Do I continue to see therapist who has cancelled last 3 appts (4/7)?

February 27, 2018 5:34 PM

Hey everyone. I've been seeing a mental health counselor for anxiety at a facility specifically for counseling. Here's a timeline of what has happened so far: Week 1: Goes well Week 2: Cancelled (she said she had jury duty) Week 3: Goes well Week 4: Goes well Week 5: Cancelled. Does't give explanation, but says she will be out of the office and returning next week) Week 6: Says her extension to her license hasn't gone through and it should be in by the end of the week, do I want to be squeezed in if possible, etc. I ask right away if she can see me in a few days and she says she'll let me know ASAP, but doesn't. I text the day before our next scheduled meeting and she texts me the next day... Week 7: Cancelled. Says they still won't let her see clients, we can "reconnect" and she can try to see me sometime this week, but if I want to transfer she "could help me with that as well."

Here's what I'm making of this. At first I thought she was avoiding me because my presence or something I said made her uncomfortable. Then I thought maybe it's my insurance. While I don't have medicaid, I know that doctors and the like don't get fully reimbursed for services. I belong to a union and my copay is cheap. Is this somehow factoring into her decision? I really am not knowledgeable about insurance.

So what's the issue here? Is she telling the truth about her extension? How long does this really take? I'd like to stick with her because she has helped me in the few sessions that we've had. It feels like she is pushing me away. Should I just get another therapist?

Thanks for reading my question and helping me out.

posted by outlander to Health & Fitness (19 answers total)

This is nothing to do with you. She's appallingly unprofessional and you should tell her so and then find a new therapist.
posted by kjs4 at 5:42 PM on February 27, 2018 [32 favorites]

Don’t read more into it than is necessary. Her licensing failure excuse is more than enough reason to find a new therapist. If true, she sucks at her job. If false, she’s incapable of communicating effectively with her clients and therefore sucks at her job.
posted by xyzzy at 5:45 PM on February 27, 2018 [13 favorites]

I’m not a gambler, but I would bet money that her license extension wasn’t going through because of some not-good Reasons which have nothing to do with you. She’s trying to cover for it and buy time, but you don’t owe it. You don’t even really have time: you need care on your schedule, not at her convenience.

Three strikes is plenty, and her bizarre unprofessionalism is not your fault/responsibility to fix. Get a new referral (not from her, but from whichever source you used before — insurance, EAP, counseling facility, whatever).

By the way, and I speak from experience: if you’re thinking of leaving a therapist but obligation/guilt is the thing holding you back, then that therapist is not meeting your needs. If a therapist screws up and you immediately wonder what you did to deserve it, then that therapist is not meeting your needs. It can be a pain in the neck to get a re-referral who suits you, but I promise it will be worth it once you do.
posted by armeowda at 5:55 PM on February 27, 2018 [11 favorites]

She doesn't have a license?! And she's having issues getting another one? Clearly she is not able to practice! Literally, she isn't allowed to!

It's not you, it's her. Find another one.
posted by jenfullmoon at 6:02 PM on February 27, 2018 [11 favorites]

I'll disagree with the notion that this therapist might no be The Worst Ever™. There really are a couple of legitimate reasons why a therapist might not be able to see you, including a licensure renewal not going through properly (this can be a huge hassle, but depending on the state you live in, this might not be her fault at all). It could also be that she's explaining this poorly and she's been having difficulty being renewed with an insurance panel, which happens with frequency, especially more modest insurance plans.

However, none of these are your problem at all, and you should bail ASAP with as little drama as possible. If she works with an agency, having her refer you out might allow you to bypass some wait times.
posted by furnace.heart at 6:02 PM on February 27, 2018 [10 favorites]

I’d bail unless you are super convinced it’s a great match. It was her professional responsibility to be on top of this.
posted by Smearcase at 6:05 PM on February 27, 2018 [2 favorites]

Response by poster: Thanks for making me feel better. I know licensure can be a pain and it's possible, just don't know how plausible. Also, my insurance doesn't require me to get referrals so I can do whatever I want and find someone else. I'm just going to find someone else, but I'm still open to hearing what others have to say. I've never been in this situation before. Very strange.
posted by outlander at 6:11 PM on February 27, 2018

Use this opportunity to schedule consultations with other therapists. At best she sounds flakey, and that's not really what you want. With a flakey therapist who doesn't have an assistant or office manager to corral their loose ends, you're likely to find yourself impacted by rescheduling, insurance paperwork snafus, and more - when really your therapy should be about you.
posted by bunderful at 6:23 PM on February 27, 2018 [2 favorites]

Just on the very slight chance you do make her uncomfortable (and I don’t think that’s what is happening), this would be handling it in a ridiculous unprofessional way. So even then, you’d do well to find someone better.
posted by FencingGal at 6:34 PM on February 27, 2018 [1 favorite]

So, here is a plausible explanation (I have no idea if this is really what is happening but it makes sense): Week 2: actual jury duty. Week 5: discovered that her license was not renewed on time - but it was in process and she hoped it would be OK by next week. In the meanwhile it is illegal for her to see clients Week 6: realizes that she doesn't know how soon it will get renewed and needs to admit to clients that there is a problem. She probably doesn't know how long it will take and ethically she needs to give you option to continue your treatment with someone else.
posted by metahawk at 8:49 PM on February 27, 2018 [5 favorites]

At least in IL, licences are public record and so are citations. You may be able to look her up to see if this is a oops I forgot issues or a bigger issue .

Either way, there isn't a reason for you to stay especially if it is going to impact your ability to trust her going forward. There are lots of therapists out there, and you haven't invested a lot of time with this one.
posted by AlexiaSky at 9:59 PM on February 27, 2018

I'm a healthcare professional and, obviously, required to maintain my licenses. I get plenty of advance notice (six-ish months) when my licenses are due for renewal; for my board certification, I have a couple of years. The schedules are also standard, so it's not like I can just forget (e.g., nursing license every two years, board certification every five).

Is it possible that she is a student and was practicing on an interim license? Those can be harder/more burdensome to renew, which might provide more of an explanation for the mix-up. I say it's good that she's been honest with you about not being able to see you due to a lack of a license but not good that she's bailed on three appointments in such a short time, whether newly-licensed or not. Regardless, it sounds like something rings funky about this for you, which might have shaken your confidence and compromised your therapeutic relationship.
posted by stillmoving at 11:47 PM on February 27, 2018 [1 favorite]

Who cares what’s really going on. You need a therapist you can see, and she is not it, so unfortunately it’s time to find a new one. It’s not you, it’s her.
posted by warriorqueen at 4:31 AM on February 28, 2018 [4 favorites]

If you really want to continue seeing her, ask her. I felt good about our sessions, but this has been disruptive. Will you be able to continue working with me? Unless the answer is really solid, and I doubt it, call the counseling office, ask to speak to a manager. Explain that a number of appointments have been cancelled, that it is disruptive and bad for your care, and they should find yo a new therapist with no delay.

It's not up to you to worry about the finances; they have a contract with your health insurer. You deserve much better treatment than this.
posted by theora55 at 6:32 AM on February 28, 2018

If her license isn’t up to date, it’s most likely illegal for her to see clients, so I wouldn’t take that personally. Licensing boards can also take a long time to renew licenses (mine takes 6-8 weeks), but therapists should plan for that. I agree that the lack of a license plus her lack of communication reflect poorly on her professionalism and if it were me, I’d just find a new therapist.
posted by lazuli at 7:32 AM on February 28, 2018 [1 favorite]

Your anxiety is increasing due to this situation. Get a new therapist who will help reduce your anxiety. Not helping =-no good.
posted by Enid Lareg at 12:10 PM on February 28, 2018 [2 favorites]

Response by poster: Again, thanks for the answers.

I’m actually a therapist myself (speech therapist) and I am currently completing my clinical fellowship so I know what a pain it is. I would imagine that reminders were sent out to her anout renewal and as it got closer she would have planned ahead of time. Of course she can’t see clients without a license. That’s pretty obvious. It’s plausible that she is having difficulty and it will take some time.

I just found it odd how she kept making promises she didn’t keep. I feel at this point she should be honest about the length of time this will take instead of getting my hopes up everytime.
posted by outlander at 1:51 PM on February 28, 2018 [1 favorite]

The therapists I've been around who have let their licenses accidentally lapse have all been deeply embarrassed by it, so my guess is that she's dealing with her own shame/anxiety that's keeping her from being effective at either accepting what's going on or communicating what's going on.
posted by lazuli at 2:25 PM on February 28, 2018 [2 favorites]

Therapist here -- I have accidentally let my license lapse once before, and at least in my state, it did take WAY too long for them to process my (immediate as soon as I found out) payment. It was longer than it should have been and I was deeply ashamed/concerned about having to cancel my appointments.

That is to say -- it happens to the best of us, but as always with therapy questions, if it doesn't sit well with you then it's okay to ask for a transfer!
posted by fairlynearlyready at 4:55 PM on February 28, 2018 [1 favorite]