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Erford, B., Eaves, S., Bryant, E.., & Young, S. (2010). 35 Techniques Every Counselor Should Know.

AIPC. (n.d.). Verbal and non-verbal communication skills. Report 1: AIPC's Counselor Skills Series. Retrieved from https://www.counsellingconnection.com/wp-content/uploads/2009/10/report-1-verbal-and-non-verbal-communication-skills.pdf

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https://www.counselingschools.com/blog/counseling-referrals

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Therapeutic healing sometimes takes a village. Each one of us can benefit from a multitude of supports that help us navigate through tough times. For this reason, it can be useful to incorporate many types of helping professionals to achieve a client's goals for treatment. Throughout the counseling process, counselors often elicit the help of professionals within their workplace and beyond to benefit their clients' care.

When you consider a referral for your client, know your reason for making the referral. It can be helpful to discuss this with your supervisor or a trusted colleague to receive another opinion and a list of contacts.

Next, do your homework. Know your referral source and be prepared to explain how this source will benefit your client's treatment. It can be helpful to personally reach out and gather more information about how this referral source works.

Giving Your Client the Referral Information

Present this information to your client, explaining why this referral source will benefit your client's care.

Allow the client to express his or her thoughts and feelings about the referral. The client may feel resistant to seeing a new or additional person. Validate any concerns and encourage your client to seek this additional help.

If the client does not wish to use the referral source, the counselor must decide whether to continue treatment without the additional support(s) or end treatment in certain cases.

If your client wants to go to the referral source, have your client sign a release of information form. This allows you to communicate with the referral source.

Signing a Release of Information Form

Confidentiality must be broken if your client is in imminent danger or a court order mandates a release of information. Outside of these rare circumstances, any type of communication or information cannot be shared without a signed release of information:

The HIPAA Privacy Rule, from HHS.gov US Department of Health & Human Services (2022):

...establishes national standards to protect individuals' medical records and other individually identifiable health information (collectively defined as "protected health information") and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically. The Rule requires appropriate safeguards to protect the privacy of protected health information and sets limits and conditions on the uses and disclosures that may be made of such information without an individual's authorization.

The Rule also gives individuals rights over their protected health information, including rights to examine and obtain a copy of their health records, to direct a covered entity to transmit to a third party an electronic copy of their protected health information in an electronic health record, and to request corrections.

A signed release form can vary from counseling practice to practice, although in general, it shows the counselor's name, address, and phone number and the referral source's name, address, and phone number. There is an expiration date that can be set by the client and counselor. The client can also rescind the release of information at any time.

Lastly, the release can specifically state the exact information to be shared. For some clients, it may be a diagnosis, for others, it could be symptoms. This depends on the circumstances of the referral and the client's case.

The signed release also facilitates communication between the two sources. This ensures both parties are working in collaboration rather than opposing goals, which could impede treatment.

The Primary Care Doctor Referral

One of the most important first referrals for clients who experience anxiety or depression can be to their own primary care doctor. Many medical issues can cause anxiety and depression. It is best to rule out anything medical with a blood test and physical exam. Once the client is treated for any underlying medical issues, you can see a clear presentation of his or her symptoms.

Types of Referral Sources

The list of referrals goes well beyond what is listed below. Through this listing, you can get an idea of some of the many sources of support:

Couples Therapy - If your client's issues involve an interpersonal or romantic relationship, couples counseling may be more appropriate than individual services.

Crisis Referrals - When a client is in danger of harming oneself or others, a crisis referral is warranted. Examples of crisis referrals include the ER, police, shelters, the Department of Social Services, and Elder Services.

Family Therapy - If your client's issues involve family dynamics, a family therapist may benefit him or her.

Group Therapy - These are therapeutic groups run by counseling professionals to address various client needs. A counselor can work with multiple individuals at once, utilizing group dynamics. Some examples of group therapy are coping skills, expressive arts, and cognitive-behavioral.

Medication Management - A psychiatrist or nurse practitioner can be referred to assess the client's mental health symptoms and determine if medication could be helpful. Both of these providers can prescribe and monitor medication management.

Self-Help Groups - These groups bring together people who share similar challenges to help support one another. These are not led by a licensed professional but by peers, who have lived experience. Examples include 12-step groups, Alcoholics Anonymous (AA), Narcotics Anonymous (NA), Adult Children of Alcoholics (ACOA), Al-anon, Alateen, etc.

Specialists - Specialists are professionals with a specific skill set. Some examples are those that hold certifications or licensure in art therapy, vocational counseling, or financial counseling.

Support Groups - These groups are often run by counseling professionals who bring people together with similar experiences. Support groups can be found in counseling agencies, hospitals, or clinics. Some examples are sexual abuse survivors, bereavement, parenting classes or groups, and caregiver groups.

Psychological Testing & Assessment - A referral to a psychologist can help with diagnosis through the use of tests and other assessment tools.

In the example of psychological testing, information about the client is needed for the referral source to understand which instruments would most benefit the client.

The American Counseling Association Code of Ethics ACA E.6.b. Referral Information states:

If a client is referred to a third party for assessment, the counselor provides specific referral questions and sufficient objective data about the client to ensure that appropriate assessment instruments are utilized.

Referrals During the Counseling Process

At times, a counselor will recommend an adjunct to the current treatment. In this instance, counseling takes place, but the client also partakes in additional services. If you are continuing individual counseling with your client, it is recommended another counselor be assigned to see your client if they desire couples, family, or group therapy, to avoid any ethical or possible boundary issues.

During the experience, contact the agency for periodical follow-ups and progress. Also, ask for your client's feedback about the encounter. After the experience, process the client's feelings and experiences. Note any and all progress toward treatment goals.

Referrals Before the Termination of Services

A referral is done before ending counseling to ensure those clients who wish to continue services with a different provider can do so, uninterrupted. The client may request a referral if they do not feel the therapeutic relationship is a good fit. Counselors may initiate a referral when they do not have the skill set to work with a particular client issue, feel unsafe with the client, or have a conflict of interest. Keep in mind, a referral should be the last resort.

If a counselor does not have the skill set to work with a client, first seek to increase your knowledge through education, consult with colleagues, and seek supervision. Even if the client has seen the counselor for a short amount of time, a therapeutic relationship has been established. Any type of referral disrupts this connection and could cause harm to the client.

When a counselor feels unsafe with a client, seek supervision for guidance. If it is necessary to meet with the client, have at least one other counselor who is aware of this issue, near the vicinity of your office, when treatment takes place. You can also sit close to the door and leave it open slightly during your session.

The counselor may also recommend referrals when leaving a place of employment. In all of the above scenarios, the counselor must not abandon the client and may need to continue to provide services until the referral has been completed.

Ethical Codes from the American Counseling Association (2014) Regarding Referrals

A.11. Termination and Referral

A.11.a. Competence Within Termination and Referral

If counselors lack the competence to be of professional assistance to clients, they avoid entering or continuing counseling relationships. Counselors are knowledgeable about culturally and clinically appropriate referral resources and suggest these alternatives. If clients decline the suggested referrals, counselors discontinue the relationship.

A.11.b. Values Within Termination and Referral

Counselors refrain from referring prospective and current clients based solely on the counselor's personally held values, attitudes, beliefs, and behaviors. Counselors respect the diversity of clients and seek training in areas in which they are at risk of imposing their values onto clients, especially when the counselor's values are inconsistent with the client's goals or are discriminatory in nature.

A.11.c. Appropriate Termination

Counselors terminate a counseling relationship when it becomes reasonably apparent that the client no longer needs assistance, is not likely to benefit, or is being harmed by continued counseling.

Counselors may terminate counseling when in jeopardy of harm by the client or by another person with whom the client has a relationship, or when clients do not pay fees as agreed upon. Counselors provide pre-termination counseling and recommend other service providers when necessary.

A.11.d. Appropriate Transfer of Services

When counselors transfer or refer clients to other practitioners, they ensure that appropriate clinical and administrative processes are completed and open communication is maintained with both clients and practitioners.

A.12. Abandonment and Client Neglect

Counselors do not abandon or neglect clients in counseling. Counselors assist in making appropriate arrangements for the continuation of treatment, when necessary, during interruptions such as vacations, illness, and following termination.

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The Use of Referrals in Therapy & Counseling

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Therapeutic healing sometimes takes a village. Each one of us can benefit from a multitude of supports that help us navigate through tough times. For this reason, it can be useful to incorporate many types of helping professionals to achieve a client's goals for treatment.

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Importance of Cultural Humility based on outside assignment for social/cultural class

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Importance of Cultural Humility based on outside assignment for social/cultural class

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Includes resources within powerpoint

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Case study on Rosa, helpful resource when analyzing future clients background and how to assist them in current and future sessions

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Useful resource and research made on the awareness of human trafficking, collaborative efforts made from group

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Useful refresher course for practicing pfa, a type of trauma informed care

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https://padlet.com/ehostlersmith/unit-1-2-sections-1-2-reflections-c87vq2g4vzuag62k

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The ACA Code of Ethics are standards to be upheld when in a professional role of counseling or providing therapy to a diverse set of individuals. Attached is the preamble and purpose of the ACA's Code of Ethics:
Professional values are an important way of living out an ethical commitment. The following are core professional values of the counseling profession: 1. enhancing human development throughout the life span; 2. honoring diversity and embracing a multicultural approach in support of the worth, dignity, potential, and uniqueness of people within their social and cultural contexts; 3. promoting social justice; 4. safeguarding the integrity of the counselor–client relationship; and 5. practicing in a competent and ethical manner. These professional values provide a conceptual basis for the ethical principles enumerated below. These principles are the foundation for ethical behavior and decision making. The fundamental principles of professional ethical behavior are • autonomy, or fostering the right to control the direction of one’s life; • nonmalefcence, or avoiding actions that cause harm; • benefcence, or working for the good of the individual and society by promoting mental health and well-being; • justice, or treating individuals equitably and fostering fairness and equality; • fdelity, or honoring commitments and keeping promises, including fulflling one’s responsibilities of trust in professional relationships; and • veracity, or dealing truthfully with individuals with whom counselors come into professional contact.

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https://www.counseling.org/docs/default-source/default-document-library/2014-code-of-ethics-finaladdress.pdf?sfvrsn=96b532c_8

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Hello all, my name is Erin Hostler-Smith and my program of study is Mental Health and Wellness Counseling. One personal goal of mine would be improving health, being more active and a part of nature and the community. Currently combating the long term effects of psychotropic medication. I am an advocate for all types of mental health treatments and have benefitted from medication, however I am now comfortably in the stage of utilizing coping skills and methods I have learned from CBT. A professional goal of mine would be to successfully complete the Master's program. I would like to utilize what I have learned from the course to help those combat trauma with healthy coping skills, I hope to gain more knowledge on the types of communication and engagement styles when working with youth who have experienced complex and primary trauma. Other information about myself: I am a mother to several cats and I enjoy volunteering in my community to help people and stray animals. I also love to travel and will be visiting Mallorca soon. I am in a much better place in my life and I feel very blessed and grateful to be here.

# data[].attributes.subject
Hello all, my name is Erin Hostler-Smith and my program of study is Mental Health and Wellness Counseling. One personal goal of mine would be improving health, being more active and a part of nature and the community. Currently combating the long term effects of psychotropic medication. I am an advocate for all types of mental health treatments and have benefitted from medication, however I am now comfortably in the stage of utilizing coping skills and methods I have learned from CBT. A professional goal of mine would be to successfully complete the Master's program. I would like to utilize what I have learned from the course to help those combat trauma with healthy coping skills, I hope to gain more knowledge on the types of communication and engagement styles when working with youth who have experienced complex and primary trauma. Other information about myself: I am a mother to several cats and I enjoy volunteering in my community to help people and stray animals. I also love to travel and will be visiting Mallorca soon. I am in a much better place in my life and I feel very blessed and grateful to be here.