FACILITATING COMMUNICATION WITH NON-VOLUNTARY CLIENTS
Clients who do not elect to engage in therapy services can originate in multiple settings. For example, a spouse may want participation by an unwilling spouse in marital therapy to maintain the marital relationship. The unwilling spouse may participate in therapy for the relationship, despite being an unwilling participate in the treatment. In another example, a court may impose treatment on an individual following an arrest for driving under the influence of alcohol or as a result of a domestic violence charge.
Within the context of being non-voluntary, there are degrees of restrictiveness. For example, a child removed from their home following removal due to physical violence perpetrated by a parent may be placed in a residential treatment facility, a group home or a home-based setting. In another example, an individual with mental illness may be placed in a mental health treatment facility (inpatient hospital, residential treatment), attend a day treatment or group home setting, or may attend counseling sessions at an outpatient clinic.
To facilitate communication, six basic steps can be used to maximize the potential of an effective relationship with a non-voluntary client.
First, name the circumstance under which the meeting occurs. Be clear about the client’s purpose for being present and explain the framework and relevant laws pertinent to the assessment. Encourage the client and invite them to express their thoughts and feelings about why they are present. Use reflective listening skills, offering empathy for the current circumstance.
Second, validate legitimate concerns. Explore why they feel they need to resist and what they may lose by being part of the assessment. Provide information on the treatment planning process, how negotiation and planning is accomplished together and how negative consequences of the assessment and treatment process are or can be minimized for a positive outcome.
Third, identify the non-negotiable portions of the intervention. This is part of informed consent, and both voluntary and involuntary clients are entitled to fully informed consent. Provide the legal requirements and what will and will not remain confidential.
Fourth, identify what is and is not negotiable as part of the assessment and treatment process. Review the range of potential goals for the intervention process that meet the mandatory requirements. Be creative and introduce humor, if possible, to the process. Review the list with the client and get input as to what the client believes they may be comfortable committing to or working on in the process.
Fifth, negotiate a treatment plan that includes the mandatory requirements of the referring authority, but also includes the client interests. Include aspects discussed in item four. Document all of the relevant information while the client is present. Get a short-term goal and plan from the client to increase the likelihood of follow through.
Last, identify criteria for measuring progress toward the agreed upon plan and treatment goals. Consider how the plan may be monitored. Explore how the client will know if the plan is working toward the intended goals. Finally, discuss what happens if the client is not able to comply with some or all of the terms discussed. Document this information, as well, and have the client sign the plan.