Abstract
University counseling centers (UCC) must rely on referrals to off-campus providers, due to limited staffing, severity of clients' issues, and ethical treatment considerations. In a mixed method design, this study found that 42% of clients were unsuccessful in connecting with an off-campus provider when referred by a university counseling center therapist. Clients of color were more unsuccessful in connecting with an off-campus provider than Caucasian clients. Regardless of ethnicity, clients reported that therapist follow up, accessible referral sources, and high personal motivation assisted in a successful referral process. Financial issues were the primary inhibitory factor for the referral process. Suggestions for clinical practice and university counseling center policies are provided.