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A broken appointment, as other manifest behavior, often has quite different meanings to different patients. In addition, it may have different significance for the same patient at various phases in treatment. This is still more complicated in child treatment since the child's broken appointment may often be a manifestation of the parent's disguised feelings about the therapy.
Many successfully helped families have had a large number of broken appointments during the course of therapy. Yet we often fail with other families who reveal their unfortunate treatment experiences by suddenly breaking appointments. It would appear that a statistical approach offers little or no possibility of establishing (1) the underlying meaning of the broken appointment to the individual family; (2) the meaning of the broken appointment to the individual members of the family; and (3) the meaning of the broken appointment with regard to the process of therapy.
Some patients give several days' notice before canceling. Others telephone to cancel on the day of their interview, yet allow enough time to change their mind. Still others may telephone after their appointment time and offer an explanation for their absence. Some fail to keep their appointments and may not telephone at all. When contacted by their therapist, they may say they “forgot.” A few of the patients who break off contact abruptly may be unreachable by telephone and letter, and just disappear from treatment.