T wants me to pay a deposit or else month up front

Maybe it is a canadian/european thing.

Maybe the important thing is what this means to you? You could be viewing it as: ‘my T knows me, she wants to help me to come every week, and that feels good’, or it could have a negative meaning for you? I don’t want to make suggestions of the negative meaning it could have for you, but if it does have negative meaning then maybe it’s not so helpful of your T to do this. Do you want to tell us what it means to you, and would it be helpful to you to tell your T?

I’m uk based- I note some posters saying they would not agree to their t holding some money on account -credit card/cash in case of repeat/late cancellation
-what would they suggest instead to secure income /best utilisation of therapists time eg other/ urgent clients
I have no vested interest either way -as a veterinary surgeon the practice gets many “failed to attends” but there is always something else to do in a hospital practice eg contacting clients with results assisting with other cases etc -major surgery fails take several Hundred £ out of the till but we NEVER ask for deposits/credit card details in advance- that’s life - in business there is always something else you can be doing
I guess a therapist could set a limit of last minute cancellations before referring a client out which is clearly defined (endless vague illnesses/ excuses like a school child would require common sense to sort through)

Under those circumstances, it seems only fair. Why should Ts be penalised with clients who tend to miss sessions and hence compromise any money owed them.

If clients don't want to come, fair enough but if not enough notice is given, why should Ts be left dangling when they could have booked another client. After all, Ts also need to survive and earn a living.

You raise a very good point here. Is it possible then that the therapist is doing this for ulterior motives? By arranging things as you say for the OP, is she not ensuring she still has a client?

I keep my credit card on file with my T bc I never want there to be a problem with paying. My T is busy, and I don't want anything to go wrong that would make him irritated with me as a client on that level, bc I am a lot of work compared to some others.

I put a deposit on file for I assume missed appointments or payments. I've also cancelled under 24hr notice and been charged, which is fine with me. I'm aware of the rules and understand the business practice.

Mine doesn’t charge for cancelled sessions even if last minute. None of the doctors/dentists/therapists ever charged me regardless how close to the appt time I cancelled.

Reasons were snow storm started, got stuck at work, car broke, got sick, family member got sick Etc not often but it happened, alwars fir legitimate reason (but how do they know?) they had no issue with cancellations, just rescheduled.

I’d not see therapists or doctors who charge for cancelled appts (unless of course there was my only option).

Mine have technically charged for missed sessions (without 24 hours notice), but when I've had to cancel for something like being sick, my D being sick, weather, etc. they've never charged me. Current T even said recently that I'd probably get a free skip day because I've been so reliable.

When I worked in an agency serving Medicaid clients, charging for missed sessions was not an option, let alone asking for a deposit. Our clients were destitute. The tricky thing is that this population also has a higher no-show rate due to several factors. One is that many of our clients were on disability due to their mental illnesses and that's why they qualified for Medicaid. So they had pretty severe symptoms. Another factor was that because they were living in poverty, access to transportation was often an issue.

It was definitely a difficult problem to address, especially since Medicaid reimbursement rates are so low. From what I can recall, what we ended up doing was purchasing a fleet of vehicles and hiring transporters to assist clients with transportation barriers. We did reminder calls and if someone said they weren't coming, there was almost always someone else we could fill that slot with. We also hired a lot of therapists who were community based, so they met clients in the clients' homes. For med management, we actually double or triple booked appointments. That wasn't ideal, but it seemed to be the only way we didn't LOSE money. We obviously couldn't do that for therapy appointments since they were much longer. I think there was a limit of three cancellations or no-shows because we had a long waiting list.

Back to your original post: Is this T the only option you have? If you have other therapist options, why not check a few out? You have a history with this therapist, and it sounds like it was a bit contentious; additionally, this therapist has some preconceived ideas of you because of your past therapy with her. Would it not be a better idea to start fresh with someone who . . . A. Won’t require that kind of payment up front if that is something that doesn’t work for you . . . B. Will allow the biweekly schedule you were planning on . . . And C. Doesn’t have any preconceived ideas of who you are? It just seems like you haven’t even really started and there are several problems on the table already. To me, that screams “RUN!” Find someone better suited for your needs. Don’t settle.

I can see both sides to this issue. On the therapist's side, I can see asking for a deposit to cover missed sessions. My T's have all had cancellation policies that required a payment if the session wasn't cancelled within a certain amount of time (although former T never charged me. I was very consistent but had to cancel a few times in the 10 years for things like being in a car accident a couple of hours before the appointment etc). But I can see on the client's side that this feels punitive. Or at least it would feel punitive to me. But I think if I worked well with the T then I would pay the deposit and maybe discuss it a bit more with the T. But I think ultimately I would pay the deposit and move forward. HUGS Kit

I think that's completely unethical to ask for a deposit. Clients are not supposed to pay in advance for therapy sessions. I would never agree to any of this anyway. This therapist is treating you like a child. You're not a child. Having a 24-hour-cancellation policy is fine, I would never see someone who had requested more than 24-hour notice. I once saw a therapist who requested a 5-day-notice and I was like "lol bye".

But that’s the issue - OP has said she has a history of cancelling on short notice, so in this situation the T has every right to recoup her lost wages and/or terminate the client. (My T would let it happen once maybe twice and then he would end the relationship).

I don't agree that a therapist has a right to demand a deposit from a client no matter what. Other professions, who also depend upon clients paying for time, do not operate in this fashion. It is just a part of the business.

I think I would be willing to pay one session ahead, if I liked the T and so on, given the history. A month ahead seems excessive, especially when she wants to see you more than twice a month! Whatever you do, make sure you get a receipt!

That all said, I will not allow a T to keep a credit card on file and bill me as they wish. I did that with one I saw 4 times while my regular T was gone for 6 weeks. The substitute T charged me for 5 sessions and charged more than my copay ($40/session instead of $20). Since I wasn’t authorizing each charge and she never provided a receipt/invoice/statement I didn’t catch it until much later.

I pay my current T by check every week. I don’t need a receipt because I get the check image when she deposits them. I have paid her by credit card when I was on short-term disability (so cash flow was an issue), but I always got a receipt right away (emailed - and didn’t leave until it showed up on my phone). I pay by check so she doesn’t have to pay the transaction fee for running a card, though we haven’t discussed that.

But OP didn't say she had any history of non-payment, late payment, reluctance around paying for missed sessions, or anything else that would justify payment upfront. Having and enforcing a cancellation fee doesn't have anything to do with also requiring payment upfront.

This therapist is treating the OP based on experience. If this seems childlike then that is what it has come down to. Do not blame the therapist for acting in response to a pattern of behaviour. This very much IS maintaining professionalism.

Are there things the therapist can do to prevent this from continuing? Yes. They can have the office make reminder calls and have them determine if there is an outside factor or influence that would necessitate difficulty in making the appointment. That would give the office time then to book that slot with another client.

However, ultimately the responsibility lies with the client. If you are going to behave irresponsibly you need to expect such actions that would encourage you to step up accordingly. I see no blame on the part of the therapist and office at all here.

Perhaps standards are different in Canada. But in the US, APA issues cautions in related financial matters, such as financial inducements to research participants, fees from/to 3rd parties for consultations, obeying all jurisdictional laws regarding financial record keeping, and not behaving in a punitive manner, financially or otherwise. It would not be irrelevant to consider how such funds are categorized for tax purposes. Such funds would be held in the event of non-payment for services not rendered. This is not the same as a "retainer" payment. Not sure that would fly with the IRS.

More importantly for me, the notion that it is somehow justifiable psychologically simply because it is practically convenient and advantageous to the provider strikes me as intellectually and ethically bankrupt, as suggested by starfishing's post #20.

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.