I had a new patient. She e-mailed a few hours before cancelling, but wanted to reschedule. We agreed to reschedule for today, and she didn’t show. I called her, no answer. Shortly after, she texted saying she had a family emergency. She asked to reschedule. Normally, I would charge for no shows, but we’ve literally never met.
1. You don’t have a patient yet. It’s hard to collect money from someone in whose mind you likely have not yet provided any service.
2. Of course, you should be compensated for your time.
3. This is a person who is acting out tremendous ambivalence about entering treatment. Her behavior is showing you very clearly how conflicted she is about meeting you.
4. I’m wondering about her conflict. Is she scared? (I imagine yes, terrified.) And/but what else is she feeling?
What I’m imagining is that you’re excited about having a new patient, and that’s introducing noise into your own thinking. And you will face competing challenges with her: bringing her into contact with her ambivalence, and, bringing her into contact with you. As of now, you know nothing about how she conceives of what’s happened thus far. Does she imagine she owes you? Will she be insulted, impinged upon, if you ask her to pay you? I would want to learn all that. She’s given you so much rich material, even without meeting.
I think, if it were me, I might be inclined not to set another appointment with her without at least raising the issue, preferably on the phone, but perhaps in email or text, along the lines of, “I haven’t had an opportunity to discuss my cancellation policies with you yet, but given you haven’t been able to attend the first two sessions we’ve scheduled, I need to tell you my policy, that I expect to be paid for scheduled sessions. Given that you weren’t aware of this, I wouldn’t charge you for our first two such missed sessions unless you think it reasonable, but, if we are to schedule again I would like you to understand I will expect you to pay me, even if you aren’t able to attend.” Or something.
But it’s definitely tricky, given that you haven’t even met.
Alternatively, if you can stomach it, I might simply punt on the question until we were meeting, so I could assess her ego strength, and learn something about her, about the meaning of all this. (I think this probably is the best option for me, clinically, as it really respects her anxiety and fear.)
I’ll be curious to learn what happens.
