|This page aims to help you to consider your
role boundary around drug issues. The development of agency protocols and policy can
greatly assist this decision making.
Options include managing the case yourself with or
without consultancy support, handing one specific aspect of the case to another agency,
handing the whole case over to another agency or shared-case management.
Further information on referral options can be obtained at Agency Resources.
Indications for not referring
Indications for referring
12 Referral Steps
The development of reciprocal agreements and procedures between drug
agencies and generic agencies will aid in determining boundaries, roles and mutually
supportive structures around referral and shared-case management.
||If a client is referred to a drug agency or
specialist within the generic agency for intervention, the intent of that referral needs
to be clear for the client, the referral agency/specialist and the referring worker. Some
key questions which would need to be answered regarding referral include: |
||What other agencies or professionals are currently
involved in the case?
||Has the specific nature of the referral request been
made clear? (e.g. for relapse prevention work, drug assessment, detoxification etc.)
||Is the case being totally handed over to the drug
agency with the expectation that they will become the case manager, or will referring
agency maintain case management, or will there be shared-case management?
||Does the referral agency understand or have any
obligations regarding their management of statutory cases?
||Are there statutory conditions related to the
||Have confidentiality issues been managed regarding
the sharing of information between agencies?
||What information is being provided to the referral
agency and what information would be expected back? Has this been made clear?
Indications for not referring
The current trend in dealing with drug use issues is for them not to be seen
necessarily as a specialist only area. Rather, given that the majority of drug users do
not have serious dependencies or difficult complications, generic workers should be able
to deal with many of their cases using brief
intervention techniques. These techniques are largely based on generic
counselling skills already possessed by most workers.
|Indications for referring:
12 Referral Steps (checklist)
||Linked to assessment steps. (ie
referral should be considered during assessment)
||Ask the client who else has been involved
in the case.
||If other professionals involved, seek written
permission from client to contact them to discuss their case (i.e. release of
information). You may invite the client to be present when this discussion takes place to
||Discuss and negotiate any referral options
with client. Include any bottom-line positive and negative consequences if related to
||Discuss any obstacles to referral and benefits
||Identify and use any protocols
developed between drug and other agencies.
||Identify with client and subsequently
referral agency, whether client will continue to see the the referring worker, and if so
who will be overall case manager, or how shared case management will proceed.
||Organise referral while client is present if
possible. Either client or counsellor to make initial call, however, most drug
agencies will want to hear from the client if possible during this call. If there are
child protection or other statutory requirements, these need to be made clear at this
||Client or counsellor writes referral
details for the client to take home.
||Reminders: If suspicion of
unreliability, problem solve this with client. Solutions may include: a reminder call from
the counsellor on the appointment day; putting a note on the refrigerator; or if
necessary, arranging for the worker to pick up and accompany the client to the first
||Where possible, a referral is written
stating the purpose of the referral and relevant information. If a drug assessment has
already been completed, this should be included unless the counsellor is seeking an
alternative, external view. This is either given to the client to deliver or sent directly
to the referral agency depending upon the situation. Note confidentiality.
||Follow-up with client and/or agency
how referral went.
See: Agency Resources)
Telephone (e.g. ADIS, help lines: click here
for help-line numbers);
Professional services (e.g. Drug agencies, private counsellors, hospital psychologists,
Non-professional (e.g. AA, NA, Al-Anon, Nar-Anon);
Detoxification: outpatient or inpatient
Drug maintenance therapy: Methadone, Naltrexone...
Drug testing services: Laboratory testing services or drug agency
Specific drug counselling: Assessment, motivational interviewing, relapse prevention,
Group work: (e.g. outpatient client groups or family and friends groups at drug
Long-term residential rehabilitation
Non-drug physical and psychological (e.g. Medical examination, psychological
intervention for anger, anxiety, depression, phobia, pain management, or psychiatric
assessment for psychotic symptoms)
Other non-drug referrals - where other issues impact on drug use behaviour: (e.g.
accommodation, recreation, education, employment, parenting, social security, etc.).
Inclusion and exclusion criteria regarding drug use should be considered regarding
non-drug referrals: (does the accommodation or other service tolerate any drug use?).
See also: Agency Resources