So how do you know when it is time to refer to a more formal kind of care?
Common indicators it may be time to refer include:
- Despite an earnest desire to change/improve, the person seems unable to do so.
- You have exhausted your knowledge/experience in helping with the specific struggle.
- The time required to provide the level of support needed exceeds what you have to offer.
- The person seems hesitant to share the details of their struggle with you.
- The closeness of your relationship with the person makes it difficult to be objective.
- Prolonged depression suggested by a sad demeanor, apathy, weight loss, (appearance of lack of sleep) tearfulness
- Nervousness, agitation, excessive worry; irritability, aggressiveness, non-stop talking
- Bizarre, strange behavior or speech
- Violent outbursts
- Extreme dependency, including spending much of his or her time visiting
- Marked changes in personal hygiene
- Signs of alcohol or drug abuse
- Binging or purging of food
- Withdrawal from friends or social isolation
- Physical or sexual assault
- Self-harm (cutting, burning, picking, disordered eating)
- Talk of suicide, either directly or indirectly, such as, “I won’t be around to take that exam anyway,” or “I’m not worried about getting a job; I won’t need one.”
- Crisis – death, significant loss, betrayal (affair)