REAL QUESTIONS FROM REAL CLIENTS

"I saw my therapist out shopping the day after she cancelled my session because she was "really ill". I feel really hurt by this and just don't want to go to my next session. Am I overreacting?"

Thank you for providing this question and seeking feedback. I am a mental health therapist that is guilty of this- I live and work in a smaller community and often run into the people I work with. I know that my clients have seen me out and about doing my business, even the days I’ve cancelled clients or am out of the office to observe a sick day.

I want to expand on your question by sharing more about my first hand experience experience of being a therapist who cancels the day of appointments to take a “sick day.”

Let me begin by saying this is not a frequent activity or consistent behavior that is engaged in, nor it is done in an excessive way. I simply would not make money as a practicing therapist if I did that.

While I do think of my self as a sort of super hero helping others save lives, I too become overwhelmed and fall victim to becoming ill or experiencing some kind of sickness.  I am a marriage and family therapist and I am also a human being.   Further, as a front line worker and someone in a helping profession we are more likely to experience secondary trauma and compassion fatigue.

Secondary trauma affects individuals who are chronically exposed to people who have been traumatized, hearing or witnessing reoccurring descriptions of disturbing, violent or traumatic event. Symptoms of secondary trauma are similar to those of PTSD.

If I were honest I take sick days, and sometimes those sick days have nothing to do with being physically ill. Being an everyday person as well as being a therapist, we are impacted by the same conditions you may be experiencing: depression or anxiety, mental or physical illness, and life and relationship stress. We are also not excluded from personal loss or tragedy. As such, just like you we need to cope.

Chronic stress if left unprocessed can make you physically ill and has significant negative effects on the total human body. The experience of prolonged stress has a profound impact on the physical body and science has shown us that psychological stress is the leading cause of heart disease, hypertension, and Chrone's disease, while leaving us more susceptible to injury or illness. As a mental health therapist my goal is to model healthy life and relationship skills through practicing the use of self-care behaviors and using adaptive ways to cope.

I have a deep passion for what I do and I love my job. It is also important to me to provide the most effective and high quality treatment.

One thing you must know about us as therapists is that we’ve taken the day off because that’s what is best for you. We realize that our own issues can impact you and we don’t want to negatively affect you in anyway. If I take a day off it’s because I know I can’t give you what you need. 

With that being said, a therapist should consider the use of deceit. Direct or deceitful dishonesty from a therapist is not conducive to the therapeutic relationship, and is a consideration that the therapist should make. When appropriate, the therapist should take ownership or apologize.
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When I cancel, take a sick day, or go on vacation I will assertively state the need. When I am genuinely sick I will tell my clients, or in cases when the need is less visible I will vaguely state “something came up” or “I need to cancel and reschedule our appointment, are you available next week?” I realize as a mental health treatment provider the therapeutic relationship is important, no one would like to feel lied to or to find out they have been deceived. I have apologized to my clients several times!

If you find your feelings toward the therapist are overwhelming it’s best to bring it up. Sharing your thoughts and feelings about seeing them in public can be a great experience to learn from. It can be a great opportunity to discuss and process the expectations for ourselves and other, boundary setting or coping, as well as give yourself the opportunity to practice assertive communication and conflict mediation. Ultimately, your assertiveness can help you determine whether you want to keep working with this particular provider.

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Raquel Buchanan is a Licensed Marriage and Family Therapist in Palm Springs, Ca. Raquel specializes in building self confidence and self esteem in people who have experienced childhood abuse. Raquel offers client-centered therapy and values authentic human connection, her therapy style is a reflection of that. Raquel is a content writer on quora.com and is a featured writer in the Quora Daily Digest. This featured blog post was originally published in September 2020 as a part of Raquel’s participation on quora.com.