Counselor, Tell Them Why They Need to Show Up

Every counselor has had this case. The first session goes well. Then a work trip moves one session, a daughter’s recital cancels another, and by week six you have met three times. Now the counselee wants to know why nothing is changing.

Usually there is a reason for each absence, and most of the reasons are decent ones. That is why so many of us let it go. It is hard for us Midwesterners to say no to people. We’re nice. But it doesn’t matter if they have a good reason. If they aren’t here, they aren’t getting care. That means we have to tell them plainly, in the first session, why being present matters.

A Good Reason Won’t Stop the Bleeding

Think about going to the gym. If I only work out once a week, I can give you plenty of reasons, and they might all be true. But I still won’t get any healthier. Exercise only works with regularity.

Paul uses the same picture for the Christian life: “train yourself for the purpose of godliness, for bodily training is only of little profit, but godliness is profitable for all things” (1 Timothy 4:7–8). Here is my point. Training assumes regularity, whether it is your body or your soul.

Or think about the emergency room. Say you are badly hurt, but your daughter has her big performance tonight, so you skip the ER. In one sense that is a good reason. Okay, but you are still going to bleed out.

Counseling works the same way. We teach in the session, assign homework that builds on that teaching, and review it the next week. When a counselee misses every other week, half of that homework never gets reviewed.

Set the Bar in the First Session

The time to say this is in the first session. By week seven, it sounds like scolding.

1. Ask for radical attendance up front. In the first session, tell your counselee that counseling only works if he is here. Put it in writing in your intake document too. Now, don’t hear me say a sick counselee has to come in. If someone has a nasty cold, I don’t want him in the room with me. But most missed sessions are travel and schedule conflicts.
2. Meet on a fixed day. I only counsel on Thursdays. At my previous church, we counseled on Mondays. A set day puts some skin in the game. A counselee can move his schedule to be there a lot more easily than I can move my life around, and most employers will let someone switch a workday for a season of crisis. I recently finished counseling a couple who lived an hour and forty-five minutes away. I told them I would only meet during the business day, which meant taking a vacation day to come.
3. Use your waiting list. At my previous church, our waiting list was twenty to thirty people long, and some waited for months. We told counselees that. It is like the ER waiting room. They are going to call your name, and if you aren’t ready to see the doctor, they will call the next one. Counseling is the ER, not a long-term care facility.
4. Decide what counts as a pattern. Missing every other week means we need to talk. Missing three weeks in a row is a big deal. If the missed weeks were caused by my schedule, that is a different conversation, and that one is on me.

It Is Not Unloving to Say No

Some counselees will not meet the bar, even after you have explained it. Saying no to them will feel unloving. Do it anyway. The workers are few (Matthew 9:37), so the hours you have matter. And you are not the savior.

Sometimes the right words are, “I understand you need counseling, but it does not appear that I am the person to help you right now.” Termination because of lack of growth is a legitimate category for ending counseling. You might say, “Let’s take a year. Here are a few assignments I’d like you to complete, and if you still want to meet after that, come back.” The Lord’s mercies are new every morning (Lamentations 3:22–23).

You and I have no ability to open blind eyes. All we can do is lay out the word and pray that the Spirit would work. Sometimes it doesn’t look like He is working yet. Say so, and give it time.

Tell Them Why

Most counselees who miss sessions have never been told what missing costs. So let’s tell them in the first session, and tell them again when a pattern starts. If they still won’t come, let’s make room for the next name on the list.

About the Author

Josh Greiner is an ACBC-certified counselor and Fellow. He serves as Lead Pastor of Berean Baptist Church of Portage, Michigan, where he leads the church’s biblical counseling ministry. He is married to Shana, and they have four children.