Week 7 - mandated coerced & 'voluntary' clients

Question 1

What ethical issues do mandated clients raise?

Answer 1

Perceived coercion (linked to impaired process and outcome)

This affects informed consent and confidentiality

We need the client to ‘buy into’ the process and identify meaningful benefits from it.

Perceived coercion is linked to a sense of de-valuation in adults

Question 2

Identify 3 client presentations where higher levels of perceived coercion might be a consideration?

Answer 2

1. Mandated therapy / workplace ordered
2. Couples therapy
3. court order

Question 3

Identify some ways that the initial stages of your work with a mandated / coerced client might differ from other clients?

Answer 3

• They might start with hostility to the process
• They might not be ready to do the work / pre-contemplative
• More scrutiny of the client’s account may be needed - more collateral info may be needed
• our own biases may be an obstacle

Question 4

Outline three approaches you would prioritise with a client who presents with high levels of perceived coercion/resistance

Answer 4

1 stabilisation
2 scene setting
3 information gathering

Prolonged initial phase focusing on engagement and TA - trust, client-centered, and a firm persona (= reduction in amotivation/ opposition and unwillingness)

Question 5

Discuss the role of self-efficacy with such clients (perceived coercion) and how you might go about enhancing this

Answer 5

That they are there by perceived coercion (not autonomously) may reduce their sense of efficacy and agency. would try to maximise their sense of efficacy to make progress. Setting a realistic, short-term goal to increase likelihood of success (and increase SE).