Showing Up for No Shows

photo courtesy of

Every therapist I know has to deal with the inevitable missed appointment.  This blog is not about how to set up your cancellation policy, explain it to patients, and most importantly adhere to it.  If you are interested in my basic thoughts about that you can surf on over to my site for my cancellation policy and download the intake form which has it, as well as email me with questions.

No, today I want us to think about how you show up for your no shows.  Most therapists I know use their no shows to play a game of “catch-up.”  They catch up with notes, catch up with phone calls, catch up with emails, catch up on the news, catch a few ZZZzzzzs in the chair.  Note the progressive nature of the catch-ups:  It goes from things you really should have dedicated time in your week/day for and easily degenerates to self-care before you know it.

I never thought I’d use the phrase degenerates into self-care, but there you have it.  And I say it because on a meta level it is actually not self-care in the long run. Ok, I have times during the week, a few 90 minute blocks that I have built in to have my “catch-ups.”  And if I get all my work stuff finished in the first 30 minutes, which I usually do, I go on to some self-care extras, like a walk on the Charles River near my office, surfing the net, reading on my Kindle or a quick nap.  But these are extras, I schedule self-care time in my week regularly, even color-coding it on my Outlook calendar so I have dedicated times for that.  So if you have your self-care scheduled, and you have your “catch-ups,” scheduled, that leaves your no shows.

No shows are used for me as additional times to work on my ongoing projects to build my business beyond the office.  They include:

  • Blog posts like this one
  • Research for my newsletter
  • Writing a syllabus to propose to teach at the colleges I teach
  • Writing a workshop application for CEUs
  • Videotaping a webinar or short web feature to post on my blog or site
  • Tweeting some of my required Tweeting (I try to Tweet 4 times a day, 2 original tweets, 2 retweets of quality content from others)
  • Surfing Technorati or Mashable to keep abreast of recent developments in the blogosphere
  • Designing some Freebies I give away to promote a webinar or workshop
  • Creating a workshop for helping therapists deal with managed care
  • Test-driving new (or new to me) online games like Everquest, Aion, or Civilization V
  • Checking out new apps for the iPhone or iPad

Those are all things I have done in the past month or so when I have a no-show.  They allow me to continue to work on the overall business plan I have and get me started on projects that I used to complain I had no time for.  I don’t waste time seething that I’m losing money or call a colleague to complain.  From the business perspective, the only negative in a no show is the “no” at the beginning of that phrase.  As Bettye LaVette would say, I’ve got my own Hell to raise.

How about you?  How do you show up for your no shows?


  1. I liked this. No time to waste!

    • Thanks Natasha, effective use of our time is one of the most important parts of running a successful business. If you’re feeling the need to “sneak a nap,” you may be feeling depeleted by some part of your practice that needs looking at.

  2. hello Mike Langlois, LICSW , i read your blog , this a nice blog and perfect. Good for me. bulk Uncategorized and self-promotion content. i will visit to read and review your site.

  3. Really interesting – and nice to hear of a conscientious and productive use of time! I like the way you’ve thought through your time management and strategy. And there’s me thinking you are all sat there twiddling your thumbs 🙂

  4. Roberta Russell says

    Totally failed to meet my goal of being a silent participant at the NASW HMO liaison meeting. Insurers need health care reform SCHOOL!

    Could you enlarge on this?

  5. Yes, very well put!

    For people in the human services fields (we tend to care and want to do good work), it is so easy to ask ourselves, “Why do they not value my time and expertise,” or, “Am I not helping them enough?”, or, “Did I do something wrong?” That tends to lead to feelings of guilt because we are all human and not perfect. If we are not careful, that can lead us into a vicious cycle that does not lead to better marketing, or being in an effective mind-set to help the next person who takes time out of their busy day to “show up to work” with us.

    I value your reflections on our work, keep it up!

    • Thanks TJ, you raise a good point. Are we unconsciously sending cues to our patients that we are not valuable? And when it comes time to market ourselves, do we lead with this sense of self-devaluation? Good marketing and good treatment are very different things, but difficulties with guilt and self-image could effect both!

  6. Self-Care of Mental Health Clinicians

    What a great topic, I currently have been approved to provide a workshop talking about self-care of the mental health clinician. Like you Mike, I too, block out scheduled time for dates with my hubby, and time for my adult children. We love spending time with each other, so I make time for them as well as myself. I like to travel with my family, but there are times when I like being alone, just to relax and reflect on life. When I’m at the clinic or my private practice and I encounter no-shows, that is the time I use to get caught up with paperwork, or returning calls. Since I am also a doctoral student, I carry my dissertation work with me in case I have a no-show or cancellation. I try to utilize my time wisely. The most important thing to me is taking care of me first, that means getting plenty of rest, eating healthy, working out, even if its only taking a nice walk. Having a drink of tea while sitting on the deck are all ways I relax and enjoy each moment of my life.

    Thanks for your wonderful comments about taking advantage of one’s self, and incorporating time management to make sure the clinician practices well-being.


    • Michelle, great idea for a workshop. I have heard of several workshops that address vicarious or secondary traumatization over the past decade, but do we really need to let it get that bad before we get educated to take care of ourselves?

      Thanks for giving us the rundown of your day, it definitely sounds like you are making the most of your time! What’s the dissertation on?


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