has happened in your life since your last session. That is not the purpose of therapy.  Therapy is about growth, insight development, and making genuine changes in your life.  You simply cannot accomplish these things if you are treating your therapy as an extracurricular activity.

You Want Things to Be Different in Your Life

If you want genuine, lasting, and meaningful change, you have to be consistent.  Being consistent can also mean being in therapy for a shorter period of time as things in your life begin to resolve due to the active changes you are making.  This often equates to a larger savings, as well!  Prolonging your success just means more time, energy, and cost over the long-term.

So if you are scheduled for an appointment with your therapist, this means your therapist believes the session is necessary as part of your growth and healing.  If it were not, they would space out your appointments when scheduling or tell you that you have progressed enough where you are able to terminate.  An appointment scheduled is one which should be kept if you want things to be different in your life and your relationship(s).