Episode #684: How To Handle Referrals At All Stages Of Your Practice

Overwhelmed by referrals?

 

In today’s Ask Allison, we’re unpacking the truth about building a referral network that actually lasts. You’ll learn why depending on a single referral source is like building your practice on quicksand, how to diversify so you’re consistently attracting your best-fit clients, and what to do when you’re full but the calls don’t stop. We’ll also get into the tricky part—when to refer out—and how to make those calls with confidence instead of guilt.

 

By the end, you’ll know exactly how to create a referral system that protects your time, keeps your caseload steady, and fills your practice with clients you love working with—without the constant worry of “what happens if this source dries up?”

 

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Links You’ll Love:

• Grab our FREE tools to grow your practice—weekly worksheets, the Tasky Checklist, and more: www.abundancepracticebuilding.com/links
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• Have a question for me about practice building? Submit it via our Ask Allison form, and I'll add it to the queue: https://www.abundancepracticebuilding.com/ask_allison
• Prefer video? This episode is also available to stream on our YouTube channel!

Episode Transcript

(00:07):
(Transcribed by TurboScribe.ai. Go Unlimited to remove this message.) Welcome to Ask Allison.
Y'all ask the questions about having a
fun and thriving practice and I answer them.
We have a worksheet for you today so
you can bring this answer into your life.
You can access that at abundancepracticebuilding.com slash
links where you'll also be able to ask
any questions you have for Ask Allison.
If you want more support, we've got some
free trainings in there too.

(00:28):
If you can't get enough Ask Allison, check
out our YouTube channel for our entire Ask
Allison library.
Welcome back to Ask Allison.
Here's today's question.
Everything about referrals overwhelms me.
How do I build a steady diverse stream
of referral sources?
How do I manage my caseload when I'm
full?
How do I decide when to refer clients
out who don't fit my niche?

(00:50):
I love this question because I feel like
it sounds like you're at the very beginning,
but you're thinking about the future.
So this is good.
Before I get into the answer, I would
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(01:32):
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So this is such a good and very
real question.

(01:53):
Being anxious about referrals is common, whether you're
brand new to private practice or you've finally
hit that golden sweet spot where referrals are
coming in steadily, maybe from a colleague, a
clinic, or even a single agency.
It is tempting to settle in, to ride
the wave, to stop thinking about marketing or
networking.
I mean, who wants to do more when
what you're doing is working?
There's a certain amount of scaling back you

(02:15):
can do, but if all your referrals are
coming from just one place, that is a
fragile foundation to build a private practice on.
So I'll tell you a quick story.
A therapist I know got completely booked in
just a few weeks because a local behavioral
health agency lost their only testing psychologist, and
they needed someone like yesterday.
He stepped in, he did great work, and

(02:35):
boom, he had a thriving business almost overnight.
Which sounds really ideal, right?
Except that agency was never going to go
without an in-house psych forever, and when
they finally hired someone new, the referrals stopped.
Just like that.
And he went from full to frantically checking
his voicemail and hoped something came in within
a matter of weeks.
So the kicker is, during that busy period,

(02:58):
he wasn't networking, he wasn't nurturing another referral
source, he wasn't building a buffer.
And when the first faucet turned off, there
was nothing to catch him.
And I have seen this happen in so
many ways.
When someone relies solely on a friend who's
a case manager at a local organization, and
then that friend moves.
When a colleague is sending overflow because their
wait list is six months long, and their

(03:19):
referrals dry up.
When a school counselor is referring to you
until the school hires a school-based therapist
or starts a contract with a big group
practice.
The common thread is that these are great
sources, but on their own, they're not stable.
They can disappear overnight, and when that happens,
it can feel really personal, but it's not.
So I'm saying this not to spike everybody's

(03:40):
anxiety, but I am saying if your gut
is telling you it's time to diversify, and
it probably should be if you only have
one referral source, that feeling is worth listening
to.
Not out of panic, but out of wisdom
and kind of getting in front of it
so that you don't end up in one
of these situations.
So let's talk about what diversification actually looks
like, particularly in a private pay referral-based

(04:01):
practice.
Start thinking beyond one or two key people.
Here are some solid places to build relationships
depending on your niche.
You can think about case managers.
You can think about primary care providers.
Psychiatrists.
Therapists with different niches.
Therapists with the same niches.
Dieticians.
School counselors and college counseling centers.

(04:22):
Local parent coaches.
Postpartum doulas.
Oh gosh, the list goes on and on.
So here's the beauty of this kind of
intentional diversification.
No single referral source has to carry the
whole weight.
When you build relationships slowly and strategically, you
actually get better referrals.
People start sending you ideal clients, the ones
that you're most effective with, the ones that

(04:43):
light you up.
And speaking of clients, I'm frequently asked, should
I refer out clients who don't fit my
niche?
This person is not the only one with
that question on their mind.
And my answer for that is it depends.
If there are potential clients wanting to come
in for an initial session, if you get
an inkling that they won't be a good
fit on that phone call, then absolutely refer

(05:03):
them out.
And this doesn't even have to be related
to your niche or not.
This could be just they don't feel like
a good fit to you.
Recently in my practice, someone called and emailed
six times within 12 hours, starting in the
middle of the night, didn't return calls to
the number we requested they call back to
the clinician that she'd see.
There wasn't a crisis.

(05:23):
It was more of an impatience because we
didn't schedule them at 4 a.m. And
that's an example of someone I would probably
refer out from the phone call.
My practice is not set up for that
amount of responsiveness.
And the boundaries that I set, they were
like just railroaded.
So if you're doing great work with somebody
who is not within your niche or is

(05:44):
within your niche, it doesn't really matter.
If you're doing great work with somebody, it
feels fulfilling, then no, you don't refer them
out just because they're outside your niche.
Your niche is a marketing tool.
It's not a moral imperative.
It helps people find you, but it doesn't
have to box you in.
If the work you're doing feels draining, if
you're not doing your best work, if they
aren't making progress, you find yourself dreading their

(06:04):
sessions, whether they're in your niche or not,
it is okay to refer them out.
It's not just okay, but it's ethical and
smart because we want them to get better.
It's within most of our codes of ethics
that we are making sure our clients are
progressing.
We're not just sitting in stasis with them.
Now, let's flip the coin.
What happens when the phone is ringing, when

(06:24):
you're full or you're close to it?
When should you stop marketing?
Should you ghost your referral network?
The short answer is no.
You can slow down.
When you're full, that's actually the best time
to get strategic.
This is the moment to look at your
referral data, to start thinking like a business
owner, not just a therapist.
Who's sending you the most clients?
Are they sending your ideal clients or a

(06:44):
mix?
Which referrals are turning into actual bookings?
Take note.
You have a couple options here.
If you have a smaller caseload when you're
full, you're well-connected, you have the bandwidth,
you can continue to receive those referrals from
these folks and send them to other therapists
you know do great work.
Then your referrers continue to refer to you
without interruption.

(07:05):
If you don't have the bandwidth for that,
then let those top referrers know you're full
right now, but you're happy to stay on
their radar and keep them updated when spots
open up.
Speaking of being full, make it really clear
everywhere if this is the way you're going
to go.
Put it in your voicemail, in your website,
in your email autoresponder, your Psychology Today profile.
You can put currently full or next openings

(07:26):
in October if you know your timeline.
The level of clarity protects everyone's time, including
yours.
Now let's talk about another situation I hear
all the time.
People say they're referring to me, but I'm
not getting any new clients.
This can be so frustrating, especially early in
your practice when every potential referral feels like
gold.
So what's going on?

(07:46):
There are a few possibilities.
The first is timing.
The person they referred just isn't ready to
reach out yet.
Or maybe they did feel like they were
ready, but they got busy or anxious, so
they talked themselves out of therapy altogether.
This happens.
Number two, you're not top of mind.
They gave out your name, but also three
or four others.
And that's why clarity and connection matter.
We want people to remember you.

(08:06):
That's where your wrong niche messaging and follow
-up comes in.
Number three, your website might not be resonating.
I have seen incredible therapists not filling up
because their websites are really generic.
If someone's struggling, they are scanning fast.
They don't feel that instant connection.
If your niche or your voice or your
understanding doesn't come through, they're going to move
on.

(08:27):
And number four, you might be hard to
contact.
Is your call to action clear?
Does your contact form actually work?
Do people know how to reach you and
what to expect from you when they do?
So honestly, check that stuff off in a
broken form, link, or unclear directions can silently
kill a referral stream.
Also, are you clearly saying who you serve?
Let's say you specialize in supporting young professionals

(08:48):
of color navigating workplace trauma and microaggressions.
That is incredibly powerful.
But if your website just says, I work
with adults on anxiety and stress, people aren't
going to know you're their person.
And if your website's just okay, that's your
sign to give it some love.
Write copy that sounds like you, add client
-centered language.
Even something simple like a short intro video

(09:08):
can help someone feel safe with you before
they ever reach out.
So finally, let's talk about networking.
Should you be strategic with who you meet
with?
Absolutely yes, but not in a gross or
calculating way, in a really sustainable way.
Start with therapists in your niche who are
full.
They're getting calls they can't take.
If you're clear about who you help, you'll
stand out as the perfect fit for their
overflow.

(09:28):
Reach out to therapists who serve adjacent populations.
Even if they don't work on your exact
niche, they might still be seeing people who
need your work.
Like if you're a sexual trauma therapist, get
with couples therapists.
Networking is not about collecting business cards, it's
about building relationships and community.
Yes, it takes time, and yes, sometimes you'll
go months before a connection bears fruit, but

(09:48):
consistency and clarity always pays off.
So let me lay on the plane here.
Don't depend on one referral source, even if
it's working great right now.
Keep refining your niche and making your message
clear.
Build genuine, intentional relationships.
Make it easy for people to refer to
you, and even easier for clients to reach
you.
And when you're full, don't disappear.

(10:09):
Stay present, keep the lines open, protect your
time and your reputation.
You've got this.
And if it feels overwhelming, that's okay.
It just means you're building something real and
you're learning.
If you want help organizing all of this,
your referral strategy, your niche messaging, how to
keep your caseload full without feast or famine
panic, DM me the word party or click
the Abundance Party link in the show notes.
We have all of that laid out in

(10:30):
there.
This week's free worksheet is how to not
hate networking, since I mentioned networking a fair
amount.
And I know a lot of you feel
really lost or repulsed by the idea.
DM the word sheets, and I'll send that
to you.
You don't have to figure out any of
this alone.
If you're ready for a much easier practice,
Therapy Notes is the way to go.

(10:52):
Go to therapynotes.com and use the promo
code abundant for two months free.
I hope that helped.
If you have questions for Ask Alison, or
you want to get your hands on the
worksheet for this episode, go to abundancepracticebuilding.com
slash links.
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(11:13):
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