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Unit 15 Referral and Intake

1. Define referral.

Referral can be defined as the process in which a client is sent for seeking a higher level intervention or opinion.

2. Write short note on intake.

Intake session is an initial family interviewing. It would be presumptuous to suggest there is 'one' correct way to carry out such a consultation. The main goal of the intake process is to map the aspects of systems of the present complaint. This will be limited to defining those aspects of the systems which are relevant to the immediate present difficulty and to the immediate family.

3. Briefly describe the process of intake.

The initial interview is full of excitement, uncertainty, newness and difficulty of understanding. In this, parties come together by previous arrangement, and they meet for the first time in the knowledge that they will need to find a way to work and live together. 

The tentative establishment of an emotional contact between the family and therapist takes place. Intake process also determines if family therapy is required or not and further referral to other helping source

4. List down the important points that should be kept in mind while conducting intake.

The important points to remember while conducting intake are:

• Establishing rapport.
• Understanding the reason for the session.
• Understanding the exceptions.
• Appointment.
• Duration of intake.
• Payment norms.
• Members to be present.
• Motivating the family for family therapy.
• Duration of family therapy.

5. What do you mean by referral? Explain with the help of an example.

Referral is the process of sending a client to another professional or service for a higher level of intervention or a different perspective. An example would be a counsellor who is working with a family that has a member with a severe eating disorder. If the counsellor doesn't have experience in that area or thinks that the client requires more specialised help, the counsellor may refer the family to a treatment centre that specialises in eating disorders.

6. How can referral help the family and the family therapist?

Referral can help a family by ensuring that they receive the most appropriate care for their needs. If a therapist feels that they do not have the necessary skills or expertise to help with a specific issue, they can refer the family to a more specialised professional. Additionally, it can aid the family therapist as they become aware of their own limitations, and that a client may need something that they cannot provide. Referrals can help build a broader network of professionals, meaning more collaborative work.

7. Explain the process of intake.

The intake process is an initial family interview, it may involve the therapist and the family meeting for the first time. The main goal of the intake process is to define the aspects of the family's present complaints, focusing on what is relevant to their immediate difficulties. It can be an exciting and new experience for everyone involved, and can be full of uncertainty and difficulty in understanding the situation. The key components are establishing rapport, understanding the family's reasons for seeking therapy, clarifying expectations, and setting the stage for further work. The therapist must be aware of the need for confidentiality and informed consent. The therapist will need to take careful notes during the session to help plan the next steps.

8. What are the aspects that a family therapist or counsellor needs to bear in mind?

A family therapist or counsellor needs to keep several key aspects in mind, as outlined in the sources:

• Confidentiality: It is essential to communicate the confidential nature of the information shared by the family, and not reveal details of the therapeutic relationship without the client's permission. This also means that the therapist needs to ensure that others do not have access to therapy notes and that privacy is maintained. When multiple family members are involved, any release of information must be agreed to by all parties. An exception is when the therapist fears the client will harm themselves or others.
• Informed consent: Clients need to understand the counselling process, including their rights and responsibilities, as well as the therapist’s. This should be reviewed both verbally and in writing. Informed consent is an ongoing part of the process, and documentation of these discussions is important.
• Neutrality: The therapist should maintain a neutral position, not taking sides with any family members. It is common for therapists to be drawn to a family member who seems like a "sufferer," but the therapist must give equal time to each member and avoid meeting with single members unless the opportunity is available for each member.
• Understanding emotional aspects: Therapists need the skills to handle the emotional issues that arise during sessions. Clients may express a range of emotions, and the therapist should respond appropriately.
• Gender issues: The therapist should be sensitive to gender issues, taking into account whether the family is comfortable with the therapist’s gender, and being aware that in some situations a co-therapist of the opposite gender may be useful.
• Ethical issues: Therapists must adhere to the code of ethics of their professional organisations, addressing confidentiality, financial, research, advertising, and other business and professional concerns. They must be non-exploitative, respect client confidentiality, and do no harm. They should also be aware of social services and other resources that may be helpful to clients and make appropriate referrals.
• Responding to life-threatening behaviours: If a client is a danger to themselves or others, the therapist must intervene to protect both the client and potential victims. It is important to utilise support systems, including supervisors and colleagues, to help implement and cope with these reactions.
• Supervision and continuing education: Therapists must address their own biases through supervision and ensure they are providing appropriate services to clients. They should also engage in continuing education through attending conferences, workshops, seminars, reading professional literature, and holding case conferences.
• Documentation: Therapists must maintain confidential records, which can be written or automated. Records should be stored, accessed, transferred, and disposed of in a manner that maintains client confidentiality. They should include only directly relevant information and be stored for a required number of years.

These aspects are essential for family therapists and counsellors to ensure they are providing ethical and effective support to families.

Important Points

• Referrals can be made by another counsellor.
• If the feelings of client are not explored there may be resistance in new counselling situation.
• It is important to understand the expectations of client from a counsellor/therapist.
• It is helpful to be aware of the complementary therapies available, that could be used in conjunction with counselling.
• Some clients need psychotropic drugs through psychiatric intervention in order to control their problematic thoughts, feelings or behaviours.
• A call or a letter from a source helps therapist to form an initial hypothesis.
• It is essential for the counsellor to have the contact details of the family whom they are counselling.