Nearly all helping professionals at some time or another find themselves needing to make a referral to another specialist. Whether one is a physician, pastor, or a psychologist, we sometimes find that the client’s needs and goals can best be met by someone who has special training beyond what we possess. Sometimes we discover that the client’s needs conflict with our own needs, as in the case of a pastor who may have a client in need of intense, long term counseling. To provide such counsel with very many people would distract the pastor from his responsibility of ministering to the whole church.
Referral is a skill. Making a referral is like any intervention in a professional’s toolbox. If the helping professional is skilled in making referrals, clients often follow through and seek the services of the one to whom they are being referred. As with any skill, referral may be ineffective if we are not confident and competent in making referrals.
Helping professionals are sometimes reluctant to make referrals because they feel guilty that they are not able to help, or they may feel that referral casts doubts about our competence. We may be fearful that the client will perceive the referral as rejection. When a client expresses resistance to seeing a professional therapist, we may be tempted to attempt to provide the counseling ourselves, even though it may be against our better judgment.
Referral is particularly advisable when we recognize that we do not have the competence, training, or experience in dealing with the unique problems that are being presented to us. To practice beyond one’s training is considered unethical for professionals and is frequently a factor in malpractice lawsuits. Helping professionals must not allow their own feelings of guilt or fear of a client feeling rejected to keep us from doing the professional and competent thing which is sometimes to refer.
It is best not to work with some clients. It is advisable to refer when we find ourselves sexually attracted to a client, when we find ourselves angry, when we dislike our client, or in cases where there is a potential conflict of interest due to our other relationships with a client. Dual relationships increase the possibility of our objectivity and judgment being hindered when making diagnosis or treatment decisions.
Referral is appropriate whenever we have provided counseling services to a person who is not showing signs of improvement. After a reasonable period of receiving counseling, clients should show signs of improvement. If they do not, it is our ethical responsibility to not continue counseling when it is not producing progress. We also have an obligation not to abandon a client in distress, but we are responsible to facilitate a referral to another helping professional.
