When to refer on, part 2

In a previous post, we considered when we should refer a client on (here), and I suggested a few considerations for us to reflect upon, so we could see if we had missed some steps in our practice. However, if we reverse those reflection prompts and if we have experienced any of the following, we do indeed need to refer on:

• We feel we are working beyond our level of competency
• We feel there is someone better suited to working with this client
• The expertise required for this work is better suited to another practitioner or agency
• The work between us and the client is not related to the contract we originally negotiated 
• A psychological issue emerges in our session which cannot be contained within the session
• A health issue emerges within the session which cannot be dealt with in the session.

But further, in considering the first item listed above, we could also take five minutes, and ask ourselves the multiple choice questions in the image accompanying this post - and we can select as many items as we think apply (Cooper, 2011, p. 144):

• Which of the following are components of burnout?
• Which job factors in healthcare settings contribute to the most distress?
• Affective signs of work stress include [what?]
• Accumulated loss phenomena include which of the following[?]

Suffering on in our practice does not help either the client or ourselves. We are much less able to bring our best selves to our practice. So if we answer a and d; b and e; b; and a and b, we should seek some help (Cooper, 2011, p. 146). That "support can be emotional (clinical supervision/mentorship), or accessing practical support to help solve a work task" (p. 144). And that includes referring a client on.

For best results for our client, we refer on with a 'warm' handover (Fletcher, 2021), hosting our client into the hands of the new practitioner by "directly introducing" them (p. 30).

And so lightening our load.

Sam

References:

Cooper, P. A. (2011). Chapter 10: The implications of workplace stress on service development. In D. B. Cooper (Ed.), Developing Services in Mental Health-Substance Use (pp. 137-146). Radcliffe Publishing Ltd.

Fletcher, S. (2021). "It's one less thing I have to do": does referring patients to a co-located psychology service impact on the well-being of primary care health providers?. [Master's thesis, Massey University]. https://mro.massey.ac.nz/server/api/core/bitstreams/0bf33e5f-b236-409b-aca9-af77c9ff6a93/content