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Default Apr 09, 2019 at 04:14 PM
  #41
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Originally Posted by WishfulThinker66 View Post
Why are we so quick to judge the service provider? The OP clearly stated a history of not showing up to appointments. It only makes sense then that there be repercussions for this behavior. The therapist could have terminated them altogether. The fact she is trying to make suitable arrangements that would allow the OP to have a continuous cycle of care is actually commendable.
Maybe because it is manipulative in some ways?

But if the cancellations of 1 client (are we talking a once a month cancellation here?) will threaten the therapists business and livelihood, maybe she has bigger issues we are unaware of.
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Default Apr 09, 2019 at 05:31 PM
  #42
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Why are we so quick to judge the service provider? The OP clearly stated a history of not showing up to appointments. It only makes sense then that there be repercussions for this behavior. The therapist could have terminated them altogether. The fact she is trying to make suitable arrangements that would allow the OP to have a continuous cycle of care is actually commendable.
Because it's gross to set up things so that they are to your own benefit and then turn around and try to convince the other party that they are the actual beneficiaries.

Edit: And to be clear, it's not that I think it is wrong to set things up to your own benefit, but don't act like it's some sort of therapeutic intervention, ffs.

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Default Apr 09, 2019 at 07:22 PM
  #43
I don't see a continuous cycle of care that rests on a punitive tactic as being of benefit to the client. I would say it's incumbent upon the therapist to approach the behavior psychologically (while also imposing whatever missed session fees are usual and customary). And if, upon reflection, the therapist cannot do so, ethics would require the therapist to refer out. The only beneficiary otherwise is the therapist's financial security.

There seems to be this assumption that such a financial imposition is psychologically neutral--or pushed to the extreme, positive for the client. I think that's a naive assumption. It seems more akin to me to physical punishment of a child. Some believe it teaches the child about the consequences of bad actions; others believe it teaches the child that people bigger than you will hurt you.

Both of these behaviors involve coercion.
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Default Apr 10, 2019 at 04:37 PM
  #44
How on earth is this being manipulative. It is she who is responding to the actions of the OP. Are you suggesting she ignore them? Is her business to be held hostage while she waits for the client to show up or not? And, to stir the pot here, are you all also suggesting the OP's irresponsibility and actions are permissible without repercussions?
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Default Apr 10, 2019 at 04:40 PM
  #45
No one has suggested not to charge for a cancellation without sufficient (24 hours) notice.

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Default Apr 10, 2019 at 04:43 PM
  #46
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No one has suggested not to charge for a cancellation without sufficient (24 hours) notice.
Reading through the lines, it has been indicated this was problematic. Clearly, the therapist has been unable to guarantee this will infact happen. That is the very reason why payment up front is now required. Reliability is the issue here.
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Default Apr 10, 2019 at 04:46 PM
  #47
I would not see a punitive therapist. If others would, that is up to them.
I do not read it that the client did not pay. If a client does not pay then perhaps an exploration of why would be in order.
(and as a solo practitioner - I have had clients not show up and not pay me for my services - I do not demand up front payments or retainers for my work and certainly not for missed appointments)

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Default Apr 10, 2019 at 05:16 PM
  #48
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.....If a client does not pay then perhaps an exploration of why would be in order.....
Valid point, but I am willing to assume - it would be the most reasonable, logical, and professional thing to have done so - that the therapist did entertain this. Ultimately though, we have to acknowledge that the therapist's choice in how to manage the situation has come as a direct result of the history she has with the client. We also need to acknowledge such decision is hers to make and I point out a recognised method of professionalism. Were the client to have been more reliable and consistent then we wouldn't even be discussing this.
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Default Apr 10, 2019 at 05:21 PM
  #49
I would suggest that it is manipulative because the therapist is not responding: she is reacting. Professionalism requires a therapist to be reflective, not reactive. There seems to be no reflection psychologically, but simply a reactive action (which can easily be seen as punitive) which only focuses on the therapist securing payment. Even if the OP has a history of non payment--which I see no indication of in her post--the therapist's job rests on addressing the issue psychologically; it is this which distinguishes the therapist from most other professionals offering a service for a fee. If she is unable or unwilling to do so, she shouldn't work with the client. And I would repeat that APA speaks to these sorts of issues and always keeps the ethical duty to reflect, not react, as a central tenet.
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Default Apr 10, 2019 at 05:45 PM
  #50
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How on earth is this being manipulative. It is she who is responding to the actions of the OP. Are you suggesting she ignore them? Is her business to be held hostage while she waits for the client to show up or not? And, to stir the pot here, are you all also suggesting the OP's irresponsibility and actions are permissible without repercussions?
This T is being very manipulative. The T is a separate person-her behavior is irrespective of what the client does. This T's behavior/reaction is not the client's responsibility or fault.

In addition to what feralkittymom said, the therapist is taking an action to try to influence/get the client to do something. It's controlling. And engaging in the client's pattern is acting out--this is the very type of thing that leads to enmeshment with a T and client.

Feeling like being held hostage would come from the T, not the client. And yes, the client does deal with the consequences-the missed session, lack of support, missed session fee, whatever else. Engaging in the pattern-enmeshment-leads to more problems. Letting the client have autonomy to work the issue out will likely result in the issue running it's course on its own.
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Default Apr 10, 2019 at 06:06 PM
  #51
Manipulative,just about money,creating or perpetuating some type of unpleasant psychological response in the client ... seems like may be an over analysis of the situation and judgments being made without knowing the full extent of the OP’s history with this therapist -she may be all the things above or she may have exhausted all other options for her time to be appreciated as valuable-
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Default Apr 10, 2019 at 06:12 PM
  #52
The same over analysis/assumptions without all facts is occurring by those choosing to defend the bizarre approach of the therapist

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Default Apr 10, 2019 at 06:38 PM
  #53
Exactly-over analysis all round - but that’s maybe what the profession does to us
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Default Apr 10, 2019 at 06:43 PM
  #54
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Manipulative,just about money,creating or perpetuating some type of unpleasant psychological response in the client ... seems like may be an over analysis of the situation and judgments being made without knowing the full extent of the OP’s history with this therapist -she may be all the things above or she may have exhausted all other options for her time to be appreciated as valuable-
The therapist did not have to accept OP back as a client. They previously worked together, but that doesn't mean she had to accept OP again.

But again, the issue is not the therapist wanting her time to be treated as valuable. I don't think anybody is saying she needs to act as a doormat for OP. The point of contention is that it sounds like she attempted to muddy the waters regarding WHY she was establishing certain rules. It was completely unnecessary for her to say that OP would benefit from the arrangement. She could have just said take it or leave it, and not thrown in anything that could have been construed as manipulative.

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Default Apr 10, 2019 at 08:31 PM
  #55
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Manipulative,just about money,creating or perpetuating some type of unpleasant psychological response in the client ... seems like may be an over analysis of the situation and judgments being made without knowing the full extent of the OP’s history with this therapist -she may be all the things above or she may have exhausted all other options for her time to be appreciated as valuable-
My response is related to the type of therapy I do where the T remains neutral. So less judgment, more observation and perception.

As you said above, this type of 'analysis' sort of is what the therapy did to me, in a way. I don't do this type of analysis day in and day out, but in general, I am much less reactive of a person overall, adjust my expectations of others in healthy ways, don't act on impulse quite as much as before, and can usually avoid interfering with a person's autonomy, thanks to this type of thinking. 🙂
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