Members refer clients to other professionals in various circumstances: due to temporary unavailability of the member; a full client load; supplementing the care of a client; or where the member is unable to provide the kind of care required. Members are professionally obligated to refer a client to another professional when the member lacks the knowledge, skills or judgment to offer needed services (see Standard 2.1 Consultation, Clinical Supervision and Referral).
When referring clients to other professionals, members inform clients of the reasons for and implications of referral, and obtain the client’s informed consent before making the referral. Members should also take reasonable steps to ensure that the other professional is appropriately trained and/or certified; that they adhere to accepted standards of their profession; and that any information provided by the member about the other professional is accurate. Whenever possible, it is advisable to provide the names of more than one professional when making a referral.
Self-referral occurs when an RP working in one professional setting refers clients to him/herself in another professional setting. For instance, a member working in an agency or Employee Assistance Program may refer a client to his/her own private practice.
Members are not prohibited from making self-referrals, so long as the following safeguards are followed:
- the conflict is disclosed to the client (e.g. the member stands to gain by making the self-referral);
- options are provided (e.g. whenever possible, a list is offered of three similar service providers); and
- the client is reassured that if s/he chooses to obtain the service elsewhere, the existing relationship and service will not be affected.
Technically, a referral to a related person or corporation places the member in a conflict-of-interest. However, there will be situations where this is appropriate. As long as the member adheres to the safeguards outlined above, and s/he documents the conversation occurring around the self-referral, s/he will not be creating a prohibited conflict-of-interest.
The Standard: Referral
Members adequately inform clients about any referral they propose to make; obtain the client’s informed consent; and take reasonable steps to assure themselves of the competence and character of the professional to whom the client is being referred. Members avoid self-referral unless the benefit to the member is disclosed to the client, alternative options are provided, and the client is reassured that the existing relationship will not be affected by the client’s decision.
Demonstrating the Standard
A member demonstrates compliance with the standard by, for example:
- informing clients of the reason a referral is being proposed;
- taking steps to ensure that the other professional is qualified and competent;
- disclosing to the client any actual or perceived conflict-of-interest in proposing a self-referral;
- when proposing self-referral, providing the client with the option of seeking alternative services, and reassuring the client that the existing relationship will not be affected;
- documenting any disclosure relating to self-referral.
Standard 3.2 Consent
Standard 2.1 Consultation, Clinical Supervision and Referral
Standard 1.6 Conflict-of-interest
Standard 1.7 Dual or Multiple Relationships
Professional Misconduct Regulation, provisions 3, 4, 8, 9, 16
Note: College publications containing practice standards, guidelines or directives should be considered by all members in the care of their clients and in the practice of the profession. College publications are developed in consultation with the profession and describe current professional expectations. It is important to note that these College publications may be used by the College or other bodies in determining whether appropriate standards of practice and professional responsibilities have been maintained.