People in psychotherapy tend to make more progress when they have goals, are being honest, and are working towards their goals in between therapy sessions.
Clients are responsible for calling 24 hours in advance to cancel an appointment. If this is not done, the client can be charged a no show or late cancellation fee. That fee is $70.00. If something unforeseen and uncontrolled comes up and 24 hour notice is not provided, I typically just forgo the charge.
If a client feels that they are having a life and death emergency, they are expected to take care of themselves, and call 911 or go to the nearest emergency room. A comittment to living is essential to making progress in therapy. In therapy, we would work on skills and processes to deal with discomfort and misery, with an emphasis on self care, and reaching out, versus self-destructive behavior.
My phone is on basically 24/7, unless I am in a session, or out of range temporarily for some reason for phone coverage service. If a client calls off hours, typically I will answer the phone. It is requested that clients do not call after hours unless they have some issue that is time sensitive. If I do not respond in a reasonable time, I ask that my clients do not assume that I actually received the message due to the vagaries of cell phones. My clients are asked to call again if the do not hear back from me in a reasonably prompt manner. I am typically very prompt in returning calls if I actually get the message. I do accept emails, but I prefer phone voice mails, as my voice mail is more secure than the internet is.
When I go on vacation, I arrange for coverage by another mental health professional. I try to provide that information in person to my clients, but that is not always possible. Therefore, that information is on my voice mail message (and email vacation message) for my clients if they call in while I am gone.