Ethical implications of charging for missed sessions

The argument is made that the common practice of charging psychotherapy patients for missed sessions constitutes unethical conduct from which the therapist benefits at the patient's expense. Although various rationales and rationalizations have been put forth to justify the practice, the essential facts are that therapists are being paid for a service not performed and the patient-therapist relationship is often damaged, with the result that the patient's progress is impeded. The practice is therefore alien to the basic goals of psychotherapy, an enterprise that involves human interactions centering on positive bonding and collaborative problem solving. It is suggested that mental health workers' professional associations scrutinize the practice more closely and make stronger recommendations to discourage it.