Identify and Answer Common Client Questions About Referral, Referral Processes and Referral Agencies.

Identify and answer common client questions about referral, referral processes and referral agencies.

How do I get a referral Your GP can refer you to see a practitioner, or you can refer yourself. If you are already seeing a practitioner, they may refer you to someone who specializes in your specific area.

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How can counseling help
By discussing your concerns with you, the practitioner will be able to help you gain a better understanding of your feelings and actions, as well as suggesting ways for you to find your own solutions to your problems.

What happens next
I can either call to set up an appointment for you, or I can give you the phone number and address and you can set up a meeting yourself.

What type of counseling will I need
That depends on you, both you and your practitioner can discuss which therapy would suit you and will be best for you.

Cognitive behavioral therapy (CBT) attempts to retrain a person??™s way of thinking to help them to deal with stressful situations through tasks and goal setting. It can be used to help the client address a number of problems such as, depression, anxiety, obsessive compulsive disorder, eating disorder, addiction and schizophrenia.

Humanistic therapies take a holistic approach to a person??™s problem in order to help them develop to their full potential and live life to the full. Humanistic therapies are often used to treat problems such as depression, anxiety and addiction. N.I.C.E. (National Institute for Clinical Excellence) recommends this type of therapy for children and young people with mild depression.

Psychodynamic therapy will help a person to consider how their personality and life experiences influence their current thoughts, feelings, relationships and behavior. This understanding enables them to deal with difficult situations more successfully. Psychodynamic therapy can be used to help treat: depression, anxiety, post-traumatic stress disorder, eating disorders and addiction.

How long will it take
Again that depends on the type of therapy you require. Therapy can range from a few weeks to many months or years. It depends on the person and how much time and effort they are willing to put into addressing their issues.

Am I crazy
No. It can be easier to work on any issues if they are addressed before they reach crisis level. counselling can be used for a wide range of issues theses days, e.g., anxiety, depression, grief, relationship problems.

Summarise the types of service that organizations can offer on a range of issues.

The Salvation Army ~ is avoluntary organisation that runs support groups and self-help networks where people who have similar experiences can meet and chat. It is one of the largest, most diverse providers of social services and care in the UK and worldwide. Programs include homeless centers, drug rehabilitation centers, schools, hospitals and medical centers, as well as nearly 16,000 church and community centers.

Relate ~ is a helping organisation for relationship counselling, it offers advice on relationship counseling, sex therapy, workshops, mediation, consultations and support to those who require it.

Parentline ~ is a helpline for parents under stress; it is the leading national charity providing help and support to anyone caring for children, be it parents, grandparents, step-parents, relatives, and is for families living together as well as apart. Using a team of volunteer parents it advises families on issues both big and small.
Cruse ~ is a voluntary support network that is there to help the bereaved by enabling them to understand their grief and to cope with their loss. It focuses it many different areas, such as the military, children, traumatic loss and sudden death.
Ocean Quay ~ is a day service for anyone who has had problems with drugs or alcohol, is currently out of work. It provides people with a safe environment where they can make use of facilities such as groups on relapse prevention, life skills training, stress management, individual or group counselling. The project also provides advice on housing, benefits, volunteer opportunities, careers advice, further education and training courses accredited by National Open College Network

Evaluate ways to manage resistance ??“ Your own and clients.
Resistance is a natural reaction to any change in your life; it is the fear of the unknown, something new. In counselling, there will be times when both the practitioner and the client will face resistance and will have to try to manage it.
As a practitioner I may not believe my client is ready to finish counselling, but my client is adamant that they no longer require counselling. I can encourage my client to stay, but at the end of the day it is their decision. There is nothing I can do, except make my client aware that my door is always open and hope that they will return when they are ready to continue.
There will be times when I have a client referred to me, and it is very obvious that the client would rather be elsewhere. Despite the client??™s resistance towards my helping them, I would continue to attempt to build a therapeutic relationship and help the client. If, after numerous attempts I was still unable to build a relationship, I would have to refer on to another practitioner in the hope that they could succeed where I could not, and help the client.
As a practitioner I may have been in a counselling relationship with a client for a long period of time, it is possible that the boundaries have become blurred. As a result, the counselling relationship has become more of a friendship. This could impact on my ability to refer on, as I am no longer impartial or objective. Here I would hope that during supervision, my supervisor would make me aware of this and I would refer on.
Finally there may be times when I feel a client is pushing me to refer them to another service when I don??™t believe they require that service.
I would start by asking them why they think they require this service; maybe they see something that I am not aware of. After exploring with them their reasons for wanting to move on, if I still felt uncomfortable with them moving to another service, I would explain to my client why I believe they do not require referral. If this was not successful, I would probably seek supervision. However at the end of the day it is my client??™s right to choose and I have to respect this.

Summarise the processes of ending(s).
During your first session with your practitioner you will have gone over a counselling contract where he / she will have explained about confidentiality, boundaries etc??¦ In this contract you will initially have been offered six sessions, although you may require fewer sessions than this. Towards the end of your allotted sessions, your practitioner will have reminded you of the contract and you can discuss with him / her how you think you have progressed and if you believe you require anymore sessions. There will different options to consider on how to move forward,
??? end the counselling contract as you no longer need treatment.
??? start a new counselling contract as you both believe you require more treatment.
??? consider referral to an external agency, e.g. your G.P., specialist counselling or self help groups.
??? consider referral to another internal service such as a self help group or another service available.
Explain the reasons why you would refer a client.
There are many reasons a practitioner may find to refer a client, such as moving to a different area, if the client needs on going care, then referral to a colleague or another practice may be necessary.
The practitioner may not be qualified to deal with the specific issues a client may present, such as post traumatic stress disorder in repatriated soldiers. In this case referral to a practitioner who specializes in this area may be required.
The client may wish to only see a female practitioner, possibly due to religious beliefs, or if they had been sexually assaulted in some way; if the practitioner is male then referral is necessary.
The client may be coming to the end of a phase of treatment, such as rehabilitation for alcohol or drug misuse and require a less intensive course of action, referral to a day service may be in the client??™s best interests. The practitioner may have specialized in Humanistic counselling, when the client requires Cognitive Behavioral or Psychodynamic counselling, in which case referral to another practitioner may be necessary. The practitioner may not be qualified to the level required to deal with the client??™s issues.
There may be personality differences (which cannot be resolved) between the practitioner and the client which may interfere with effective progress.
Referral is necessary if after a period of time it may become apparent that an effective therapeutic relationship cannot be established.
I would also refer a client if I knew them outside of the counseling relationship as it would not be ethical for me to continue with treatment.

Explain how to refer ethically.
When considering whether to refer a client to another service or practitioner, you should first discuss your reasons for this with your client and get them involved in the decision. Always ensure you get their consent, preferably written, and make sure they feel happy, safe and ready with moving forward.
The practitioner can either set up the appointment for the client, or preferably offer the client your phone so they can call, encouraging them to take responsibility.
It is also essential that the practitioner gets consent, preferably written, to disclose any confidential information from the client.
If the client has agreed and wishes you to talk to on their behalf, make sure you do not discuss any personal details in front of him / her. This could cause the client to feel ???gossiped??™ about and self conscious.
When considering whether to receive a referral, the practitioner should bear in mind whether this is in the best interests of the client, if the client feels happy and has consented to being referred.

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