When The Going Gets Good: Is It Time To Refer Out?
We’ve all encountered the question: Is it time to refer this client out? It’s never an easy decision, and it comes with ethical, practical, and emotional considerations. We want to provide the best possible care, but sometimes that means helping a client transition to a different provider or a higher level of support.
Referrals can be tricky, especially when long wait lists make finding timely care a challenge. And when working with children, school staff may be the first to notice concerns but might not always know when to seek outside help. So, this month, we’re diving into when to refer out, how to do it ethically, how to collaborate with schools, and ways to support clients during long wait times.
When Should Mental Health Providers Refer Out?
Referrals are necessary when a clinician’s expertise, resources, or availability no longer meet the client’s needs. Some common reasons include:
Specialized Care is Needed – If a client has complex concerns (e.g., trauma, eating disorders) that require expertise beyond your scope.
Higher Level of Care is Required – Suicidal ideation, psychosis, or severe self-harm may warrant inpatient or intensive treatment.
Lack of Progress in Treatment – If therapy has stalled, another provider with a different approach may be beneficial.
Conflicts of Interest – Dual relationships or personal biases that may affect objectivity.
Changes in Client Goals – Perhaps the goals for the reason the client originally presented have been met, but new challenges and goals have emerged that may be better addressed by a different provider.
Referring Out Without Abandoning a Client
Referring a client doesn’t mean leaving them unsupported. Here’s how to handle the process ethically and with care:
Communicate Openly and Compassionately – Frame the referral as a step toward better care rather than a rejection.
Example: "I want to make sure you get the best support possible, and I believe a specialist in [issue] would be a great fit for your needs."
Offer Thoughtful Referral Options – Provide at least two or three options and ensure they’re accessible based on the client’s needs and resources.
Support the Transition – If possible, help facilitate the first contact with the new provider and offer guidance on next steps.
Plan for Long Wait Lists
Suggest interim resources, which may require maintenance of therapy until the client can be seen elsewhere.
Check-in periodically on the client’s progress toward meeting with the new
Collaborating with Schools for Student Mental Health Referrals
Schools play a crucial role in identifying mental health concerns, but staff may not always know when or how to refer students for outside support. Strong collaboration between mental health providers and educators ensures students get the help they need.
How to Strengthen School Collaboration:
Train School Staff on When to Refer – Offer workshops on recognizing anxiety, depression, and self-harm. Provide clear guidelines for when to involve a mental health professional.
Create a Structured Referral Process – Work with school counselors, social workers, and psychologists to develop a streamlined system with trusted local providers.
Foster Ongoing Partnerships – Keep schools informed about mental health trends and offer parent workshops to increase awareness.
Final Thoughts
Referrals, when done with care, strengthen client outcomes. However, doing so with care for how the client will receive the referral and while being mindful of long waitlists is vital.
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Finish the year strong!
Join Aimee Kotrba, PhD for her upcoming session geared toward supporting parents and educators in making the most of these last months of the academic year. You can learn more and register by visiting this link. The session is taking place on March 6th - secure your spot today!