When In Doubt, Refer Out

Raise your hand if you love “trial by fire”, doing something that makes you feel uncomfortable, or the concept of powering through.

Which one are you?

• I just love trial by fire, discomfort, and powering through
• I prefer being able to work within my strengths

Let me just say, my hand is not up and I'm choosing answer #2. Another draw to private practice for me is that I don’t have to experience much of the above. I’m all about challenges and being a forever learner, but there is nothing wrong with not being an expert or uncomfortable with all your title says you can do (check out this blog for a crash course on the many areas under an SLP’s license: https://www.cradletotable.com/post/wait-what-even-is-speech-language-pathology). 

For the therapists and professionals here, as the title says, when in doubt refer out! There is no shame in that. I know that not all settings or organizations are willing to turn a paying client away, but maybe someone else in your office or school is more equipped that could take the case that would force you into “trial by fire” or extreme discomfort. I know there will be times that you can’t do this. When that happens, ask for help. Seek the experts. Learn what you can. Do your best.

For the parents and non-therapist/doctor/professional-that-makes-medical-referrals here, do not be discouraged if you are referred to another therapist, or for another service/support! A practitioner humble enough to turn away a paying client is looking out for your best interest in an effort to make sure you or your child receive the best care possible.

---

Now, no one grows in their comfort zone. Avoiding challenges and only taking cases that are perfectly within your comfort zone is not what I’m suggesting. For example, I have been Sequential Oral Sensory Approach (SOS) to feeding trained since 2020 and feel pretty good about working with children aged 2-8 who need support with oral motor skills or increasing their food repertoire. I feel less comfortable with children under 2 years old transitioning from breast and/or bottle to solids. But I’m not running away from this! I am actively taking courses to support this population. In fact, the day I drafted this blog, I received a referral for feeding therapy with a client just outside of my comfort zone. As the grips of imposter syndrome reached for me, I decided to embrace this challenge instead. There’s still a chance I’m not the right fit, and if that should be the case, I can still help by accepting that truth and referring them to another provider that will better meet their needs. I will always be transparent about my abilities. I am only human after all.

There can be an immense pressure to see anyone who comes in the door with not enough support and encouragement to refer out when your license says you can address it, even if your actual experience or expertise is minimal. Sometimes referring out IS helping. Sometimes referring out IS the right move. Even if it feels like you’re letting someone or something down. The pressure to know it all or do it all can be heavy in this field. When in doubt, refer out (when you can). And if you ever need a pep talk about how you did what was best for not only your client, but also yourself, I got you! Talk to me about it via email at kknowsley@cradletotable.com or comment below.