One of the most powerful tools in your clinical toolkit isn’t a modality or intervention—it’s the ability to say: “I’m not the best fit for this client’s needs, and I want to connect them with someone who is.”
Referring out isn’t a failure. In fact, it’s a mark of clinical maturity, ethical integrity, and commitment to client care. Knowing when to refer protects clients, preserves your professional well-being, and strengthens trust in our profession.
Why Referring Out Matters
It’s an ethical obligation.
Our professional codes of ethics (ACA, AAMFT, NASW, APA) all highlight competence as a core principle. In Washington State, WAC 246-809 specifically notes that counselors must practice only within the boundaries of their education, training, and experience.
It serves the client’s best interests.
When a client’s needs fall outside your skill set—or require more intensive care than you can provide—helping them connect with the right provider is an act of care, not abandonment.
It protects you from burnout and liability.
Working beyond your competence can lead to poor outcomes, ethical complaints, and emotional exhaustion. Referring out can save both your career and your mental health.
There are many situations that can signal it’s time to refer out.
If you lack competence in the client’s presenting issue—such as severe eating disorders, advanced substance use treatment, or complex medical-psychological conditions—it’s best to connect them with someone trained in that specialty.
High-risk or crisis situations beyond your resources, like those requiring 24/7 crisis capacity or specialized suicide intervention skills, may require a higher level of care.
When clients need modalities you don’t offer, such as EMDR for trauma or Gottman Method for couples, it’s respectful and ethical to refer them to someone who does.
Sometimes a dual relationship or conflict of interest makes it difficult to maintain objectivity, or the client may need a provider who shares a lived experience, cultural background, or worldview to make therapy most effective.
How to Refer Out with Care
Be transparent early. Don’t wait until months in. If you recognize from the start that you’re not the best fit, share that openly and compassionately.
Offer specific referrals. Provide names, contact information, and a brief explanation of why you believe each option could be a good fit.
Coordinate when appropriate. With client consent, you can collaborate with the new provider to ensure a smooth transition.
Affirm the client’s courage. Let them know the decision is about matching their needs to the best possible care—not about them doing something “wrong.”
Overcoming the Guilt of Referring Out
Many clinicians feel uncomfortable referring out, especially newer therapists. We may worry the client will feel rejected, or that we’ve “failed” them.
But here’s the truth: Referring out is not rejection—it’s redirection. It’s about putting the client’s healing above your ego and honoring your ethical responsibility.
In time, you’ll find that clients often respect you more for recognizing your limits and advocating for their needs.
As clinicians, our work is built on empathy and dedication. But dedication doesn’t mean doing everything for everyone. Knowing your limits—and acting on them—makes you a stronger, safer, and more trusted therapist. In the long run, referrals don’t weaken your practice; they build your professional credibility and deepen the trust clients have in you. Your best work happens when you’re working within your zone of competence. And sometimes, the bravest and kindest thing you can do is to help someone find the therapist who’s exactly what they need.