The involuntary client is someone ordered to come in to see you, by someone else. The involuntary client may or may not agree with the order or the reasons for the order. These clients may become voluntary clients by identifying a goal they would like to work on, but at least initially they have been referred and ordered to come in by someone else. Much of the early articulation of this schema was worked out by Insoo Berg and by Eve Lipchik (Berg, 1990).
Our work with them follows this schema:
Whose idea is it that you come here?
What makes think you should come here?
What does want you to be doing differently?
Is this something you want? (Goal frame)
If yes, proceed as with a voluntary client.
If no, ask: Is there something you would like out of coming here? (Goal frame)
If yes, proceed as with a voluntary client.
If no, explore the consequences of not coming to sessions.
Once the consequences are clarified, ask again what the referring person expects out of the client coming in for therapy.
If the client knows, ask if she or he is willing to do what the referring person wants.
If the client does not know, send her or him to the referring person to find out what the referring person wants as a result of completing therapy. Have the referring person be specific.
If the client is willing to do what the referring person wants, proceed with what the referring person wants as the goal.
If the client does not want to adopt the referring person’s goal, compliment the client and …
(1) say goodbye or
(2) state conditions for further sessions if continued sessions are required by the court or agency policy.
The thrust of this schema is to explore the idea that involuntary clients may turn into voluntary ones with a goal within which you can be helpful using a solution-focus. If you and the client cannot identify a goal that you can agree to, then you can support the client enough so that if she or he ever decides there is something around which help is needed, the client may return as a voluntary client.
Simultaneous work may be necessary with the referring person to help the referring person clarify her or his goals and expectations of the client, to clarify your role, and to clarify the referring person’s role.
Now that we have an overview of procedures to follow in therapy when an involuntary client is involved, let us go back to the beginning with an example. The social control roles of the investigator and manager have all been identified and are being performed by people other than the therapist.
Therapist: What is your goal in coming here? (Goal frame)
Client: The judge and social worker have decided that I need to come here.
Therapist: So, this was their idea. What makes them think you need to come here? (Goal frame, for the other position)
Client: They recently took my two kids away from me because they said I was neglecting them. The kids are in a foster home and the court has taken custody. The school social worker made the report. The judge says that if I want to get my kids back, I have to come and see you.
Therapist: Oh, I’m sorry about your kids, you must miss them very much.
Client: Yes, a lot. They are the world to me. All I have are my children and I just don’t know what to do with myself.
Therapist: So, they are saying you need to parent differently? Is this your goal too? (Clarification)
Client: Yes, I haven’t been too good with the kids sometimes. They just get to be too much and I get myself in trouble with my drinking. (Problem statement)
This client has agreed with the reason for the referral and has begun to identify ways in which she is having problems. The therapist will proceed with this now voluntary client by helping her formulate her goals.
If this client had said “No,” the therapist would follow the next step of exploring what the involuntary client might want that may be different from the referring person’s goal.
Client: No, I don’t think I have been neglectful at all. These social workers just don’t know what it means to be a single parent. They think that just because you leave your kids alone for a moment you are doing something wrong or you don’t care about your kids.
Therapist: Well, it seems to me that you must love your kids very much and want the best for them. (Supporting the client)
Client: That’s right, and I don’t need someone telling me what to do. My lawyer and I are going to take care of the social worker.
Therapist: I can understand that. So is there something apart from what the judge and social worker said that you would like out of coming here? (Goal frame)
Client: Well my oldest one is failing school. I don’t know what is going on with her. She just doesn’t study anymore and is skipping school. (Complaint statement)
Therapist: So, you would like help in changing that situation. What about this would you like to change? (Asking the client to redefine her complaint as a goal)
The client, although stating she is not in agreement with the reason for the referral, is stating a complaint with which she would like help. Given her statement, we would proceed with the complaint she has stated and work with her as a voluntary client. She is the voluntary client about the complaint she chose—that is, the complaint about her oldest daughter failing school. It is not up to us to make her work on the complaint of the referring person. We would need to clarify with the client that we would inform the referring person of what goals she was working on. The goals the client decides she wants to work on may not be acceptable to the referring person and more negotiation may be needed.
If involuntary clients state that they do not agree with the reason for the referral and do not have any problem or goal of their own that they want to talk with us about, we move onto the next step of the schema: exploring the consequences of their not coming to therapy.
Therapist: So your sense at this point is that the judge and protective service worker have it all wrong. They think that you are neglectful as a parent and so they have taken your kids from you and required that you come to therapy if you want the children back. However, you see it differently. You think that they just don’t know the difficulties of being a parent and what really happened. And I imagine you have tried to convince them that they are wrong about the situation, right?
Client: I tried to explain that I just left the house for a few minutes and that I never would leave my kids without attention. But they just had their minds made up. That judge would only believe the social worker.
Therapist: So what is going to happen if you don’t come to therapy? (Eliciting consequences of not coming to therapy)
Client: They say I won’t get my kids back.
Therapist: So what are you going to do? (Hypothetical solution frame). You want to get your kids back, and so far you haven’t convinced the judge and protective service worker that you are a responsible parent.
Client: I don’t know; I just have to get them back.
This discussion of the consequences clarifies for the involuntary client and therapist the parameters of the situation. The situation is that the client has to come to therapy for something she does not believe is a problem. She has to do this in order for her to have the children returned—and if she does not attend therapy, she will not have her children returned.
Many clients need further clarification of the situation and your role in it …
Client: Can’t you just tell the judge and protective service worker that I don’t have to be here?
Therapist: As much as I would like to help you, I’m afraid I couldn’t write a report about what I don’t know.
Client: But you could tell them that I am a good parent and they would believe you.
Therapist: Without any evidence, I am afraid they wouldn’t believe me either. I’m afraid I couldn’t write any report like that, at this time.
Through this discussion, the client realizes that you are not going to write a report that would put you in an evaluative role of their behavior.
Therapist: So your situation is that you have to come here in order to get your children back, and you have to convince the protective service worker that you have changed in the way the worker believes to be more responsible. Tell me again what the worker wants you to be doing differently as a result of your coming here. (Goal frame, using the “for other” position, for the worker)
Client: She wants me to be more responsible. But I am responsible.
Therapist: What will the worker say you are doing differently when she thinks you are acting responsibly in her eyes, and allows the children to return? (Hypothetical solution frame, “for the other” reporting position)
Client: I don’t know, she never said.
At this point, you might explore what the client thinks the worker wants and then instruct the client at the end of the session to find out in between sessions what specifically the protective service worker wants. You could contact the worker, too, and help the worker, if necessary, identify what would be signs for the decision that he or she will make as to whether to allow the return of the children to the parent. This coaching can help the worker clarify the criteria for the decision that will be made. You want to be sure to stay out of the position of being the decision-maker.
Therapist talking to protective service worker: I talked to Ms.______ today and she said she wants to do what she needs to do in order to have her children back. She was not clear what she needed to do beyond going to therapy. I suggested that she speak to you and find out more specifically what your goals might be.
Worker: You know she isn’t a very responsible parent. She had these children so young. She just gets overwhelmed and takes off for hours on end. She just does not know that she cannot be leaving these kids like this or trusting her oldest with the responsibility.
Therapist: I see. So, assuming she is sincere about turning this around, what will be signs to you that she is beginning to act more responsibly?
Worker: I will start allowing for supervised visits. On these visits, she has to show up and be on time. She has to play with these kids without flying off the handle and show some patience. When the kids don’t mind what she tells them to do, she needs to show some skills in discipline. If she handles these visits, then maybe we will talk about further steps.
Therapist: Okay. I hope she will be asking you this same question so that she knows what you expect. We will keep in touch.
If the client speaks to the protective service worker and finds out specifically what she has to do, she can then use you for help in deciding if and how to comply with the expectations and how she will go about fulfilling such expectations. By keeping the decision about the disposition of the children with the worker, you are free to be the therapist for the client without mixing roles.
Client to Therapist: I talked to the worker and she says I can have supervised visits and that I have to be on time and be patient with the kids.
Therapist: Are you willing to do that and convince the worker? (Goal frame)
Client: I don’t think I have much choice and I think I can do it.
Therapist: How will you do that? (Specification of the process)
Client: I will just have to plan ahead so that I can be on time. She wants me to be patient though and I don’t think she knows how bad these kids can be.
The remaining part of the session would be used to explore how she might be “patient” in the worker’s eyes and what she can do differently with the kids that might enable her to not only appear more patient but even have a better time with her children. This is discussed in terms of the “worker’s eyes” since the worker is the one who has to be convinced and who will make the decision about the return of the children.
If the client had said that she was not willing to do what the worker said she had to do, then you have a choice of either saying good-bye or making arrangements for sessions without a goal.
If you say good-bye, you compliment the client on coming in and possibly on other things you notice in the session. The purpose of the compliments is to maintain rapport and ensure as much as possible that if the client later changes her mind about therapy, she will think of you as a sympathetic person and come in for help in the future.
If you have no choice but to continue to see the person because of the requirements of your situation, (agency policy, for example) you spell this out to the client and continue appointments without a goal and without trying to solve a problem.
QUESTION:
What about situations in which you are both the case manager and the therapist?
While these situations are beyond the scope of this book, a useful question can be, “What will you be doing differently when / (the therapist) am more convinced that your children can be returned? (Hypothetical solution frame, from the detached position).
Some clients will never perceive you as a helper. As the case manager, all you can do is set the requirements and hope that the clients will choose to comply. They may or may not comply.
QUESTION:
What about situations where you are required to submit a report to the case manager or protective service worker?
Whenever possible, create the report with the client. Try to make it a joint report. This facilitates further client rapport and cooperation.
With a partner, play out each option of the above schema. Pay particular attention to defining what reporting position you want the client to follow. If the client is required to comply with someone else’s requirements, be sure to use the “for the other” reporting position, with the referring person as the “other.”*
*For a more complete presentation of how to work with clients in involuntary circumstances, see Insoo Berg’s A Solution-Focused Approach to Family Based Services (1990).