How to maintain the therapeutic relationship during an eating disorder referral
Clincially reviewed and written by BALANCE eating disorder treatment center™. Published February 16, 2026.
Referring a client to another provider or a higher level of eating disorder care can feel like a challenging moment for both therapists and clients. It may bring up worries about being left behind, concerns about disrupting the therapeutic relationship, or uncertainty about what comes next. These reactions are common and understandable.
However, a referral is not a sign of giving up and does not mean the therapeutic relationship has to end. Instead, it can be a thoughtful step toward ensuring a client has the level of support they need at a particular point in their recovery. When referrals are approached with care and collaboration, they can strengthen treatment and support long-term recovery.
Why referrals can feel hard for therapists
As therapists, we want to support our clients to the best of our abilities. When concerns arise that require a level of structure or specialization beyond what outpatient therapy alone can provide, it’s natural to feel unsure about next steps. Many clinicians find themselves wondering, “Will my client think I’m giving up on them?” or “Could this damage the trust we’ve built together?”
These concerns are common and understandable. Referring a client to a specialist or a higher level of care is not a sign that something has gone wrong. It is a thoughtful and ethical clinical decision that reflects a commitment to the client’s safety and long-term recovery. A referral means expanding the support a client receives so their care best meets their needs at that moment.
Why referrals can feel hard for clients
Just as referrals can feel challenging for therapists, they can also feel difficult for clients. Clients may worry about having to “start over,” feel like they’ve failed, or fear losing the therapist they trust.
In many cases, this transition does not require ending outpatient therapy altogether. Instead, it involves bringing additional providers onto the client’s team so they can feel more supported as they continue their recovery.
The referral process matters
During the referral process, it is important for clinicians to clearly communicate that they are not abandoning or leaving the client. Instead, a referral is about adding support, not replacing existing care. Needing additional help does not mean a client is “too much” or “too difficult.” It means they deserve the right level of care.
Transparency around why a higher level of care is being recommended and how it supports the client’s safety and well-being can help preserve trust and reduce fear during the referral process.
Get the next email on managing and growing your private practice!
Staying connected when making referrals
When a client enters a higher level of care or begins working with additional providers, staying connected is an important part of maintaining continuity of care. With a client’s consent, treatment teams often coordinate with outpatient providers to share updates. This communication helps clients feel supported rather than “passed off,” and reassures therapists that they remain an important part of the client’s care team.
Ongoing collaboration allows everyone involved to work from a shared understanding of the client’s needs and progress, creating a more cohesive treatment plan.
Collaboration at BALANCE
Our goal at BALANCE is to support both you and your clients with care that integrates seamlessly with the work you’re already doing together. From the very first point of contact, our admissions and clinical teams collaborate closely with clients and their existing treatment providers. In addition to verifying insurance coverage, we coordinate care with each client’s outpatient team and provide updates throughout treatment.
Whether a client is participating in our Partial Hospitalization Program (PHP), Intensive Outpatient Program (IOP), or one of our 14-day seasonal intensive programs, our approach is designed to complement, not replace, outpatient care. We believe communication and collaboration are essential to long-term recovery.
BALANCE is currently in-network with UnitedHealthcare, Cigna, and Oscar, with Aetna coming soon. If you or someone you care for may be struggling with an eating disorder, you can schedule a complimentary consultation with our admissions team at balancedtx.com/get-started.
