The Do’s and Don’ts of Client No-Shows in Your Private Practice

The clock ticks past the hour and your client isn’t there. What do you do?

It can be a common scenario for some of you and others of you it is something you worry about happening. Here are some do’s and don’t’s of handling no-shows in your practice.

DO call the client to check on their welfare. Leave a message. If they never show for session, follow up with one more call. If you are concerned about the client, you may request a welfare check from the police. Never assume. That is part of our role as a therapist is to set aside our preconceived ideas when we observe and listen. Yes we all have a bias and yes you may be thinking you know why the client didn’t show up, but all of that is wasted energy. Reach out and care for your client. 

DON’T post on facebook that your client no-showed and now you are going to watch the latest netflix series. In fact don’t post anything about your clients on Facebook and keep that information of theirs private. You may think that your social media profiles are only for your friends. People can screenshot your posts and you never know if someone is connected to a client that you see. We are in a different profession where we just can’t afford to spout off our frustrations about work because of the privacy issues. Get someone you can consult with or talk to a colleague on the phone or in person. Just keep your client’s information off of the internet.

DO charge for missed sessions. This should be in your informed consent and is easy to follow through on when you have a credit card on file, stored in the electronic health record. There are exceptions and before you make one, it needs to be clear to you how you determine those exceptions. If your informed consent says you charge and you don’t, there is not only a business/financial impact to you, but more importantly there is a break in the communication between you and the client. Communication is key so have integrity when you do uphold your policies. 

DON’T go into fear mode. A missed session doesn’t mean that your practice will fall apart. Fear doesn’t help you and in fact it can be a huge distraction. You are smart and capable. Go back to your marketing and business plan and make sure you have the financial plans in place to account for missed sessions. Your clients and you will get sick, take vacations and have emergencies come up. 

DO pay attention to your response. Do you feel relief? Why? This could speak to your work with your client or it could speak to your business as a whole. Evaluate your business processes and where there might be gaps in how you run your business and how it contributes to possibly more no shows.

So let’s talk quickly about how to reduce no shows.

  • Take a credit card from the beginning. Yes, over the phone at the initial consultation.

  • Get your informed consent and credit card authorization form signed prior to the session, at least 48 hours prior if possible. This gives you time to follow up with the client and confirm that they are attending the appointment.

  • Go over your informed consent in the first session and be clear about your policies. Having a credit card on file for my clients has helped so much that I literally can count on one hand how many no shows I have had.

  • If a person still understands your policies and continues to have issues, this doesn’t mean they are not the right fit for therapy. It may not be the right fit for you however please get clinical consultation.