When a Therapist calls to ask for program recommendations

This has happened to be more often than I’d like to admit.  Instead of being annoyed that I’m being called and asked for this information, I’ve chosen to think differently.  I appreciate that folks think of me, and yet I don’t want to be put in this position again.  Below, you will read my analogy of what it might be like for a Therapist if the roles were reversed in asking for support for a client.

I’ve been called by Therapists who work for programs, and therapists within private practice.  Let me start by saying I appreciate that a therapist sees me as a placement expert for consultation in recommending programs to their clients. Instead of immediately rattling off names of programs I’d recommend after hearing 2 ½ minutes’ worth of the client profile, I have to pause. Internally, I’m cringing.  I’m giving away free information.  Information from my own time and energy visiting programs across the country.  Visits that allow me to make sure when I’m recommending placements for clients, that I truly know the program I’m referring.  This is me doing my due diligence.

If I ask that same therapist if their client needs a consultant, they quickly tell me no.  When I follow up with in asking why, some of the answers I’ve gotten are:

1.   “They can’t afford a Consultant” [In my head, all I’m thinking is how will they pay for treatment then?]

2.   “They’re already willing to go to treatment.  They don’t need a consultant” [So as their therapist, you’ll be asking for a release to continue to speak with the clinicians at the treatment program so you can be a part of the transition/continuum of care planning?]

3.   “I’ve already recommended two programs for them.  I was only calling you to see if I was missing a program that you might also recommend.” [Have you visited these programs?  If not, you may be liable.  Also, if you’ve already got names of programs, just go with what you know and there’s no need to loop me in. And lastly, in hearing about the programs you’re recommending, I’m cringing.  In hearing a little about your client, I would not have put those programs you’re recommending on the list. Period.]

This is where it gets kind of murky.

It’s a liability for me to share names of programs, haphazardly.  I never refer my clients to programs unless I’ve called to confirm the program’s milieu is appropriate at that time, that they have an opening, and if it’s within my client’s price range.  I imagine that being a Therapist with a client who’s willing to go to treatment is exciting. What you need to know is that you, as their Therapist, won’t be in communication with your client while they’re in treatment. Essentially, you’re handing your client off and hoping that they’re doing well and come back to you when they return to the area.  Unlike a Therapist, I stay with the client throughout their treatment.  I provide case management to ensure the client is, in fact, in the appropriate place to get the help they need.  If they aren’t, I hustle to find another place.  When they are ready for discharge, I’ve spent time on the phone linking them up with next steps for continued care.  That means that when they discharge, they don’t necessarily just return home to see their individual therapist every other week.  They will most likely need much more. Not to mention, while they’re in treatment I turn to their family system and see if there’s additional supports I can provide in that space as well.  From parent training, to finding support groups or therapy for family members, I can help make sure that when your client is in treatment there truly is systemic change happening.  That’s how we’re going to ensure that your client stays stable and sober.  That’s the difference between your work and mine.   

If the roles were reversed, here’s how it might be perceived if I were to call you asking for recommendations for my client:

Me: Hey Therapist!  You may not remember me, but we met once. How are you? 

Therapist:  Hey Joanna!  I’m well.  Of course, I remember you!  How are you?

Me: I’m great!  Thanks for asking.  Hey – So I don’t want to take up too much of your time, but I wanted to run a client of mine by you.  I’m hoping you can help!

Therapist: Sure!  Thanks for thinking of me!  Tell me a little about your client and I’ll see if I can be of help.

Me: Well, my client is returning to the area after treatment.  The clinical recommendations post discharge are for my client to participate in a DBT group, and see an individual therapist for continued healing around complex trauma.  I know you are trained in DBT and run a DBT group, and I also know you’re trained in EMDR and Brainspotting.  To me, you’re the expert!  So I was hoping you might be able to tell me a book I might be able to read quickly to give me the skills to be able to help my client myself.  Although I’m not trained, I really think I can help with trauma work and DBT skills.  Can you point me in the direction of a book or videos?  Or tell me some of the key components to using this type of therapeutic modality with your clients?  I’d so appreciate it!

Therapist: Um… what?!  It sounds like your client needs to see an individual therapist and join a DBT group.  Would you like to refer your client to me?  I do have openings for individual trauma work and in the DBT group?

Me: Oh, no.  Definitely not.  They don’t have an individual therapist, and quite honestly, I’m trying to help them by doing this for them.  What do you say – can you give me some of those tips or skills?

You can imagine how this conversation may play out.  Most likely the therapist would gawk at the thought of giving books, videos, or tips for me (not a practicing Therapist) to do therapy with my client.  No one in their right might would give that information.  If anything, I’d be scolded for thinking it was appropriate for me to do that for my client, and reminded that I am doing more harm than good to my client.

If you’re a therapist, you may be horrified in reading that narrative.  First, I need to make it known I would NEVER do this for a client.  Why? Because I’m not acting as their therapist.  My job as their Therapeutic Consultant is to get them connected to the right therapeutic resources.  I am the matchmaker and expert of said resources, not a practicing therapist.  I would certainly hope if you are a therapist and you have a client who needs a higher level of care, that you’d consider connecting them to a Therapeutic Consultant to work with them, instead of only calling to ask for program recommendations.  

If you’re a therapist and are reading this, you’ll now understand how it’s not entirely appropriate to call and ask for program recommendations from a Therapeutic Consultant.

For questions or comments contact Joanna.