How do we know when to refer?

While I have written about referral before (here), there is always more to understand about a topic. Let's begin with a definition: when a client has approached us, but we feel for any reason that we cannot meet their needs, we then suggest or "direct[... them] to a[n alternative] counsellor or [to an] alternative source of treatment" (Counselling Tutor, 2022; Feltham & Dryden, 2004, p. 192).

Why might we consider we could not see them? We are obliged under our professional memberships - for example, as laid out by the Career Development Association of New Zealand's code of ethics here in New Zealand - to be appropriately qualified for the services we are providing. The CDANZ Code of Ethics makes it quite clear that professional members must "Represent services, qualifications, and experience accurately and fully, and only undertake those practices for which they are qualified and in circumstances where they have appropriate experience" (2016). If we are not expert, we must refer clients on to someone who is an expert, particularly when we are dealing with people who may be considered vulnerable.

Further, the process of referral consists of four stages, that of "(1) identifying the need to refer; (2) evaluating potential referral sources; (3) preparing the client for the referral; and (4) coordinating the transfer" (Gladding, 2000, p. 102). This needs to be a hosting process: we host our potential client out of our care, and smoothly into the care of another, with appropriate briefing or hand-over. Think five star hospitality.

An alternative to referral is, should our client have a strong preference to continue working with us, for ourselves as the practitioner and our client to place ourselves under the supervision of an expert in the required field. However, our duty of care is to always ensure that we act in the best interest of the client, and to minimise our collective exposure to harm.

It can be difficult to do the right thing. But we need to.

Sam

References:

CDANZ. (2016). Code of Ethics. http://www.cdanz.org.nz/uploads/CDANZ_CoE_Word%20English%20Final.pdf

Counselling Tutor. (2022). Referrals in Counselling. https://counsellingtutor.com/referrals-in-counselling/

Feltham, C., & Dryden, W. (2004). Dictionary of Counselling (2nd ed.). Whurr Publishers.

Gladding, S. T. (2000). The Counseling Dictionary: Concise definitions of frequently used terms. Merrill Prentice Hall.

Good Therapy. (2022). When Should You Refer a Client to Another Professional?. https://www.goodtherapy.org/when-should-you-refer-a-client-to-another-professional.html

NASW. (2022). Ethical Standard of the Month: 1.16 Referral for Services. National Association of Social Workers. https://www.socialworkers.org/About/Ethics/Ethics-Education-and-Resources/Ethical-Standard-of-the-Month/Referral-for-Services