Best Practices for Responding to Therapy Referrals

Therapy referrals are an essential part of the success of many behavioral health organizations and practices. Through your referral sources, you can grow your reputation and keep a steady flow of clients coming into your practice. You can generate referrals through networking with other mental health and medical providers, building relationships in the community with professionals like religious leaders, school counselors, and nutritionists who might send clients your way, providing excellent care so your clients want to share you with their friends, and using marketing tools like registry listings. 

Getting new practice referrals is great, but what do you do with them when they come in? What is the best way to handle your referrals so that the people who reach out become new clients?

Responding to Therapy Referrals

Quick Response

Do not leave a potential client waiting. If someone has referred an individual to you for mental health services, a quick response is one of the best ways to bring them in. Prompt replies show potential therapy clients that you are ready and able to help them. When you let too much time pass between the therapy referral and your response, you send a negative message to the client. You are telling them that you are too busy for them. When it comes to mental health services, clients need to know that you are available and care about helping them now rather than later.

Create a Positive First Experience

Your first interaction with a potential client sets the tone for the therapeutic relationship. Whether you or a staff member are responding to a referral, make sure to offer a personable, efficient, caring experience. If you open the door with the royal treatment, they are more likely to feel positive about you and the work you can do together.

Have a Plan

It is wise to have a plan in place for what to discuss on this first contact. A solid plan will help communicate that you are organized and ready to support new clients. Below are four topics to consider bringing up at the first point of contact.

1. Consultation

It is helpful to set expectations about what the first session will look like for your client. If you offer a free or priced initial consultation, that is important to note as part of your introduction. 

2. Scheduling

Talking about your availability will help a potential client figure out whether they can make therapy with you work. 

3. Cost and Insurance

Do you accept insurance? If you are a mental health provider who accepts insurance, make sure you ask the patient if they have coverage that you accept. A lot of people are specifically looking for an in-network therapist, so 1) if you do take insurance, be sure to list that information publicly, like on your registry profiles and website and 2) if you don’t take insurance, but can offer a superbill so clients can file for out-of-network reimbursements, be ready to explain that process. Be prepared to talk about out-of-pocket costs for self-pay sessions.

4. Payment

How do you accept payment? Make sure to let the client know when and how you collect fees. For example, do you collect at the time of the visit? Do you send them a bill once a month? Do you accept credit card payments online or in-person?

Take Care of Your Referral Sources

Refer Clients Outward

You have to give to receive. If you get a potential client whose needs your practice is ill-suited to address, refer them to someone who does offer what they need. The time and thoughtfulness you spend referring clients out will help build relationships with other providers and increase the therapy referrals you receive from these referral sources. 

Personal Touch

If you receive a therapy referral that leads to a consultation or new client, make sure you express your gratitude to the referral source, especially if they’re a professional too. Sending a note of appreciation to the people who are helping new clients find your practice goes a long way. In some cases, it may be appropriate to loop them in on new things you’re learning or new research that is pertinent to the populations they work with. Some practices do this by sending an infrequent (quarterly or annual, for example) newsletter to their referral sources. But showing individual appreciation is really impactful when another professional sends a new client your way—that personal touch demonstrates the kind of care you give to the clients you see, which makes them more likely to send more referrals to your practice.

Registries like GoodTherapy position you to be found by people seeking therapy on their own. To learn more about what a GoodTherapy membership can offer you, click here.

The decision to initiate any interpersonal relationship is anxiety-provoking, and the decision to talk with a therapist might be uniquely so. When we decide to meet with a therapist, we are faced with numerous challenges: allowing ourselves to depend on someone else for help and support; revealing our problems; risking trust in a stranger; facing what we have avoided; and relinquishing long-held, sometimes beloved habits, to name a few.

When we refer someone to therapy, it is important to keep this in mind. Though the statement “I recommend you talk to a therapist” sounds simple and benevolent enough, we cannot lose sight of the fact our caring act is simultaneously an anxiety-provoking challenge to the would-be person in therapy. So how can we go about this in a way that doesn’t provoke any additional, unnecessary worries or fears?

The following is a list of principles one can consider when making a referral to a therapist. While these ideas do not guarantee a certain outcome, they may reduce the chances of triggering anxiety that could promote avoidance.

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1. Make it about their needs and goals.

Therapy is much more likely to succeed if the person is there of their own free will, motivated by their own goals, trying to meet their own needs. External pressures to be there and pressures to work on problems that other people see, but that we do not see, can lead therapies to get stuck. The last thing we want to do is refer someone to therapy because we want them to change or conform to some goal that we have for them. That’s usually a recipe for someone either avoiding therapy or showing up but hating it.

Good therapy involves difficult, anxiety-provoking work, so most people will want to do that only if it is their only option for reaching specific goals. That is why it can be important for your referral proposal to include a reference to those goals, and to the way their emotional difficulties hold them back. An example could be: “Seems like the headaches you are getting are really hassling you at work, and it seems like they get worse with stress. Therapy can help with that and it might make you less miserable at work and home.” In this example, it is clear the referral is in the service of the person’s feelings and interests, done out of care and concern for them and not out of some demand or expectation by the referral source.

2. Make it optional.

I encourage you to make your recommendation optional, with liberal use of comments such as, “It’s really up to you,” “I’m not sure if I’m right, but it’s something you can decide for yourself,” and, “It’s not a requirement, just a thought.” I encourage you to phrase your referral as optional because going to therapy is optional. Therapy is anxiety-provoking enough to begin with, and we only add anxiety if we make the person feel like it’s an expectation, a demand, or a requirement.

When we approach therapy as a demand or requirement instead of an option, we can trigger a few responses that decrease the effectiveness of our referral. If the person we are hoping to refer has submissive tendencies, they may comply with our wish that they be in therapy. That will get them as far as a therapist’s office, but because they are not there of their own free will, they may not get the full benefits of the therapy. Other people may respond to our demand that they seek therapy with defiance or stubbornness. Rather than consider the option, they may say no just to spite you and to stymie your efforts to control them, even if they feel therapy could help.

Therapy has the highest likelihood of helping if the person is there of their own volition, not out of compliance, so be sure to remind yourself and the person you want to refer that the referral is optional.

If we’re clear about the reality of therapy—that the length of treatment and the level of commitment is up to them—they may find it less threatening and be more likely to try it.

3. Make it conditional.

What do we commit to when we commit to meeting with a therapist? Many people fear that by meeting with a therapist, they are committing to a long-term relationship. They sometimes also fear the therapist will decide how long the therapy lasts. These are anxiety-provoking preconceptions, and they are incorrect. When we try to refer people to therapy, it is important that we remind them of the truth—they are agreeing to one session at a time, and the length of the treatment is their choice, based on their goals and preferences.

It may help to be frank about what an initial therapy session is: a test drive. You can say, “You can meet with Maury and decide if you’d like to meet with him again. The first session or sessions can help you decide if you think he might help. You may know right away you’d like to meet with him more, but sometimes it can take a few sessions to decide if it’s worth continuing to invest in the therapy. Either way, it’s up to you how many sessions you go for. A therapist is an employee whom you can hire and fire.”

When we present the idea of therapy as a test drive, something the person can continue for as long as it meets certain conditions for them, we take away anxieties that therapy will be more of a commitment than the person may want. If we’re clear about the reality of therapy—that the length of treatment and the level of commitment is up to them—they may find it less threatening and be more likely to try it.

4. Do not make promises.

Ethically speaking, even a therapist cannot make promises, predictions, or guarantees about what they can do. We do not have a crystal ball with which to see the future. Often, my initial phone call with a new referral includes a difficult conversation along these lines:

Person: “So, do you think you can help me?”

Me: “Well, for better or worse I can’t know that just yet. We’d have to meet for you to form an opinion about that.”

Even if it’s a bit disillusioning, this is the truth. Like physicians or personal trainers, therapists can’t know whether their efforts will turn out to be helpful—only time and a careful, continuous, collaborative assessment will tell. We find out if our treatment plan is helpful once it helps.

There is great danger when a referral source makes promises about therapy or a therapist. Any expectations you give to the person you’re trying to refer can give them false hope or make them unnecessarily anxious and avoidant.

Every therapy session is, like every day of life, an experiment—we assess the problem that’s going on, pick an intervention or style of intervention we think might help, try it out, see what result we get, and adjust our treatment plan according to what works and what doesn’t. There is no magic to it, just a workaday process of trial and error, where we work hard to tailor a unique therapy to the unique person and their unique goals. In that sense, any preconceived expectations about therapy, just like in any other relationship, will be false.

For these reasons, there is great danger when a referral source makes promises about therapy or a therapist. Any expectations you give to the person you’re trying to refer can give them false hope or make them unnecessarily anxious and avoidant.

For example, a referral source could say, “He specializes in depression—he gets great outcomes.” Even if that is true, no two depressions are the same because no two people are the same. Likewise, no two treatments are the same because no two therapy teams are the same. Making promises or suggestions regarding a particular outcome can promote misleading or false hope. It may also distract from the fact it’s the work of the person in therapy, not the work of the so-called “expert in depression,” that makes or breaks the therapy.

Referral sources sometimes also make claims about a therapist’s technique when making a referral. For example: “He’s a very confrontative therapist—he’ll bust right through your defenses!” While it may be true that a therapist is capable of being confrontative, and while that kind of therapy may be appropriate for some people’s needs, presenting a referral in this way can be problematic. Good therapists base their technique on a careful assessment of the unique needs of the person in therapy, not based on what the therapist is good at or known for. Because of that, there is no guarantee the person you’re referring will ever have their defenses “confronted”—it all depends on the therapist’s assessment of what might help in the moment. Making such claims about a therapist can set up false expectations or give a person something to fear. Imagine already being nervous about letting go of certain defense mechanisms and then hearing a therapist is going to “bust right through” them.

For these reasons, when I refer someone to a therapist, I say something like, “There’s no way of knowing how it will go in advance, so the best way to find out whether the therapist can help is to go and check them out, assess how you feel with them, and make the best decision you can about whether to keep investing in the therapy. Hopefully they’ll be flexible and you two can make a therapy together that meets your needs.”

5. Let go of your desires!

If you haven’t caught it yet, my main thesis here is that while we can suggest that someone goes to therapy, or reveal our desire that they go, it is up to them. Pressuring people into doing something that is anxiety-provoking will usually lead to avoidance, submissive compliance, or stubborn defiance.

It is hard, but we must accept that we all have the right to avoid therapy and the anxieties that are built into it. No matter how badly we want to see a friend, loved one, or other person get help, our wanting it cannot make them want it. Only their inner desires can do that. So, while we can feel free to make suggestions to people about going to therapy, we must remember that they can do it only for them, not for us. Our desires for them can play only a very limited role in someone else’s therapy journey.

Example of Referring Someone to Therapy

Here is an example, based on the principles above, of what I might say to refer someone to a therapist:

“You seem to be suffering a lot and you’ve been clear that you’re not liking that, so I’ve been thinking that therapy might be useful to you. Obviously, it’s up to you if you want to go, but I do have the name of a person who I think might be able to help. Of course, that’s no guarantee, and you may have to shop around a bit to find someone who is a good fit. Either way, if you want to check this person out, they could be helpful. Do you want me to pass their contact info along?”

You can phrase this any way you like, but I think the key points for any referral are here:

1. Seems like you’re hurting, so therapy might be worth a shot.
2. It’s up to you.
3. You’re not committing to a lifetime on the couch, just one initial session.
4. There’s no guarantee it’ll be worthwhile, but the only way to find out is by trying.

Of course, this approach does not guarantee a specific outcome, but I believe it gives the best possible chance that the person will feel cared about by you, make the decision for themselves, and have the most realistic expectations possible going into therapy. Let me know if this helps!