How to Make a Counseling Referral
by Anthony J. Garascia, M.A., M.S., LCSW
Couples who are experiencing difficulties in their marriage often look to the church for help. Although most pastoral ministers are not professional marriage counselors, you may be the first person to whom a couple turns. Problems emerge in any loving relationship. Most of the time a couple takes these problems in stride. When a couple faces a problem beyond their ability to solve, however, as a helping professional you are in a unique position to make a referral to a competent marriage counselor. When a couple approaches you with questions about their marriage, they want someone who will look at both sides and serve as a mediator, coach, therapist, and offer genuine and concrete suggestions. Of course, in asking for a referral, a couple places an enormous trust in your recommendations.
MAINTAIN A LIST OF QUALIFIED PROFESSIONAL COUNSELORS
Most states have some form of licensure for counselors. This means that counselors must have a degree that meets certain standards on theory, practice, and ethics. Counselors should be licensed in their particular state and have a Ph.D. or Masters degree in counseling or clinical psychology, or a Masters in Social Work from an accredited university. Here are some criteria to consider when making your list.
• Experience. Couples want to know that the person they see has “been around the block” and will be comfortable talking about issues like finances, conflict, communication, sex, and just about any other issue that gets raised in the course of a marriage.
• Skill. When someone approaches a counselor they assume that he/she hasthe skill necessary to help them solve their problems. The best way to find the most skilled therapists is to listen to the evaluations from people you have referred in the past. Don’t be afraid to ask a couple to let you know how the experience went. This will assist you in refining your own list of counselors.
• Areas of expertise. Some therapists are great at communication and conflict, others are more helpful at dealing with anger; some won’t deal with issues like domestic violence, others will. Some counselors are great at dealing with adolescents. When a couple approaches you for a referral, it is best to know a little about the problem so you know who on your referral list can best help them solve the problem.
• Faith and Spirituality.
A therapist who is “pro-marriage” will do everything possible to keep a marriage intact while at the same time recognizing that marriages do indeed fail. Many couples today want someone who views spirituality as an important part of the overall process of being successfully married.
HELP COUPLES FIND A GOOD FIT
Once you have developed a referral list of qualified counselors, you may assist the couple in discerning a “good fit” for this particular couple. For example,
• Consider age and life experience. If the couple seeking counseling has children or is middle aged, they may not have confidence in a counselor who is young and single.
• Consider counselor gender. Although a good counselor should be free of gender bias, the client may not always be. Check out if either spouse would feel uncomfortable with a counselor of the same or opposite gender.
• Match the couple’s presenting problem with the expertise of the counselor when possible.
• How important is faith? For many couples seeking a referral from a religious source, faith is important to them and having a counselor who can draw on faith and spirituality as a resource can be helpful. On the other hand, some couples would not be receptive to a heavy handed faith approach.
• Consider practicalities such as cost, location, and urgency of appointment. For those who don’t have insurance that covers counseling, marriage counseling can range from $50- 150 per hour. Short term counseling often takes the form of weekly sessions for three to six months. Some social agencies and churches offer a sliding scale adjusted according to the couple’s income. Fees may also vary according to the cost of living in your geographic area. It may be helpful to have sources available that can help with co-pays or financial assistance, especially when insurance is not available.
• Always offer more than one name as a referral.
PREPARE COUPLES TO MAKE THE MOST OF COUNSELING
Many marriage counselors will take a short term, problem solving approach to marriage counseling. This means that a couple will be in counseling anywhere between 6 to 12 sessions. Knowing this information can also help a couple estimate how costly the counseling process will be to them. Some tips to pass on to couples seeking counseling for the first time are:
• Before the first session, spouses should ask themselves, “What is the end goal of counseling for me?” Encourage couples to be as specific as possible. In order for both to trust the counselor, both spouses should give themselves permission to ask questions.
• The counselor is there to listen to their story and will ask questions that assist in the listening process. At the end of the first session the counselor may give suggestions or homework for the next session. It is important that a couple gives the process some time to work. A couple should be realistic about instant results and be prepared to give the process some time.
• A client usually knows counseling is working when the original problem is solved or at least significantly improved. At that point the therapist may ask if there are other issues to be solved or whether the counseling process is finished. Often, a couple will move on to other significant issues.
• The most effective counseling is done when a couple fully participates by saying what they both want to see happen. The counselor guides them to solve their problem and improve their relationship satisfaction.
WHEN MORE THAN MARRIAGE COUNSELING IS NEEDED
Sometimes a spouse confides that there are deeply serious problems present. Perhaps there is drinking, substance abuse, or domestic violence. Here, it is important to have not only counselors who specialize in these areas but also a list of resources that offer a safe place for a spouse and children when violence is occurring; agencies that offer anger management courses, or treatment programs for substance and alcohol abuse. Your role as a Family Life minister is to help sort through the options. This can often be a moment of grace for someone who is anxious about his/her future.
In addition to counselors in private practice, several national counseling agencies that, when desired, take one’s faith into consideration are:
Diocesan Catholic Charities provides counseling to people of any faith and usually have a sliding scale according to income.
Samaritan Centers provide cost-efficient counseling emphasizing the interrelatedness of mind, body, spirit, and community.
Tony Garascia is Clinical Director, Samaritan Counseling Center, South Bend, Indiana. Adapted from “When to Seek Counseling” www.foryourmarriage.org.
