Influences on Decisions to Refer at University Counseling Centers

Seventy counseling centers with APA approved internship training programs were sent surveys about variables that influenced their decision to refer a student client for services elsewhere. Forty-two of these 70 institutions (60%) responded, with 152 staff at these 42 centers completing the survey. Eighteen of the items included in the survey were subjected to an exploratory factor analysis. Three well-defined factors, accounting for 44% of the total variance emerged and one correlated significantly, but only moderately (r = .41) with reported rates of referral. The top ranking consideration for staff referring outside the center was the client's request for such a referral, followed by severity of client's concerns. The least prominent considerations were training needs and the clients ability to form a therapeutic relationship.