Excellent article. I had not known to this to be a noteworthy enough problem for a full article, but I'm glad they addressed it.

And I'm not saying that it can't happen. But the article demonstrates that it is clearly against the written code of the APA for a therapist to be paid for referrals, which means it's actionable if an ethics complain is lodged against them. They can straight up lose their license to practice. Rightfully.

Your decision to go to a doctor for meds is your decision, not the decision of your therapist. A doctor might take the written suggestion for an SSRI from a therapist a bit more seriously than the suggestion from your plumber, but it's still ultimately the doctor's decision.

The point I'm making is this: you can go to a therapist and do work with them. And they can say, "I think you should try this medication, go to this person." And you can say, "I don't really want to use psychiatric medications."

That's the end of the conversation. The therapist at that point will 99% of the time drop it. If they don't, then you can fire them and, if you feel it's appropriate, lodge an ethics complaint with the APA.

Being referred for medication by a therapist means nothing legally. Nobody is going to care if the therapist put in your file that you should be on medication, because they almost never have the legal power to make that decision. No courtroom is going to take your guns because you told a therapist you weren't interested in being medicated.

The only times you can be absolutely compelled (as in, held down and injected) with medication is if you're an IMMINENT danger to yourself or others. And even then, it's not by a therapist. A therapist can say whatever they want, but even if they DO get payouts for referrals (and want to risk their license for that), you can still just say no and they get no payout. Find a better therapist. Problem solved.