The Art of Referral in a University Mental Health Center

Abstract

With the growth of managed care into university mental health settings, clinicians there often find themselves in unfamiliar role of “gatekeeper,” deciding who shall receive psychotherapy and referring those clients to an outside clinician for psychotherapy. However, the rates for client follow-through on these referrals are often low. Based on the experience of one clinician and his supervisees, the present discussion presents a framework for understanding the referral process with university students and for improving rates of follow-through. It is assumed that the psychodynamic forces, including transference and countertransference, operative during long-term therapy, are also at play during the referral process. When unanalyzed, many of these forces can interfere with follow-through. On the other hand, attention to these psychodynamics can increase the probability of follow-through by informing the referral process in relation to timing, interpretation, and the creation for the client of a transitional space from one clinician to the other.

Key Words:

• Referral
• college students
• timing
• transitional space