Counseling Court-Mandated Clients
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Clients who are involved with the legal system can be referred to attend counseling as part of their treatment, probation, or parole terms. Court-mandated clients do not choose to go into counseling and often must have their progress reported to a third party. Mandatory or court-ordered treatment areas can range from alcohol or substance use disorder, protective services cases, sex offenses, or anger management.
In The SAGE Encyclopedia of Marriage, Family, and Couples Counseling, Howard 2017 cites, “Court-mandated clients, also referred to as ‘involuntary clients,’ are individuals who are required by the court to attend counseling. These individuals have legally sanctioned relationships with counselors, case managers, social workers, and other individuals providing services within the spectrum of human services, individual, family, and marriage counseling. Court-mandated clients can have legal sanctions with the criminal justice, child welfare, and mental health systems and can be adults, children, or adolescents.”
Self-Referred vs. Mandated Clients
There are a few differences between self-referred and mandatory referred clients. Self-referred clients come to therapy with a presenting issue or problem. It is their choice to seek out and attend treatment. Mandated clients may view their presenting issue differently than the external system that referred them. Since these clients are not motivated to seek treatment, they may lack awareness of a presenting problem. For example, the court may refer a potential client for behavioral issues connected to a crime or legal issue. The client views the referral as a requirement by the court and may not take responsibility for their behavior. Some clients may admit they will return to the behavior once their legal consequences are over.
Many clients who are mandated to treatment appear resistant to counseling. Their motivation may stem from avoiding legal consequences or punishment such as fines, jail time, or inpatient treatments. Other clients may utilize therapy to improve their behavioral issues while avoiding consequences. A select few may continue therapy services after their legal requirements are fulfilled. A self-referred client often does not have the same resistance as some mandated clients and would face no consequences if they chose to terminate therapy services.
The Limits of Confidentiality
The counselor must explain the limits of confidentiality with court-mandated clients. This includes communication that will take place and also the consequences of noncompliance. It must be clear what the legal source considers noncompliance, for the client to understand the expectations of treatment clearly.
What makes court-mandated clients different from self-referred clients is the court-mandated will face consequences if they terminate services. All clients, whether self-referred or mandated, can refuse services. It is also the counselor’s role to explain the consequences of a mandated client’s refusal.
These clients have limits to confidentiality as conditions of their treatment could involve disclosing client progress to an outside party, such as a probation officer, parole officer, or judge. Before any disclosures, the client must agree to these communications by signing a consent form.
According to the NAADAC, the Association for Addiction Professionals Code of Ethics:
Addiction professionals who work with clients, who have been mandated to counseling and related services, shall discuss legal and ethical limitations to confidentiality. Providers shall explain confidentiality, limits to confidentiality, and the sharing of information for supervision and consultation purposes prior to the beginning of the therapeutic or service relationship. If the client refuses services, the provider shall discuss with the client potential consequences of refusing mandated services, while respecting client autonomy.
Unless exceptions to confidentiality exist, counselors obtain written permission from clients to disclose or transfer records to legitimate third parties. Steps are taken to ensure that receivers of counseling records are sensitive to their confidential nature.
A release of information must be signed to talk to the probation officer, parole officer, or the court. Most releases of information are to discuss the client’s attendance, motivation of the client towards goals, and, at times, diagnosis, especially if an evaluation was requested.
The following ethical code discusses Informed Consent in the Counseling Relationship from The American Counseling Association (2014), for A.2.e. Mandated Clients:
Counselors discuss the required limitations to confidentiality when working with clients who have been mandated for counseling services. Counselors also explain what type of information and with whom that information is shared prior to the beginning of counseling. The client may choose to refuse services. In this case, counselors will, to the best of their ability, discuss with the client the potential consequences of refusing counseling services.
Client Resistance
Due to this coerced nature of entering treatment, counselors may face increased resistance from a client in therapy. Furgeson et al., 2021 stated, “Involuntary clients and hostile relationships have a very powerful presence in statutory social work. Acknowledging this and the presence of difficult emotions in the dynamics of hostile and avoidant relationships is a very important way to begin to overcome them.”
Additionally, “They do not share the goals of the person who pressured them to come in (hereafter designated, for lack of a better term, as the ‘pressuring individual’ or ‘PI’). Thus, in coming to therapy, they are acting on the motivation of others—often others who are seen as infringing unjustifiably on their autonomy” (Bergner 2019).
Ways to Work with the Resistance
Acknowledge & Normalize Feelings
Be open to listening and give the client time to process the reason and feelings of being a mandated client. The counselor can normalize feelings of anger, frustration, reluctance, or ambivalence. It is also normal for clients to have a mistrust of the counselor. Some clients may associate counselors with authority or legal figures, with whom they have had a negative association in the past. Work with the client to acknowledge and normalize these feelings and experiences, while addressing any cognitive distortions.
View Resistance as Countertransference and Transference
In the Journal of Clinical Psychology, Messner 2002 writes about five forms of resistance:
Five forms of resistance are presented, including: resistance to the recognition of feelings, fantasies, and motives; resistance to revealing feelings toward the therapist; resistance as a way of demonstrating self-sufficiency; resistance as clients’ reluctance to change their behavior outside the therapy room; and resistance as a function of failure of empathy on the part of the therapist.
Clients sometimes work in opposition to their therapists, a phenomenon known as “resistance.” Such behavior is not simply an impediment to treatment, but also a potentially rich source of information about each client. This information can be assessed and utilized to strengthen the therapeutic relationship, help the therapist better understand the ideographic obstacles to change, and devise interventions that may motivate the client toward therapeutic activity and growth.
As with all countertransference and transference, seek supervision to get a clearer picture of what is happening therapeutically.
Use Empathic Confrontation
Empathic confrontation is a counseling technique counselors employ to get clients unstuck by addressing their behavior in a gentle but directive manner. Farrell & Shaw state, “Empathic confrontation can be defined as the therapist’s approach to addressing early maladaptive schemas and dysfunctional mode behavior, with empathy for how they developed, balanced by confronting these behaviors as needing to change for the patient to have a healthy life.”
Also, “Court-mandated treatments imply a dual role for therapy providers not only of caring for, but also of having control over, involuntary clients. We conclude that legal mandatory treatment does not have to necessarily result in perceived coercion and reduced satisfaction with treatment and that a caring and authoritative treatment style aids a favorable therapeutic alliance, motivation, and therapy outcomes” (Hachtel, Vogel & Huber, 2019).
Consider Motivational Interviewing
Motivational interviewing can be used with clients who are unmotivated to change. It is “an evidenced-based counseling approach that health care providers can use to help patients adhere to treatment recommendations. It emphasizes using a directive, patient-centered style of interaction to promote behavioral change by helping patients explore and resolve ambivalence“ (Levensky et al., 2007).
Jacobsen’s research found, “Five social workers discussed the engagement process and strategies they use to encourage the engagement process with involuntary clients. They emphasized the importance of giving the clients choice and control over their treatment, and having the capacity to genuinely like the client. Motivational interviewing and relational approaches were cited as beneficial for fostering engagement with involuntary clients, a view that is consistent with previous research.”
Does Mandated Treatment Work?
The answer will depend upon the clients and their motivation. Although research suggests the longer a client is required to attend treatment, the better the outcome:
The findings from this study support other research demonstrating that offenders who are court-ordered to treatment have better completion rates than those who enter treatment voluntarily. The present study demonstrated that offenders enrolled in outpatient treatment also experience better completion rates if they are mandated. The findings from this study show that even those who had low internal motivation at treatment entry were able to successfully complete treatment. It could be reasoned that mandated offenders may begin treatment with low motivation, but are retained longer due to the threat of incarceration which allows them to engage in treatment and provides them with the time needed to experience behavior change” (Coviello et al.,2012).
Hachtel, Vogel & Huber, 2019 found, “There is some evidence that mandatory treatment does achieve the required treatment targets of legal coercion: reduction of recidivism and symptoms. The longer the attendance can enable motivational interventions and strengthen therapeutic relationships.”
Lisa Hutchison, LMHC
Writer & Contributing ExpertLisa Hutchison, LMHC, is a licensed mental health counselor for the Commonwealth of Massachusetts. She works for professionals who want to treat and prevent compassion fatigue. With over 20 years of psychotherapy experience, she helps her clients assert themselves, set boundaries, and increase their coping skills. Her specialty is decreasing stress, anxiety, and depression while increasing realistic methods of self-care for those who help others. Ms. Hutchison’s psychological advice has been featured in Reader’s Digest and the Huffington Post. Her articles have been published in numerous magazines, including Grief Digest and Today’s Caregiver.
Lisa is the bestselling author of I Fill My Cup: A Journal for Compassionate Helpers and a faculty member writer for NetCE. Her latest continuing education unit publication is “Setting Ethical Limits for Caring and Competent Professionals.” She has taught creative writing in colleges and presented on boundaries for the compassionate helper; the use of expressive art to heal grief, anxiety, and depression; inspirational and motivational topics; and creative writing techniques.