As with all professions, we vary in how much we charge for our services. You’ll find some therapists in private practice charging £25 a session (admittedly rare in London), while others may charge upwards of £100. We all have different cancellation policies too – some of us ask for 24hrs, others 48hrs, others maybe 2, 3 or 4 weeks. We set our policies differently for varied reasons – any business sets their prices according to competition, overheads and financial goals. But, unlike other businesses, we also take into (much) consideration of how our fees and cancellations affect the therapeutic relationship. It’s part of what we call ‘the therapeutic frame’: the container of the therapy/client relationship.
Other parts of this ‘frame’ include the physical space (the room you meet in, the chairs you sit on, the decoration of the room) and appointment time (in my practice, it’s the same time each week), confidentiality rules and how much a therapist will disclose details of his or her life. Therapists working with an ‘analytic’ frame (rooted in Freudian ideas) tend to hold the frame very tightly. They may ask for fees to be paid for each week apart from those when the therapist is on holiday (stipulated in advance) and they are unlikely to leak any personal information at all. The session space and time become wholly that of the patient, regardless of any physical presence, and the therapist ‘holds’ this for him or her, keeping the relationship as uncontaminated as possible with the therapist’s life. This is not meant to be punitive, although it may well feel tough at times.
Other therapists work differently of course, and what may fit for therapist A may not sit so comfortably with therapist B. Cancellation policies may be flexible, and you may even read on a therapist’s website some details of his or her lives – I’ve heard many people describe the value of a therapist sharing narratives of life experiences with their clients. There’s no hard and fast evidence of which ‘frame’ is better than the other – different frames suit different therapeutic relationships and different clients. It’s worth talking this through with your therapist if you are unhappy or don’t understand anything about the frame that you are in – usually valuable material emerges from these chats.
For more on these ideas, try here.