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Kentucky Social Work Code of Ethical Conduct
Ethics Boundaries continuing education counselor CEUs

Section 12
Kentucky Administrative Regulations: 201 KAR 23:080
Referral and Termination

CEU Question 12 | Ethics CEU Answer Booklet | Table of Contents
Social Worker CEUs, Counselor CEUs, Psychologist CEs, MFT CEUs

     Section 12. Referral and Termination. (1) A social worker shall make a timely and appropriate referral of a client for a social work or other service if:
     (a) The social worker is unable to provide the work or service; or
     (b) The client's need exceeds the competency of the social worker.
     (2) A social worker shall terminate a social work service if a client:
     (a) Has attained his stated goal or objective; or
     (b) Fails to benefit from the social work service.
     (3) A social worker shall communicate the referral or the termination of a social work service to a client.
     (4) A social worker shall not terminate a social work service or refer a client for the purpose of entering into a personal relationship with the client, including:
     (a) A sexual, romantic relationship;
     (b) A financial or business relationship; or
     (c) Other activity that might serve a personal, political, or religious interest of the social worker.

- Kentucky Legislature. Title 201, Chapter 23: 080 Board of Social Work. 2018 Kentucky Administrative Regulations. Section 12. Referral and Termination.

Let's look at boundaries as they relate to the referral process. Just as you cannot be all things to all people, so there is no one social institution that will serve all the needs of a complex individual in a complex society. Failure to refer can have tragic consequences in cases when the physical health of the client is in question or when physical factors may play a potential role in the client's quality of life.

For example, the possible physical complication of a client with anorexia nervosa requires the monitoring of physiological consequences by a physician. This example of the boundary of referral to a physician in the case of anorexia nervosa is pretty clear cut.

♦ 4 Questions to Explore Referrals
But let's look at a more complicated example. What if you have been seeing a client for several years and you feel a colleague who specialized in, for example Gastault training would be of benefit to your client. As you know being referred usually carries with it elements of rejection, anger, hope, and expectation.
-- 1. How do you introduce the idea of a referral to alleviate your client's feeling of being rejected?
-- 2. How do you handle possible anger from the client regarding your suggestion concerning a referral?
-- 3. How do you introduce the idea of a referral to another therapist, while not raising false hope in the client?
-- 4. How do you bring your client's expectation level regarding the new therapist into line with reality…so he or she does not view the new therapist as a cure-all for their problems?

Think over your current or past clients whom you felt may have needed a referral. Think of a client you referred to another agency or professional. Now think of client you did not refer to another agency or professional that possibly could have benefited from the treatment or services of another. Where and how did you draw this boundary in your mind? Was a referral not made as a measure to avoid dealing with you client's possible feelings of rejection, anger, hope, and expectation?

♦ 3 Key Test Questions Regarding Ethical Referrals
Thus, three boundary questions are proposed here.
The first question is, when to refer and when not to refer?
The second question is, when does referring or not referring serve to meet my own needs and not the needs of my client?
To find an answer to these two boundaries ask yourself the following three questions:
1. What is the context of the situation for considering a referral?
2. Would my client's goals be better served by a referral?
3. What is the potential harm resulting from referring or not referring to another?
- Clapton, Kerrin. Developing professional boundaries guidance for social workers. Journal of Adult Protection. 2013. Vol. 15 Issue 1. Pg. 37-44.

Ethics CEU QUESTION 12
What are four possible reactions your client may have when a referral to another professional or agency is suggested?To select and enter your answer go to Ethics CEU Answer Booklet.

 
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The article above contains foundational information. Articles below contain optional updates.
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As we approach conversations on gun violence, we need to keep in mind social work values of integrity, respect, human relationships, and competence.
Ethics Alive! Religious Freedom and Social Work: Ethics of Referring Clients - January 01, 2019
Allan Barsky explores religious freedom in the context of social work practice, specifically whether it is ethical for social workers to cite religious differences with clients as the basis for referring clients to other workers.
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Social workers use varying terms related to culture and social diversity - cultural competence, cultural awareness, cultural sensitivity, cultural humility, and cultural responsiveness. What do they mean? What’s the difference?

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