The Real Reason You Keep Cancelling Therapy — and How to Break the Cycle
There’s a quiet moment in therapy that often doesn’t make it into the public conversation — the moment a client sends that message to cancel or reschedule a session. Sometimes it’s for a completely understandable reason — a genuine emergency or unavoidable. But sometimes, the reason is harder to name. It’s the feeling of not wanting to face something painful, the discomfort of vulnerability, the creeping thought that maybe this just isn’t helping, or that you’re too tired to talk about it all again this week. And that’s the very moment when the decision to cancel can have a far greater cost than just the cancellation fee.
Therapy, by its nature, works through rhythm and consistency. It’s like building strength — emotional strength, relational strength, cognitive flexibility — all of which require repetition, exposure, and practice. The therapeutic relationship and the internal changes that occur through therapy rely on continuity. When therapy becomes sporadic or is repeatedly delayed, that rhythm is disrupted, and the work can lose momentum. What begins as a short-term decision for convenience can end up subtly reinforcing some of the very patterns that therapy is there to change.
When we reschedule because we “don’t have time,” or “don’t feel like it today,” or “don’t want to talk about that thing,” what we’re often doing is avoiding discomfort — a completely human and understandable response. Our nervous systems are wired to avoid pain, whether physical or emotional. But avoidance is also one of the central mechanisms that maintains anxiety, depression, trauma responses, and many other forms of psychological distress. In other words, cancelling or postponing therapy because it feels too hard can be a symptom of the problem itself.
For example, someone with social anxiety may find themselves cancelling because they feel embarrassed about their progress or fear being judged. A person struggling with depression might think, “What’s the point? It won’t help anyway.” Someone with trauma may feel the session is “too much” or that they don’t deserve help. Or maybe it’s more subtle and sneaky as we try to convince ourselves of a “good reason” to not attend therapy that day. For example, my child is unwell and at home. Seems a valid reason right? Depending on the circumstances it might be, however are they that sick that we couldn’t do a phone session while they lie on the couch and watch telly? Or we ourselves are feeling unwell. Do we need to cancel or can we still attend via Telehealth but modify the agenda of the session to suit? Sometimes when we are a little more vulnerable the defences we were using to resist change become a little more obvious to us. Being unwell can also be an opportunity to explore self-care and self-soothing techniques. Each of these cancellations reinforces the underlying belief — that people will judge me, that I will fail again, that other’s seem to be able to do what I can’t, that things won’t get better, that I’m unworthy of care. In this way, the act of cancelling isn’t neutral; it can quietly strengthen the very neural pathways we’re trying to rewire.
Research supports what many clinicians observe daily — that regular, consistent attendance is one of the strongest predictors of positive outcomes in therapy. Studies by Swift and Greenberg (2012) and Wierzbicki and Pekarik (1993) have shown that early dropout and inconsistent attendance significantly reduce treatment effectiveness across therapeutic modalities. The process of therapy works cumulatively, with each session building on the last. Missing a session interrupts this cumulative effect, just as skipping medication doses or physiotherapy appointments would interrupt healing in a medical context.
The true cost of cancelling therapy, then, goes far beyond the inconvenience or the financial charge. It’s measured in the slower pace of recovery, the delay in emotional growth, the frustration of feeling “stuck” or “unchanged.” It’s felt in the self-critical thoughts that can creep in — “Maybe therapy just doesn’t work for me,” “I’m too broken,” “Psychologists are useless,” or “I can’t be helped.” These thoughts are rarely the truth — they’re defence mechanisms of a weary mind trying to protect itself from disappointment. But when therapy is inconsistent, these beliefs are given room to grow, unchallenged by the continuity of therapeutic work.
There’s also something quietly powerful about showing up when it’s hard. When you turn up to therapy on the day you least want to go, you are, in a sense, rehearsing resilience. You’re teaching your brain and body that discomfort can be tolerated and that you can face what’s painful without being destroyed by it. Those moments often end up being the turning points — the sessions that bring insight, relief, or even just the quiet satisfaction of having done something difficult in service of your healing.
From a therapeutic perspective, consistency also deepens the relationship. The therapeutic alliance — that sense of safety, trust, and collaboration between client and psychologist — doesn’t exist in isolation. It’s built through repeated contact, through being seen and understood over time. When sessions are skipped or rescheduled frequently, that relational thread frays a little. It’s harder for both therapist and client to stay attuned to the emotional narrative and momentum of the work.
This isn’t about guilt or shame. Life happens, and sometimes sessions do need to be moved or missed. But when cancellations or reschedules become a pattern, it’s worth getting curious — what’s really going on underneath? Are you protecting yourself from vulnerability? Are you prioritising everything else above your wellbeing? Are you afraid that if you commit to this, it might change you in ways you’re not yet ready for? Therapy can be a mirror, and sometimes even our resistance to it is part of what we’re meant to explore.
Many clients have shared that keeping a regular time for therapy — the same day, same hour each week — helps them commit to the process more fully. It becomes part of their routine, something predictable and stable in a busy or chaotic life. It’s no coincidence that the same people who guard their weekly Pilates class or Friday drinks with friends often progress steadily in therapy when they treat their sessions with similar respect. We live in a world that celebrates external productivity — appointments, deadlines, appearances — but undervalues inner work. Yet the internal changes we cultivate in therapy ripple outward into every other area of life: relationships, parenting, work performance, creativity, physical health.
Think of therapy as an investment rather than an expense. The returns might not be immediate or tangible like a haircut or a gym session, but they are foundational. Regular attendance doesn’t just mean showing up physically — it’s also a commitment to yourself, to your growth, to your capacity to face what you’d rather avoid. The value lies in the showing up, especially when you’d rather not.
If you notice yourself wanting to cancel, pause for a moment and ask yourself a few questions.
1. What am I feeling right now that’s making me want to avoid therapy?
2. What might I miss out on learning or shifting if I don’t go?
3. Is this discomfort an old familiar pattern of avoidance or self-protection?
4. Could this be something to talk about in therapy rather than a reason to skip it?
Sometimes the very act of naming those questions and bringing them into session can become a powerful part of the work. Your psychologist doesn’t expect you to be enthusiastic about therapy all the time — therapy is not always comfortable. It’s about being real, even about not wanting to be there. The paradox is that when you bring that resistance into the room, it loses its grip.
Prioritising mental health means safeguarding the time you’ve set aside for therapy in the same way you would for other important commitments. We make time for our hair appointments, gym classes, or social rituals because we know they’re good for us, even when we don’t always feel like going. Your therapy session deserves that same respect — maybe more. Because therapy isn’t just maintenance; it’s transformation.
So the next time you feel tempted to cancel or reschedule, take a moment to reflect on what that really costs. Beyond the cancellation fee lies the cost of postponed healing, prolonged distress, and missed opportunities for growth. Therapy only works if you attend. Your psychologist can walk beside you, guide, challenge, and support you — but only if you keep showing up.
And if showing up feels hard, that’s okay. That’s often where the real work begins.
If you’re struggling to prioritise your mental health or feeling stuck in patterns of avoidance, a psychologist can help you unpack and work through what’s getting in the way. You can book an appointment with a psychologist to begin, or begin again, your commitment to your wellbeing.
