Reading F

In any session, counselling trainees may face decisions about referring clients elsewhere. Even experienced counsellors have types of clients with whom they feel competent and comfortable and others where they feel less so. Lazarus states that an important counselling principle is to ‘Know your limitations and other clinicians’ strengths’ (Dryden, 1991: 30). He considers that referrals should be made where other counsellors have skills that the counsellor does not possess or more appropriate personal styles for particular clients. Important ethical issues surround referral: for instance, ensuring the best treatment for clients where other counsellors are more expert with specific problems, such as schizophrenia or post-traumatic stress disorders.

Referral may not be an either/or matter. Sometimes you may continue working with clients but also refer to other counsellors and helping professionals. Alternatively, you may be the recipients of referrals from other helping professionals who continue to work with the clients concerned. I worked as a sessional counsellor in a leading career outplacement company where all my clients were referred by other professionals who continued seeing them for job search counselling. I acted as a ‘back-stop’ for clients whose problems were more severe or different from the normal clientele presenting for job search assistance.

Sometimes clients were referred to gain additional knowledge about their problems. For example, clients with thought-blocking problems or sexual dysfunctions might be referred for medical checks. Depending on the outcome of these checks, you may gain relevant information to help determine whether or not to continue seeing them.

On other occasions you can refer the clients’ problem rather than the client themselves to other counsellors and helping professionals. For example, you can discuss with colleagues or supervisors how best to assist certain clients. Occasions when one may refer the client’s problem rather than the client include: being the only counsellor available in the area; when clients state a clear preference for continuing working with you; and when clients are unlikely to follow through on referrals in any case.

The following are some skills for making referrals.

• Know your strengths and limitations. Be realistic about the kinds of client with whom you work well and those with whom you are less skilled. Be realistic about your workload and set appropriate limits on it.
• Build a referral network. Get to know the resources available in the area so that you can make good referrals. Where possible, avoid referring ‘blind’ to someone whose competence is unknown. Furthermore, check whether another counsellor or helping professional has the time available to see the client.
• Provide appropriate information. Provide the client with relevant information about an agency or individual to whom they are referred: for instance, a contact person, their telephone number and professional address, their theoretical orientation, and the scale of fees charged, if any.
• If possible, refer early on. When you defer referrals longer than necessary, you waste clients’ and your own time. In addition, it is preferable to refer clients before emotional bonding takes place.
• Avoid unnecessary referrals. Sometimes it is better for clients to continue working with the counsellors that they have. Tune into anxieties and fears about seeing certain clients. You build confidence and skills by expanding the range of clients with whom you can work. However, wherever possible, you should ensure that you have appropriate supervision and support.
• Build a support network. A support network provides professional support when you want to refer clients’ problems rather than the clients themselves. Your support network is likely to overlap with their referral networks.