Sessions Two and Three - No Show and Cancellation

no show

Session Two - No Show

Sessions don't always go the way you think they will and in this case, Mary's a "no show" for session two. She doesn’t call or email for a cancellation – she just doesn't show. When Joan first started counseling, she took this very personally – thought there was something terribly wrong with her.

Now Joan is more careful to remember that this is about the client, not her. If the client was not happy with the session, she had the option of changing counselors.

Still, Joan cares – she knows Mary is feeling so low. So she puts a call in to Mary – and gets the answering machine. She leaves a friendly message, “Hi Mary! It’s Joan. We had a meeting today at 2 pm. It’s now 2:15. If you would like to rebook, you are welcome to call the front desk at #4321 and ask them to let me know you have rebooked." If Mary didn’t have a private phone, Joan would have sent her an email.

Joan would dearly love to know if Mary had booked a health appointment – but doesn’t have a permission to release information form filled out to request this information. The downside of client confidentiality is that – without written permission – you cannot go asking around.

Joan is also aware that sometimes all a person needs is to be heard, to be really heard. By admitting they have a problem, reflecting on it, saying it out loud, and getting some perspective – that’s all some folks need to start resolving the issues. Perhaps this is what has happened.



Session Three - Cancellation

Mary called in a cancellation in advance. All clients are informed by reception if they miss two appointments in a row, they will have to provide reasonable explanation for why this happened – in writing. Curiously, Mary didn’t cancel her fourth appointment. Yet she hasn’t contacted Joan either.

And then, a few days later, Joan gets an email. “Joan, I’m sorry I didn’t show up for our second appointment and I had to cancel the third. I was just feeling so lousy I couldn’t face it. After our first appointment I felt really good. Like I could beat this. And then ‘boom’ – I felt worse than ever."

"I did go see the doctor and he recommended an antidepressant as well as counseling. That really p*ssed me off too. But today I had a moment of clarity – I felt like I used to. So I called the pharmacy and got the prescription filled. The pharmacist insisted on talking to me. I was hoping for a ‘magic bullet’ – that if I took this today, I would feel better right away. She told me that antidepressants work best in conjunction with counseling and was insistent that I take a list of counseling services with me."

"Tra-da! The university’s counseling service was listed. I mentioned your name and she knew of you. So I’m back! See ya Tuesday! Oh yeah, and thanks for calling.”

Joan writes back a friendly short email. “Hello Mary, I am very glad to hear from you. Good for you for seeing the doctor and following up with the meds. I look forward to seeing you soon! BEST! / joan”

This pattern of disappearing after a first or second session is not the norm, but neither is it unusual. Clients feel such relief in getting something off their chest and think this feeling will continue – and then the clouds come back. They can feel discouraged, even angry. All of us like quick fixes, but life isn’t like that. Building and maintain good health – physical, social, emotional, spiritual, intellectual and vocational – is a full time endeavor!

Joan has made a point of building a rapport with the university clinic’s health team and with the pharmacy team at a local store. In this way she has people she can comfortably contact regarding medical questions and her clients already have a known team to go to. But as importantly, she keeps in touch with student associations, the university psychologist, off campus mental health clinics, and other community services.

As you see, Joan always has homework too!

And by the way, Joan will never know if Mary actually did take the prescribed medication. Sometimes just knowing that one could if one needed to, is all a person needs.



Eighty percent of success is showing up. - Woody Allen

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