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How to refer your client to another therapist

Here are some ways to tell your client they need a different therapist, plus reasons you might refer a client out.

It’s your responsibility as a therapist to support your clients’ mental health the best you can — which sometimes means ending the therapeutic relationship. There are many reasons you may consider referring a client to another therapist, whether someone who has a more niche specialty or can provide a higher — or lower — level of care. In any case, recommending your client sees a different provider isn’t always easy. 

The good news: With the right mindset and strategy, you can ensure a smooth transition that ensures your clients’ needs are met. Read on to learn when and how to refer your client to another therapist.

Reasons you might refer a client out

Referral can happen for many reasons, but all of them reflect a decision to help ensure a client can access the type or level of support they need. 

You have logistical or scheduling issues.

Logistics are one of the most common reasons for referrals, says psychotherapist Michael Heckendorn, Headway’s clinical lead of clinician education. Maybe you don’t take a client’s insurance anymore, and they don’t want to pay cash for therapy. Or perhaps the client gets a new day job, and you don’t have any evening slots available. In these cases, it’s your job to recommend other options to your client so they can continue accessing therapy. 

You can’t meet the client’s needs.

Ethically, you’re required to practice within your competency. If a new or existing client presents with a symptom or condition you’re not equipped to treat, then it’s always best to provide a referral. For example, if you aren’t trained in treating eating disorders and a client discloses they’ve been experiencing anorexia symptoms, you should refer them to a provider who has experience in this area.

Similarly, Heckendorn says, you may need to refer a client to a higher level of care, such as an intensive outpatient program or partial hospitalization, if you can’t meet their needs in once-weekly or biweekly sessions. If there is a suicide risk or other emergent risk, provide an immediate referral to 911, crisis center, or ER.

You’re not a good fit.

Even if you’re able to treat a client, your therapeutic alliance may not be strong enough to ensure the clients’ needs are met. You may decide to address potential issues first, such as considering and applying client feedback about interventions you use. But if time passes and nothing changes, it may be time for a referral.

 “It can be healthy to experience and resolve conflict in a therapeutic relationship, but if you can’t provide the care you should be providing, or the client isn’t getting better, you should refer them to another provider,” says Heckendorn. 

You or your clients’ goals change. 

Beyond scheduling and ethical reasons, you may determine your clients’ needs no longer fall within the practice scope you want to focus on. For example, if you’re an adolescent therapist and you want to focus on your specialty, it’s OK to refer an older client to someone else.

Similarly, even if you’re competent to treat someone, you may realize a modality like EMDR feels more appropriate to address your client’s presenting concerns, level of functioning, symptoms, and treatment goals. In that case, you may want to recommend they see a therapist who practices something you don’t offer, such as EMDR or neurofeedback.

How to refer a client to another therapist

Knowing when to refer someone is only one part of the equation. Every client is different, but following these steps can help streamline the referral process. 

Create a referral list.

A successful referral process begins before you even refer someone. To help ensure continuity of care for your client, Heckendorn suggests creating a referral list of other trusted therapists. Aside from peer therapists, identify prescribers, specialists, IOPs, PHPs, and rehab centers in your area. Networking events can help you find trusted local providers, as can therapist Facebook groups or online directories. 

Give the client ample notice. 

No matter when you refer in the therapy process, it’s important to give the client ample notice — and incorporate conversations about this transition into the work itself. Doing so prevents client abandonment, which can be damaging to your therapeutic relationship and your client’s mental health, along with posing a legal risk for you as a therapist.

Know when to coordinate care.

There may be times when it’s appropriate to coordinate your client’s care: For example, if you’ll continue to see someone but are also referring them to a prescriber for medication management. In this case, you may contact the provider on your client’s behalf and ask your client for a signed release of information that allows you to communicate about care with the other provider. 

Provide the referral to your client.

If you won’t be continuing to see a client, then Heckendorn says it’s perfectly appropriate to simply provide suggestions of other clinicians. Consider providing a list of therapists, along with contact information, to make it easier for your client to efficiently find someone who can meet their needs. It helps to make sure your referrals take your client’s insurance.

Write a discharge summary.

Once you officially stop seeing your client, it’s time to write a discharge summary. This can help ensure the next provider has appropriate context to treat the client, while protecting you as a clinician should any legal concerns arise.

How to tell your client they need a different therapist

Before making a referral, you’ll want to have several conversations with your client. Every referral is different, but certain discussion points can help your clients feel supported in the process. 

Summarize your progress. 

Even if you can’t continue to treat someone, you still spent time working together. At the start of the conversation, acknowledge the progress they’ve made toward their goals. 

Share potential limitations.

Next, explain that it’s your responsibility to make sure a client is appropriately supported and share the benefits of getting a different service or seeing another provider. 

Remind them of their choice.

Remind the client that the referral is a suggestion, and that they have a choice in who they see and when. 

Offer continued support.

Finally, let them know that if the referral doesn’t work out, you’re happy to provide additional contacts for them to consider.

Therapist referral script

Here’s an example of what to say when you refer a client to a new therapist. It’s based on a hypothetical scenario, though the points covered can help you decide how to start your conversation.

Over the last few months, we’ve made some good progress toward your goals. You’ve shared your struggles with me and we’ve developed strategies to support your well-being. Last session, you told me you’re struggling with something I don’t have experience treating. I want you to get the best possible care for your mental health, so I’m recommending you see a therapist who specializes in this. I’m going to give you a list of a few therapists I trust who have expertise in this area. I’m happy to keep seeing you until you find another provider. Do you have any questions or concerns?

Headway is a free service that makes it easier and more profitable for therapists and psychiatrists to accept insurance.

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