نبذة مختصرة : Several factors shape practices in counseling centers today, including an increased need for referral to external mental health services. Providing external referrals can lead to both practical and ethical implications when counseling center employees also operate private practices. Guidelines to negotiate the potential ethical dilemmas inherent in this scenario are provided. ********** Tightening of higher education budgets is affecting counseling centers in most areas of the country (Cooper, 2000), leaving many institution-based centers understaffed. Meanwhile, demand for services on campuses continues to increase (Cooper, 2000). In such a climate, one way of coping with shrinking budgets and increasing demand has been to limit the center's scope of practice. Placing restrictions on the nature or severity of student problems and on the duration of services provided is a common way of limiting a facility's scope of practice. Although an effective means of managing budgetary and demand issues, these practices almost certainly result in an increased need for referrals for treatment outside of the counseling center. There are other circumstances necessitating outside referrals, such as those times of the year when many college counseling centers do not operate or have only limited staff available (summer, holidays, etc.). In the interest of continuity of care, outside referral options are required. Another scenario requiring an outside referral is when a student, for reasons of privacy or a desire to see a particular counselor, asks to see that counselor in her or his private practice even though the counselor is also employed in the college counseling center. A final example of a situation requiring an outside referral would be when a particular expertise or frequency of care required by a student is not available within the counseling center. Regardless of the setting or motivation, counselors who work in counseling centers often face an array of challenges when referring student clients to external counseling resources (Francis, 2000). At the same time that the potential for use of outside providers is increasing, many college counseling centers encounter a long-standing practical problem: a limited number of referral options (Archer & Cooper, 1998; Bishop, 1995). When this lack of local resources is combined with the aforementioned pressures to refer, it stands to reason that there will be an increasing likelihood for counselors who operate a private practice to see students in that practice. Francis (2000) pointed out multiple ethical challenges that can arise in this circumstance, including issues involving dual relationships, threats to confidentiality, mandatory counseling, session limitations, and referral issues. To this list offered by Francis, we add the critical issues of conflict of interest, conflict of commitment, and informed consent. In our counseling center, there were no clear policies providing guidance to practitioners in this potentially challenging ethical area. To reduce confusion, promote ethical practice, and provide for client welfare, we initiated a process to develop guidelines for counseling center staff members who concurrently maintain a private practice. The guiding principle for this effort was to manage the inherent ethical issues, particularly minimizing potential harm to students (Kitchener & Harding, 1990). This article describes how our counseling center developed the guidelines, which may be useful in facilitating ethical practice at other institutions. Development of the Guidelines As a first step in the process of developing guidelines for practice, the counseling center's ethics committee conducted a review of the professional literature. Thorough searches failed to locate articles directly addressing the issue of providing referrals to staff members' private practices. …
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