If you’ve ever been in therapy and your therapist said something like, “I think you would be better served with a different level of care,” or “I think it is a good time to discuss movement to another therapist to continue your work,” it might have felt confusing, frustrating, or even hurtful. But in many cases, this decision isn’t personal — and it’s certainly not a sign that you’re “too much” or unworthy of care. It is also never from a place of distain or lack of positive regard.
So why does this happen? Let’s break it down.
1. Scope of Practice
Therapists are trained in specific approaches and populations. If your needs fall outside of their expertise — like if you’re seeking trauma-focused EMDR but your therapist specializes in couples therapy or exclusively Cognitive Behavioral Therapy — an ethical provider will refer you to someone better equipped to support you. At St. Augustine Counseling, we are blessed to have a group of providers who all have slightly different specialties and passions. We may even encourage you to consider working with another provider in our same practice! That is okay, the cool part with that is that new provider, with your permission, can even access your current provider’s notes and pick up where you left off.
2. Level of Care Needed
Sometimes therapy reveals that someone may need a higher level of care than outpatient sessions can provide — like intensive outpatient (IOP), partial hospitalization (PHP), or even inpatient care. Rather than continuing sessions that aren’t meeting your needs, a good therapist will help connect you with more appropriate support. Let’s be honest, therapy is expensive, as ethical clinicians, it is doing you a disservice to continue working with you when your needs happen to be better supported with a higher level of care.
3. Dual Relationships or Boundary Concerns
If a therapist discovers they have a personal or professional connection with you that could affect the work (e.g., you start dating their friend, or you’re in the same small community), they may refer you to maintain ethical boundaries and keep the space safe. Saint Augustine is a really small town and most of the providers at St. Augustine Counseling may run into you, this is not a dual relationship however, if these arise, it is in your best interest to have a therapist interested in keeping your privacy, confidentiality, and social supports yours.
4. Client-Therapist Fit
Sometimes, the connection just doesn’t click. Maybe the style doesn’t align, or you don’t feel seen in the way you need to. Therapists can sense this too, and referring out can be a sign of care — helping you find someone who does feel like a better fit. This is nothing personal, in fact, it is saving you multiple additional sessions in which it may feel as though you are not getting anywhere.
5. Non-Engagement or Therapy Interference
Therapy is collaborative. If someone repeatedly no-shows, doesn’t follow basic agreements, or is actively using substances in a way that disrupts therapy, the therapist may pause or end sessions until there’s more readiness or stability. This is not a personal attack but again, awareness from the Clinician that a pause, referral, or end is necessary.
The Bottom Line:
Termination isn’t a punishment. In fact, it can be a deeply ethical, caring act. When a therapist refers you elsewhere, they’re saying: “I want you to get the care you truly need, even if I’m not the one to give it.” Therapists are also acutely aware that their role in your healing journey may be to simply start the conversation and allow you to begin to see that areas in which work is possible. Being referred to a new clinician allows for a fresh start with the knowledge gained up to that point.
If this happens to you, it’s okay to grieve, to ask questions, and to seek support in transitioning. Therapy is about you — and that includes finding the right fit at the right time.
By: Bethany Kleinhans, LCSW
