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Myriad factors influence the initial phase of treatment. Among these, the impact of the referral source and what transpires during the referral process is a neglected area. The patient, therapist, and referral source will inevitably introduce their unique selves into dynamic interactions. This article focuses on the experiences of the therapist. Several factors, including economic and personal ones, contribute to how vulnerable a therapist will be to the ubiquitous pull of self-interest. In addition, the thinking and behavior of each participant—patient, therapist, referral source—may be further shaped by the contextual fields within which these individuals exist and in which treatment takes place. The term “referral matrix” is proposed to capture the dynamic interplay of the constellation of factors within and surrounding the three participants, which may manifest at conscious and unconscious levels. Case studies are presented to demonstrate how the various influences can intertwine. The author discusses clinical situations when, due to heightened self-interest, therapists alter their usual modes of listening and responding to patients. These shifts can result in a diffusion of boundaries among all the participants and a greater tendency for enactments to take place. Frequently encountered countertransference reactions are discussed, as well as the implications of the referral matrix for supervision.