Factors affecting referral decisions in a university counseling center.

Abstract

The purpose of this study waste investigate the referral of 170 university counseling center clients to short-or long-term individual therapies or to various group therapies. Results suggested that nonclinical factors (financial resources, staff availability) were primary considerations in the referral process. Results also suggested that the referral process is largely a process of elimination. First, referral options that are not available (e.g., no group openings) are eliminated; second, options that may not be appropriate for the client (e.g., because of problem severity) are ruled out; last, the client is matched with any remaining treatment options. Results are discussed in terms of the effect of universities' fiscal policies limiting professional practice.Long-term psychotherapy no longer is the only outpatient treatment clients can or will receive. In some cases, long-term individual therapy is simply not the treatment of choice (Mann, 1973), and in other cases there is clearly not enough time or personnel to meet client demand with long-term individual psychotherapy (Bishop, 1990). On the other hand, the more timeefficient treatment modalities are not appropriate for all cases, and the ethics of the practice of psychology require that clients be appropriately referred to treatment (American Psychological Association, 1990). Obviously, referring clients to the various treatment modalities is much more complex now than in the past. Unfortunately, not enough is known about how clients are assigned to the multitude of treatment options. STEPHEN M. QUINTANA received his PhD from the University of Notre Dame in 1988 and is currently a member of the counseling psychology faculty at the University of Texas at Austin. His professional interests include university counseling and research interests include counseling process, adolescent development, and ethnic issues. CHRISTOPHER KILMARTIN received his PhD from Virginia Commonwealth University and is currently a faculty member at Mary Washington College. His special interests include men^ issues. JAN YESENOSKY received her PhD from Indiana State University in 1988 and is currently on the counseling psychology faculty at Kent State University. Her professional and research interests include clinical training, gender-role issues, and patterns of professional practice. DANIEL E. MACIAS received his MA from the University of Texas at San Antonio in 1988 and is currently a doctoral student in counseling psychology at the University of Texas at Austin. His special interests include counseling Hispanic students. WE GRATEFULLY ACKNOWLEDGE the assistance of the counselors who participated in this study, Martin Marder in his guidance of this project, and the three anonymous reviewers for their comments and suggestions.

Nonconsensual Sexual Experiences in Precollege Women: Prevalence and Risk Factors

“…Although there is little consensus among theoretical orientations regarding treatment strategies for survivors of sexual victimization, most experts agree that long-term psychotherapy is essential (Courtois, 1988). It is unfortunate that national attention to the problem of sexual abuse survivors coincides with a trend by college counseling centers to cut back on the provision of longer term counseling services (Magoon, 1991;Quintana, Kilmartin, Yesenosky, & Macias, 1991). This is likely to result in a population of students with serious psychological symptomatology whose needs for service go unmet.…”

A Collaborative Process Model for Promoting Successful Referrals in College Counseling

“…On the basis of the complexity and challenges of referral, we believe a collaborative process model will benefit counselors by providing a consistent, systematic method used to explore the essential factors, make decisions about referrals, and then execute those referrals. Although reasons for referrals to community providers have been presented in past literature (Dworkin & Lyddon, ; Lacour & Carter, ; Lawe, Penick, Raskin, & Reymond, ; Quintana et al, ; Zuriff, ), to our knowledge, this is the first coherent model of referral specific to college settings. Similar to ethical decision‐making models (e.g., Barnett & Johnson, ; Forester‐Miller & Davis, ; Luke, Goodrich, & Gilbride, ), the model incorporates consideration of relevant factors in making a decision of whether or not to refer.…”

“…Pinkerton, Talley, and Cooper () noted that developmental factors should also be a consideration in the referral process, suggesting that counselors may need to spend additional time with younger students to encourage follow‐through with off‐campus referrals. Quintana, Kilmartin, Yesenosky, and Macias () found that economic factors, such as the student's ability to pay or access to insurance, had a greater impact on referral decisions than clinical factors.…”