A Seasonal Reflection on Time, Boundaries, and Therapy Practice

This time of year tends to bring a familiar pattern. Schedules become fuller, routines shift, and many people are balancing work deadlines, family obligations, travel, and social commitments all at once. It’s a season that asks a lot of everyone.

In therapy practices, this same time of year often comes with an increase in late cancellations and missed appointments. I want to take a moment to reflect on why this matters, how therapy is structured, and how I hope we can approach the year ahead with shared respect for time and boundaries.

Therapy time is held differently

As a solo therapy practice, I reserve session time exclusively for one person or family at a time. Unlike many medical offices, therapy appointments are not double-booked or over-scheduled. When a session is missed or canceled on short notice, that time cannot usually be reassigned.

Telehealth can sometimes make sessions feel more flexible or abstract, but in reality, there is still a clinician sitting at a desk, prepared for the session, holding that time solely for the patient or family scheduled. Once that hour has passed, it cannot be recaptured or shifted elsewhere.

Why cancellation policies exist

Late cancellation and no-show policies are not meant to be punitive, and they are not applied lightly. They exist to create consistency, fairness, and sustainability within the practice.

This practice maintains the following policy:

• Appointments canceled with less than 48 hours’ notice are subject to a $75 late cancellation fee

• Appointments canceled with less than 24 hours’ notice, or missed entirely, are subject to a $150 fee

  
  

These policies apply regardless of the reason for cancellation and are outlined in the informed consent paperwork. While individual circumstances vary, the operational impact of a missed session is the same.

Like any small practice, there are fixed costs that continue whether a session takes place or not — including staff time, office expenses, and administrative overhead. Clear policies help ensure that the practice remains stable and able to offer consistent care over time.

About notifications, follow-ups, and rescheduling

Once a cancellation notice is sent, patients and families can assume it has been received and processed. Cancellations cannot be reversed after the fact, even if circumstances change. For this reason, repeated follow-up messages to explain a missed session or to ask whether a fee will apply are generally unnecessary, as these situations are already addressed by the practice policy.

After a late cancellation or missed appointment, patients and families are welcome to reach out to the office when they are ready to reschedule. Appointments are not automatically rebooked, and availability may vary.

A note about communication boundaries

The patient portal is intended for brief clinical communication related to care. Administrative matters — such as scheduling changes, cancellations, billing questions, or policy clarification — should be directed to the office email. Keeping these channels distinct helps protect clinical time and ensures that administrative matters are handled consistently and efficiently.

Looking ahead

Not every structure works for every patient or family, and individuals are always free to decide whether this model of care is the right fit for them. My goal is to offer thoughtful, reliable therapy within a framework that respects everyone’s time — including my own and that of the staff who support the practice.

As we move into the year ahead, I hope this reflection provides clarity around how therapy time is held, why boundaries exist, and how mutual respect makes consistent care possible.

Thank you for taking the time to read.