Private Practice Mini Series — Ghosted: the private therapist initiation rite


Hi, and welcome to the third post in my Private Practice mini series aimed at practitioners in private practice, and anyone who works one-to-one with clients.

In the first post of this series, I wrote about creating the mental space that leads clients to find us.

Last week I wrote about calling things into being.


This week I want to talk about those difficult times when we book clients and they either don’t show up, or they have their first session and never contact again.

This is a very tricky situation, that can leave practitioners feeling insecure about their capacity as therapists, or bringing that impostor syndrome to the forefront…or even more, wondering what it is they did that made the client “ghost” them.


I am speaking from personal experience here.


As someone that also had a start in private practice and all that entails, I can say that ghosting happened to me too.

As a supervisor, I really like Scaife’s model (read my post on that here). He talks about responsibility and gives the supervisor, the therapist and the client a set of responsibilities.

I will start with what I’ve experienced as a therapist starting out in private practice and generalise it to other practitioners. Then I will discuss what I think happens from a client’s perspective (some not all possibilities).


In regard to the therapist, I would say that our responsibility is to hold the space for the client, where it’s safe to process and work through difficult stuff.

When we are starting, we are “desperate” (my own words, not calling anyone that although I’m sure some of you reading this can relate) – urged might be a better word, to retain and find clients to fill our time slots and help us start earning an income from what we trained so hard to do.

This urge might communicate over to the client. Unconsciously of course.


I am psychodynamically trained (now working integratively) so I believe that the unconscious to unconscious communications are very powerful.

We might not verbally be saying to the client “please keep me as your therapist, I need you”, but that’s what we might be communicating in many other ways we’re not aware of.

Now, just being aware of this is a great starting point to not put that burden on our clients.

A burden that might lead them to leave.

Apart from this, I don’t think there’s anything else that I can say right now to point the responsibility of a client ghosting a therapist, on the therapist themselves.


Let’s turn to the client’s responsibility.

Sometimes a client books a first session and never shows up.

It might have taken all of their energy and might to contact and book the appointment, but might have realised that they’re not ready yet, or that it’s too scary to attend, or something might have happened that led them to not need therapy anymore.

Sometimes they let us know, other times they don’t. It can be enfuriating, but we can’t take it personally. We might never find out what happened. We might have to live with the “not knowing” of why we were forgotten by our new potential client.


I find that as we spend more time as private practitioners, we get better at setting boundaries and trusting ourselves, and valuing ourselves as practitioners, and this happens less and less.

But when we are beginning, these things might not communicate as much through our contract, or our verbal and non-verbal communications. It’s an art and it’s developed slowly and gently, as we work with more clients and spend more time acclimatising to the realm of private practice.


Other times, a client arrives for their first session, it seems to have gone well, and they never book another session again.

For some clients, the catharsis that happens in a first session might have been enough.

Or it might have been too much to start talking about something that was only in their minds up to the point they started talking about it with their new therapist.

Ideally they’d let us know. But as above, sometimes they don’t.


We must err on the side of trusting our abilities and capacity as qualified and experienced therapists (we have, after all completed quite a few hours in placements before setting up our private practice!), and consider what is our responsibility and what is our clients.

Taking it to supervision and getting reassurance and clarity about what happens when we’re ghosted by clients will build us up, help us set clearer boundaries, possibly rewrite our contracts (I’ve rewritten mine many times, mainly adding stuff as time goes on!) and work on our initial contacts with clients, and how we feel about ourselves as therapists.

I hope this post has been helpful, or at least food for thought. I welcome your feedback and comments.


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