Ethical Dilemmas: When Therapy Clients Refer Their Friends
Dr. Lisa Marie Bobby is a licensed psychologist, licensed marriage and family therapist, board-certified coach, AAMFT clinical supervisor, host of the Love, Happiness, and Success Podcast and founder of Growing Self.
Have you ever gotten that really sweet message from a therapy client saying, “Hey, I told my friend what an amazing therapist you are—they’re reaching out!” and felt… conflicted? When therapy clients refer their friends, it can feel like walking a fine line between appreciation and professional chaos.
On the one hand, it’s a huge compliment. On the other? It throws you right into the middle of an ethical tightrope walk.
In this episode of Love, Happiness, and Success for Therapists, I’ll share a behind-the-scenes story from my own practice where a client referred a friend—who happened to be their business partner—and how things unraveled when their relationship did.
I’ll also unpack the professional risks, the emotional tug-of-war, and the subtle ethical conflicts that can arise when our good intentions collide with real-world complexity. Plus, how to set therapeutic boundaries and redirect referrals.
When Therapy Clients Refer Their Friends
We all know the golden rule about not seeing multiple family members. But friends? That’s a grayer area—and one that’s not always clearly addressed in our ethical codes.
When a client refers someone they care about, it’s usually coming from a place of trust and gratitude. That’s beautiful. But what happens if that friendship takes a nosedive? Now you’re left managing competing perspectives, confidentiality concerns, and potential loyalty conflicts—and that’s not a position any therapist wants to be in.
A Story of Ethical Dilemmas
I had a client who referred a friend to me. It seemed fine initially; they were business partners and friends. But then, things took a turn. They had a massive falling out, and I was actively seeing both of them.
Picture this: I’m in a session with one, hearing one side of the story, and then, in another session with the other, hearing a completely different perspective. It was like being in a therapeutic tug of war, and it taught me a valuable lesson – never again.
This experience highlighted the complexity and potential conflicts of interest when working with friends of current clients. Sometimes, even with the best intentions, things can get messy.
Gracefully declining a referral is one of those things that makes being a therapist tricky, but it’s an essential skill that will make you a better and more ethical counselor.
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Redirecting Referrals
So, what do we do when faced with a similar situation? How do we decline or redirect a referral, especially when we know they’re connected to our current client?
Firstly, it’s essential to acknowledge the referral. Express gratitude for your clients’ trust and confidence in your work. But here’s the tricky part – you can’t tell someone why you can’t work with them in this situation, because doing so would violate the confidentiality of the client.
So here’s a script that you might find useful:
“Thank you so much for considering me as your therapist. I’m truly honored. However, at this time, I’m not able to take you on as a client. But here’s what I can do – I can refer you to another fantastic therapist who might be a great fit for you.”
This approach shows appreciation, maintains confidentiality, and offers an alternative solution.
When redirecting a client, it’s important to ensure that the referral is to a therapist who can provide the care and support they need. It’s not just about sending them away; it’s about guiding them towards the right help. Learn more about redirecting clients in my article on when to let therapy clients go.
Maintaining Therapeutic Boundaries
Navigating friend referrals in therapy requires a keen awareness of professional boundaries. It’s about ensuring that our relationships with clients remain therapeutic, not personal, and that we avoid any conflicts of interest that could arise from dual relationships.
Regularly reflect on the decisions you make in your private practice regarding client referrals. Are you maintaining clear boundaries? Are you avoiding potential conflicts of interest? Regular self-reflection exercises like this create opportunities for personal and professional growth for therapists, while keeping you out of ethical gray areas.
Support for a Thriving Career as a Therapist
Referrals from therapy clients can be fraught with ethical dilemmas. My personal experience taught me the importance of being extra cautious in these situations. Remember, our primary goal is to provide the best care for our clients, and sometimes that means making tough decisions about who we can and cannot see.
If you’re unsure about whether or not taking on a client is the right thing to do, having a strong, supportive community of fellow practitioners can be invaluable.
That’s exactly what we provide to our therapists at Growing Self. We are a collective of private practitioners who encourage, support, and offer guidance to our members, so that we can be the best therapists we can be while thriving in our practice.
Let’s Connect and Grow Together
If navigating tricky situations like when therapy clients refer their friends makes you crave more thoughtful guidance, you’re not alone—and I’ve got you.
Every week in my Newsletter For Therapists, I share real-world insights, practical strategies, and honest reflections just like this one to help you grow into the most grounded, ethical, and empowered version of your therapist self. It’s a space for support, connection, and learning—because you deserve to feel confident in your clinical decisions.
👉 Sign up for the newsletter here and let’s keep growing together.
And hey, if this topic hit home for you, I’d love to stay in touch beyond the inbox. Come connect with me on LinkedIn! I’m always sharing behind-the-scenes stories, helpful resources, and reflections from the therapy room and beyond. Let’s keep the conversation going and build a professional community where we can show up, support each other, and thrive.
With love,
Dr. Lisa Marie Bobby
P.S. — If you know a friend or colleague who’d benefit from this chat, send it over to them. It could be exactly what they needed to hear today.
Resources:
Rice, N. M., & Follette, V. M. (2003). Referral of Clients. Handbook of professional ethics for psychologists: Issues, questions, and controversies, 147. https://books.google.com/books?hl=en&lr=&id=_yg5DQAAQBAJ&oi=fnd&pg=PA147&dq=ethical+dilemma+of+therapy+client+referrals&ots=1m9eKkbl5W&sig=kd_3XlB7fP9zbmTJv8x4bwQpLoc
Haworth, R., & Gallagher, T. (2004). Referrals: clinical considerations and responsibilities. In Handbook of Professional and Ethical Practice for Psychologists, Counsellors and Psychotherapists (pp. 137-148). Routledge. https://www.taylorfrancis.com/chapters/edit/10.4324/9780203323625-14/referrals-clinical-considerations-responsibilities-rebecca-haworth-tim-gallagher
Creaner, M. (2016). Handling and processing a referral. The Trainee Handbook: A Guide for Counselling & Psychotherapy Trainees, 228. https://www.torrossa.com/gs/resourceProxy?an=5018831&publisher=FZ7200#page=253
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