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Depending on your setting, there’s a good chance that at some point in your career, you’ll have to work with a client who is being mandated to receive therapy. In my professional environment, the most common example of this would be a minor being told by the parents that he or she will have to attend therapy against their will. There are other examples of this that include court ordered adults who may have a criminal background, court ordered family therapy for families involved in custody conflicts or child protective services, and certain clients in rehabilitation programs.

What makes working with these clients so different? Well, for starters, therapy tends to work better on a client that feels he or she needs help, has actively searched for help through a therapist, and are invested in a change. Mandated clients, or oppositional ones in general, are more likely to automatically reject therapy. Often times, they won’t have anything against their therapist, personally, but will reject what therapy stands for.

 

Let’s put ourselves in this type of client’s shoes for a minute:
– You’re forced to go somewhere you don’t want to go – Loss of independence
– You’re told that there’s something wrong with you and you have to fix it – Loss of accomplishment
– You’re not trusted to handle a problem without professional help – Loss of competence and credibility
– You’re told that you have to work in an environment in a professional manner with a stranger even though you don’t want to be there – Loss of emotional freedom
– You’re told that you have to attend your appointments or their will be consequences – Loss of time 

Those are some tough cards to be dealt. So how do we help as clinicians with this in mind? Well the first thing to keep in mind is that our job IS to help and that we work for the client, not whoever is mandating them to attend. Perhaps we work WITH whoever is mandating, but not FOR them. Express this to your client and show that you empathize with the difficulty of this situation.

 

I’ve developed a bit of a speech that I use with my kids who don’t want to attend, don’t feel that they need to attend, don’t want to be told what to do, and come in with a stigma that only “crazy people” need therapy. I change this speech a little every time I say it and it can definitely be changed to fit the needs of almost any client being mandated to receive services –

Something along the lines of:
“Let me explain a few things that I think will be helpful for you to know. I know I’m an adult, but I’m not a person of authority. I’m not your parent, or your teacher, or your principal, or a judge, or the police. I work with you, not them. I’m not here to get you into trouble, to judge you, or to make you feel guilty or embarrassed. I’m here for only one reason, which is to help you. I think everybody can benefit from therapy, no matter why they’re coming. So since you’re going to be coming here anyway, you might as well get something out of it so it isn’t a waste of your time. You probably have other places you’d rather be, but you have to come for a while, so can we try to figure out how I can make sure you get something out of coming here?”

It doesn’t work 100% of the time – some people really just won’t let you in and won’t budge. But most of the time, you can “summon” an understanding from your client that it isn’t your fault that he or she is in your room right now – you’re just doing your job. And hey – after all, you’re a stranger that’s tried to be respectful and welcoming, right? So maybe you’re worth warming up to – When all else fails, maybe they’ll at least prefer to sit there quietly and play a board game, or color, or listen to their favorite music with you for a few sessions until they do warm up to you.

 

Try taking this approach, applying your own style to it so you can use it on your clients. Adapt it to the type of client you have, regardless of their age or the reason they’re being forced to attend. It definitely works more often than not, but it may take a few sessions. Most people don’t want to be mean to someone who is consistently trying to be nice and helpful to them – how convenient is it that you’re a super nice, kindhearted, compassionate, welcoming, helpful, informative therapist, right? Own it!

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