When selecting a referral or an adjunct, several factors should be taken into account, including: the qualifications of an agency to help the client, issues that would prevent the client from profiting from the referral, whether or not the client's response to being referred would be positive, whether or not there are legal considerations to take into account (because of confidentiality), and clinical considerations (will the referral affect the client's treatment plan?). The counselor has the option of providing the client with a couple of referral options, or only one if the counselor believes that one particular referral will best help the client. The counselor's selection of the referral should be based on the cost of the referral, the competence of the therapist, the clinical orientation of the therapist, and any professional responsibilities.

All in all, for the counselor to make an effective choice when choosing a referral, he/or she should be aware of the options in the community. The most commonly used referrals in communities are: ambulances and paramedics, shattered women's shelters, Bureau of Public Assistance, the Department of Public Welfare, human services, Department of Social Services, emergency rooms, employment offices (for unemployment insurance), hotlines for rape, suicide, child abuse, or runaways, PET (the psychiatric emergency team), police, and the U.S. Department of Veteran Affairs.