Mental Health UK

Counselling: When to Refer Clients

Indications for referral to a counseling psychologist

  • The patient has complaints indicating a psychoemotional disorder, for example: anxiety, depression (persistent decrease in mood, activity, tone, performance), sleep disturbance, emotional instability, irritability, as well as a violation of the logic of thinking and speech, alienation, suspicion, hallucinatory experiences and other disorders that do not require hospitalization, i.e. proceeding without aggression, protest, antisocial and suicidal behavior;
  • Complaints of a somatic nature that cannot be explained by the results of objective studies, which are supposedly functional (psychogenic, psychosomatic) in nature, for example: cardialgia, in the absence of signs of myocardial ischemia; paroxysmal shortness of breath or a feeling of suffocation without signs of bronchospasm and circulatory failure; dyspepsia in the absence of changes according to EGD;
  • Severe autonomic dysfunction that is not a direct manifestation of a physical illness, for example: sympathoadrenal autonomic crises (“panic attacks”) with severe fear of death or loss of control, tachycardia, tremors, feeling short of breath, weakness, dizziness, sweating, hot flashes heat, cold, numbness, etc.;
  • Chronic pain syndromes that do not have a clear somatogenic condition and are not relieved or insufficiently relieved by classical pain relievers, for example: tension headache, neuropathic pain, persistent somatoform (stabbing, cutting, burning, numb, constricting, bursting, itching, night, rolling and etc.) pain and paresthesia;
  • Manifestations of hypochondria and / or somatized (latent) depression, for example: multiple recurring complaints about physical health that do not have an objective justification, an obsessive search for symptoms of various diseases, fear of an unrecognized, undiagnosed disease, doubts about the competence of doctors and the reliability of research, clearly an excessive, obsessive desire for medical literature and Internet forums dedicated to the topic of wellness;
  • Psychoemotional and vegetative disorders that developed in the postpartum, postoperative, post-intoxication periods, with menopause, premenstrual syndrome, or in the form of side effects of hormonal, antibacterial, antiviral drugs;
  • Any situations associated with taking or prescribing psychotropic drugs: tranquilizers (anxiolytics), antidepressants (thymoanaleptics), neuroleptics (antipsychotics).

When the patient should NOT be referred to a counseling psychologist

  • Stable formed addictions: alcoholic, nicotine, narcotic. A patient needs a referral to a psychiatrist-narcologist, narcological dispensary or clinic;
  • Severe anorexia or bulimia. Treatment is indicated in a therapeutic or psychiatric hospital;
  • Sexual disorders or features of sexual behavior: persistent impotence, frigidity, nymphomania / satiriasis, transsexualism, etc. Referral to a sex therapist is needed;
  • Epilepsy, epileptiform syndromes, epileptic psychoses. A patient needs a referral to a neurologist, psychiatrist-epileptologist, neuropsychiatric dispensary, psychiatric clinic;
  • Alzheimer’s disease, Pick, vascular dementia (dementia) in old and senile age. A patient needs a referral to a psychiatrist-gerontologist, a gerontological hospital, a boarding school, a hospice;
  • Personality disorders (psychopathy), mental retardation, asocial, suicidal behavior. A patient needs a referral to a neuropsychiatric dispensary, a psychiatric clinic, social and judicial authorities, an emergency psychiatric ambulance service like lifeline 24/7 online help.