I favor telling the patient that my usual policy is to charge for missed sessions unless I fill the time. An exception is that I am willing to reschedule hours, if possible, when given advance notice. I state that I understand many have difficulty with such a policy. Thus, if the patient has any misgivings, I am willing to discuss them. I do believe that the policy as stated is beyond the usual experience of many.
Some patients see it as overly rigid, greedy, one-sided and unfair.
With those who are not able to understand it from the therapist's perspective, the policy is not a good one. In these cases, modifications are necessary. With some patients, where I sense that there will be clear antipathy toward the usual policy, I do not bring it up. If and when a problem arises with these patients, I approach it in a flexible manner. It is useful for the patient to be given a set of guidelines regarding psychotherapy near the initiation of treatment.