I wrote on this page that the best way I’ve found of getting referrals has been making referrals. But how do you make referrals?
Listen
I’ve found that people I know – friends, family, colleagues, acquaintances, and yes, patients – often present me with opportunities to make referrals, if I just listen closely enough. Many complaints about relationships (whether romantic, social, professional, or otherwise) hold a covert lament that someone really should be in therapy. Now. When a person’s complaining about their boss, that’s rarely an opportunity to make a referral. But when a person’s complaining about a close family member, or a partner, or a good friend? That’s different.
When I’m talking with someone other than a patient, this is straightforward enough: “Would it be helpful if I gave you someone’s name for this person to talk to?” Sometimes, the answer is something like “Hell, no!” But often enough, my friend or colleague will say, “Actually – yes. This person actually mentioned they were having trouble finding someone to talk with,” or some such.
And when I’m speaking with a patient, it’s also straightforward, if a bit different. I try hard to avoid being seductive, or to lose the thread of what my patient is really talking about, but I might say something like, “It sounds like you think so-and-so really might benefit from therapy.” Or, “It sounds like you wish so-and-so were engaged in a process like the one you and I are engaged in together.” I don’t tend to offer up a referral explicitly – both because to do so might feel like a request or even a demand to my patient (“Give your partner the name of someone I’ve suggested!”) and/or I, or my patient, might well be the last person in the world from whom this particular (future) patient might wish to receive a referral.
A subset of this case? When it sounds like a patient of mine is saying they’d like to be in couple’s therapy. Here, too, I might be a good source of a referral – but only if both members of the couple see it this way. More than once, the fact of a referral coming from me (or from the therapist of one of my patients’ partner) disqualifies that person instantly. And, at the same time, I might well be a good referral source. Everything depends on the situation.
The main point is, I listen to my patients, and when I think I hear them suggesting that someone needs therapy, I tell them that I hear them suggesting that. And, more often than not? That leads to a request for a referral.
Be generous…
I put a widget on my web site. It lets anyone schedule a 15-minute consultation with me at no charge. For most of the last few years, my practice has been full, so I haven’t actively sought new patients. At the same time, if I can help funnel people toward people I know and like? That surely will redound to my benefit down the road. And, it’s a genuine service to patients, many of whom find the marketplace for therapists to be maddeningly opaque, confusing, difficult to navigate. When someone clicks on my little widget, they’ve taken a hard step, and invested me with at least a hint of an idealizing transference. If I can transfer even some of that idealizing transference onto another clinician – particularly one who I think genuinely might serve this patient well – then that’s a win-win-win. The patient wins. The therapist to whom I refer wins. And I win – racking up some good vibes with one or both of those other two people. Which, in the case of the clinician, might well lead to a referral down the road, sometime when my practice isn’t full. (Because no one’s practice is always full.)
This practice costs me fifteen minutes here and there – I rarely have more than one such consultation a week, and many weeks go by without a single such consultation. The widget syncs with my Google Calendar, on which I keep a real-time accounting of all my time, and availability, so it’s easy enough for me to block off time I want to protect. All in all? An ounce of generosity, and a dollop of good will, all around.
… and exercise discretion
I’m not the right therapist for every person referred to me, or who might find me via some or other route. It took me a long time to have the confidence to say to a patient after an initial consultation or two, “I have a sense that I might be able to connect you with someone who’ll be a better fit for you than I would be.” This might be for purely logistical reasons – having to do with money, or scheduling. It might be for more transferential/countertransferential reasons: a teacher of mine once told me that “At least one person in the room has to hold hope; if neither patient nor therapist holds hope, the treatment is doomed.” I might just find myself with an unwelcome sense of dread when I contemplate working with someone. I might know someone with much more experience handling some or other aspects of a person’s presentation. I might simply think, “I think this person will really click with therapist x!”
In any of these cases, I like to walk away from the opportunity the patient represents, and pass along that opportunity to another clinician. Again: the patient benefits. The other clinician benefits.
And I have faith: one day, so will I.
Choose wisely
When I make referrals, I have lots of options. I know a lot of therapists and analysts to whom I might refer. So, to whom should I refer a prospective patient?
Some people feel very strongly that referrals should only be made to one clinician – that, if someone asks for a referral, they should receive just that: a referral. Some clinicians actually object to, or resent, being referred to along with other clinicians at the same time. I try to be mindful of this preference, even though I don’t share it.
My own view? Patients are entitled to whatever they think will serve them best, make them most comfortable. Some people want just one name. Others want two, or three, or five. Some people want to know a lot about the therapist to whom they’re being referred; others want to know as little as possible. While I have my theoretical perspective (I think less is more, generally), I also believe the customer is king, and there’s no time this is more so in the field of therapy than when selecting a clinician. So. I like to ask people I’m referring their preference: “Would you prefer I refer you to one person? Would you prefer two or three names?”
And then, before I give the patient a single name, I check with those to whom I’m referring the patient. Do they have availability? Does their practice have room for what I know about this patient? (Budget? Presenting problems?) And, finally, I tell them: “I’m referring this person to you alone,” or, “You should know, they asked for a couple of names, and I’d like to give them yours.”
And how do I decide whose names to give? That’s actually easy: I ask myself a simple question: whom do I know that I think will be the best fit for this person? Sometimes, that will be someone in the same group in which I practice. Sometimes, it will be someone I know from my institute. Sometimes, it’ll be someone who works very similarly to me. Sometimes, someone who works quite differently.
Regardless, there’s only one priority when it comes to choosing the person to whom I refer: the patient’s best interests.
A.I. note: The image accompanying this post was generated by ChatGPT in response to the prompt, “A therapist on a landline phone.”
