Experiencing the Role of a Psychologist in Referring Clients Out for Specification

As a seasoned psychotherapist, one of the most crucial aspects of my practice revolves around the art of referring clients to the appropriate professional when we fall short of the required expertise for effective treatment. This article delves into the nuances of such a practice, exploring the protocols, reasons, and ethical considerations surrounding the process.

Initial Diagnosis and Referral Protocols

It is an infinitely satisfying facet of my role to find a client a psychologist who can provide the treatment they need effectively. Sometimes, finding a better help for a person who has not been experiencing improvement is a weight off. I usually frame this during the initial diagnostic interview. I inform them that we will be checking back on their symptoms a few times during therapy to measure their severity, and at this juncture, we will also discuss what is working, what is not, and how to know if treatment is successfully addressing their issues or requires adjustment.

I mention the possibility of referral in a straightforward manner from the very first office visit. This transparency ensures that clients are aware of the potential need for a specialist from the outset. It allows for a collaborative approach to care, ensuring that clients are not left feeling adrift or misrepresented in their journey towards recovery.

Personal Experience as an Emergency Mental Health Evaluator

Over the last thirteen years of practice, I honed my skills as an emergency mental health evaluator in a big city hospital. My primary responsibility was to determine if a patient was an imminent threat to themselves or others and to assess their needs. This experience provided me with a unique perspective on the challenges and intricacies of referral.

For instance, some of my patients required training in Dialectical Behavior Therapy (DBT). However, I did not consider myself competent to work as a DBT therapist. I would refer such patients to a therapist or program that specialized in DBT. Similarly, many patients had indications of Borderline Personality Disorder, which would benefit from DBT therapy, and I would refer them to a specialized therapist.

The referral process also extended to those with severe PTSD, where the standard treatment protocol is Eye Movement Desensitization and Reprocessing (EMDR). Again, I would refer such patients to EMDR therapists. Eating disorders required a different approach, and I would refer such cases to eating disorder specialists. In each instance, my role was primarily to evaluate and determine the needs of the patient, ensuring that they received the appropriate care.

Ethical Considerations and Practical Challenges

One of the most compelling and significant aspects of my practice was dealing with patients who attempted suicides or had suicidal ideation. These patients required a level of care that not all therapists could provide. In such cases, I would work in a locked unit, where patients were not free to leave if they found out they were going on an involuntary placement. This responsibility highlighted the importance of my role in evaluating patients and determining whether they required acute inpatient care or could be safely discharged.

However, the referral process was not always straightforward. It was important to ensure that referring to a specialist would not lead to the client feeling left behind or abandoned. My experience taught me the value of direct and honest communication, ensuring that clients understood the process and the reasons behind referrals. It is never embarrassing to refer a patient to a specialist, and my colleagues who referred patients to me were not embarrassed to do so because few psychologists have the necessary skills to hold patients against their will or determine their eligibility for acute inpatient care.

Conclusion

As a psychologist, my role is not just to treat mental health problems but also to evaluate patients and determine their needs. The art of referring clients out is a fundamental part of my practice, ensuring that each patient receives the appropriate care. This article has highlighted the importance of such referrals, the ethical considerations involved, and the practical challenges that come with finding the right specialist for each client.