Mandated Clients
Running head: MANDATED CLIENTS/MANDATED THERAPISTS
Mandated Clients/Mandated Therapists
Anthony Nguyen, Shawne Ortiz, Geetanjali Sharma, and Kristen Vega
Our Lady of the Lake University
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Mandated Clients/Mandated Therapists
To assume something about a patient is awfully wrong
-Milton Erickson
Most therapeutic models are based on the assumption that the process of therapy will be a
voluntary endeavor in which both the client and therapist will engage in a therapeutic
relationship through mutual consent. While clients often seek mental health services because
they feel the need to, many may also be referred involuntarily to mental health professionals for
treatment. Tohn and Oshlang (1996) have defined “mandated” clients as individuals who are sent
or brought by someone else for treatment including various sources such as, courts, protective
service agencies, employers, employment assistant programs, schools, parents, and significant
others. Clients mandated for therapy may indicate the insistence of others (probation officer,
parent, spouse, school counselor) as their reason for coming to therapy, present themselves as not
needing help, or demonstrate little willingness to establish a relationship with the therapist
(Egan, 1998). This could present hurdles early on in the therapeutic process making it
exasperating both for the therapist and the client. For the purpose of this paper, we will use the
term mandated client solely when describing a referral from the legal system under threat of
legal consequences if they do not complete treatment.
Clients are frequently referred to mental health professionals for treatment through the
criminal justice system since therapy may be viewed as a feasible and economic alternative to
imprisonment (Berg & Shafer, 2004). However, clients mandated into therapy may view the
process of therapy as being forced upon them with the therapist representing yet another part of
the legal system. On the other hand, therapists may anticipate certain attitudes in mandated
clients and label them as resistant, unmotivated, uncooperative, involuntary, defiant, reluctant,
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difficult, or noncompliant (Berg & Shafer, 2004; de Shazer, 1984; Dolan, 1985; Egan, 1998;
Lipchik, 2002, Selekman, 1993; Tohn & Oshlang, 1996).
Although clients may be frequently blamed for their noncompliance and subsequent
failure in therapy, Dolan (1985) suggested that resistance reflects on the therapeutic relationship
and the extent to which the therapist, and not the client, has been unsuccessful in communicating
and achieving trust through the therapeutic process. Further, de Shazer (1984) found that the
concept of resistance in therapy is unhelpful and handicapping for therapists since it alienates the
clients by assuming they do not want to change. Instead, de Shazer and his colleagues
recommend that clients are almost always motivated for change and have adequate abilities to
bring about positive changes in their lives. The apparent resistance should be viewed as the
client’s way of cooperating in therapy since it lets the therapist know what is not working for the
clients (Berg & Shafer, 2004; de Shazer, 1984; de Shazer et al., 1986; Dejong & Berg, 2002;
Lipchick, 2002; Selekman, 1993).
Most current literature focuses on clinical work with voluntary clients; therefore,
guidelines for working effectively with mandated or involuntary clients are limited (Ivanoff,
Blythe, & Tripodi, 1994). We will provide an overview of our theoretical orientation, prevalent
perceptions of mandated clients, and the application of solution focused brief therapy with
mandated clients using an illustrative case study of a 17 year old male client court ordered to
seek therapy for anger management at our training facility.
Overview of Solution Focused Therapy
Developed by Steve de Shazer and his colleagues at the Brief Family Therapy Center,
Milwaukee in the late 1970’s and early 1980’s, Solution Focused Therapy (SFT) has emerged as
an effective and popular model of brief therapy today. SFT is one of the more recent therapeutic
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approaches to emerge in the field of counseling psychology. The theoretical underpinnings of
SFT are based on the philosophy of Milton Erickson and Jay Haley and share many
commonalities with the work of Paul Watzlawick, John Weakland, and their colleagues at the
Mental Research Institute (MRI) at Palo Alto, California (Watzlawick, Weakland, & Fisch,
1974; Weakland, Fisch, Watzlawick, & Bodin, 1974). When compared to prevalent models of
therapy, SFT takes a different approach to understanding the formation of problems and their
subsequent resolution. Solution focused therapists perceive problems as a by product of human
interactions that occur between people and not due to any inherent deficits situated within
individuals (de Shazer et al., 1986). Therefore, SFT does not subscribe to the disease model that
focuses on diagnoses and pathologizing clients. Instead, clients are considered adept at solving
their problems at all times since they are viewed as having unique attributes, strengths, values,
resources, positive qualities, and abilities essential for successful resolution of problems. The
focus on strengths, resources, and solutions instead of client’s problem and pathology in SFT
differentiates it from traditional therapies. This is liberating for the therapists because it allows
them to take a not-knowing, non-expert stance, while still remaining curious and interested in
exploring client strengths and past successful handling of problems in order to help clients
resolve their own problems (DeJong & Berg, 2002; Hoffman, 1990). In focusing on clients as
experts of their lives, solution focused therapists reinstate the idea that clients hold the key to
solving their problems. The therapists act as agents of change by assisting the clients in
constructing their own solutions to the identified problem. This frequently entails changing
interactions in the context of the situation in which the problem occurs, the perceptions and
interpretations associated with the interactions or situation which comprise the problem, or co-
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construction of alternate, problem-free futures which are acceptable to the clients (de Shazer et
al., 1986).
Solution focused therapists engage in solution talk by exploring and building on what is
going well in the clients’ lives and this begins as early as the first session. Solution focused
therapists believe that it is not necessary to know minute details of the complaints in order to
start exploring possible solutions with clients; therefore, sessions are not focused on gathering a
detailed past history of complaints and hypothesizing about or explaining why the problem
occurs (de Shazer et al., 1986; DeJong & Berg, 2002). The goal of SFT is to utilize the clients’
language to find out what is going well and to continue doing what works. However, this does
not imply that the clients cannot talk about their problems since they must engage in solution
building. Clients are asked to identify and describe the problem in order to provide information
on their perceptions of the problem and how they will know that the problem that brought them
to therapy has been resolved (de Shazer et al., 1986; O’ Hanlon, 1993).
Goals established in SFT are well defined and concrete since well defined goals provide a
tangible way to measure the usefulness of therapy for clients and also enable them to anticipate
positive change (de Shazer et al., 1986). Asking clients, “How do you think I can be helpful to
you today?” allows the therapist to begin focusing on what the clients want from therapy. Goals,
frequently set in the first session, are small, behavioral, achievable, and described as presence
rather than absence of something (DeJong & Berg, 2002). One of the ways well formed goals are
established in SFT is by asking the Miracle Question:
Now, I want to ask you a strange question. Suppose that while you are sleeping tonight
and the entire house is quiet, a miracle happens. The miracle is that the problem which
brought you here is solved. However, because you are sleeping, you don’t know that the
miracle has happened. So, when you wake up tomorrow morning, what will be different
that will tell you that a miracle has happened and the problem which brought you here is
solved? (de Shazer, 1988, p. 5)
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Dejong and Berg (2002) believe that asking clients the miracle question enables them to think
about unlimited possibilities, changes the course of the conversation from problem talk to
solution talk, and evokes hopefulness about the future. Given that initial responses to the miracle
question can be vague or grandiose, therapists may need to follow up with several related
questions that help clients describe their more satisfying and problem-free futures in terms that
also embody characteristics of well formed goals according to SFT, such as, “What else will you
be doing that is different?” or “Who else will notice and how or when will they know that a
miracle has happened?”
Frequently, even before clients come to therapy, they are able to successfully resolve or
deal with at least some aspect of the problem. They may also describe occasions when the
problem-free futures elicited through the miracle question are already happening. Solution
focused therapists ask exception questions to elicit when the problem does not occur and how the
clients were able to get the exceptions to happen (de Shazer, 1986; DeJong & Berg, 2002). Small
instances, such as, getting out of bed to make it to the appointment in a client who is depressed
or a couple is able to agree on what they want to work on when they are having marital
problems, may be considered as exceptions to the problems since only a small change is required
to have a rippling effect that reverberates through the entire system (de Shazer, 1986).
Scaling questions are frequently used with great versatility in SFT in order to make
abstract concepts like goals, aspirations, perceptions, confidence, motivation, and commitment
more concrete, and therefore, more attainable for clients. Scaling questions invite clients to put
their observations, impressions, and predictions on a scale of 0 to 10 (DeJong & Berg, 2002). For
example, a client may be asked, “On a scale of 0 to 10, where 0 means that you are not at all
confident and 10 means that you are absolutely confident, how confident are you that your
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probation officer will let you off probation early?” and “On that same scale, what will the
probation officer see you doing when you are at 8 or 9?” Scaling questions may be used early in
therapy to negotiate goals and later, to assess progress in therapy or terminate successfully. For
example, “On a scale of 0 to 10 where 0 means you are not able to control your anger and 10
means you are successful in controlling the anger, where are you on that scale now, where do
you want to be, and where will you be when therapy can end?”
Prevalent Perceptions of Mandated Clients
Individuals who voluntarily seek counseling services typically arrive at their own
conclusion to initiate the therapeutic relationship (Abu Baker, 1999). In other words, these
clients are not mandated by the legal system or referred by an outside agency. However, the
number of mandated cases in the United States has drastically increased since the 1980s. It was
during that time that policymakers sought alternative ways to treat substance abusers, in hopes of
reducing costs and excess numbers in correctional facilities. This increase in referrals has
prompted clinicians to investigate this population, in hopes of identifying how to work
effectively with these individuals (Polcin, 2001). Most therapists are trained to work with clients
who willingly refer themselves to counseling. As a result, Boyd-Franklin and Garcia-Preto
(1994) stated that therapists face unique challenges when working with mandated clients and
alluded to the idea of possibly requiring a different approach with this population. Furthermore,
Boyd-Franklin and Garcia-Preto supported the notion that appropriate clinical training would be
necessary to ensure clinicians could work with these clients effectively.
One challenge faced by therapists working with mandated clients is staying motivated
and engaged during the session, particularly if they get the sense that the client is not working
collaboratively with them (Rooney, 1992). Furthermore, if therapists continuously encounter
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similar responses from other mandated clients, they may be hesitant to start a therapeutic
relationship with these individuals because they perceive them as resistant. Moreover, some
therapists take these challenges personally, which could lead to an impasse. It is important for
clinicians to realize that some mandated clients appear withdrawn as a result of feeling
humiliated or ashamed they were forced to seek treatment, not in response to the therapists
themselves. Practitioners can usually facilitate progress if they are capable of reframing these
responses as normal ones given the circumstance (Rooney, 1992), but other dilemmas sometimes
transpire.
Under most theoretical approaches, self-referred clients are responsible for choosing their
goals for treatment. Even if therapists take a directive stance, they still value the client’s input
and worldview. Therapists want to find out what clients want to accomplish in therapy, as well as
what they will be doing differently when their goals are met (Beck, 1995). However, the goal
setting process may be different in the case of mandated clients. Romig and Gruenke (1991)
reported that the referring party often defines the goals of therapy and these clients are cognizant
that most therapists are required to provide feedback before they can terminate services. Hence,
these individuals may not be eager to participate in therapy sessions. As a result, some therapists
choose to take an indirect approach with these clients, in order to come across as less threatening
and to gain better awareness of their worldview (Romig & Gruenke, 1991).
Despite their efforts, therapists get caught between the legal system and the client at
times. Historically, therapists help clients achieve their therapeutic goals by addressing their
issues and developing effective treatment strategies. Conversely, the referring agency does not
necessarily cater to clients’ goals. Mandated clients may be given specific goals for treatment
and could face legal consequences if they do not comply with the referral’s orders. The latter
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arrangement may put a strain on the therapeutic alliance between the client and the therapist,
which could foster negative views towards the therapist or the counseling process at large
(Amundson & Borgen, 2000). Given these issues, delicate steps should be taken when working
with mandated clients.
Most research on mandated clients focuses on the substance abuse population. This
population runs the risk of being coerced by family members, the legal system, or health
professionals to seek treatment for their substance abuse problem (Polcin & Weisner, 1999). In
fact, these individuals rarely get pressured from a single source. Polcin and Weisner found that
37% of their participants reported more than one person was trying to convince them to get help
for their problem. This study enabled the researchers to illustrate some of the difficulties these
clients face.
There has been skepticism on how mandated clients will respond to treatment. Wild,
Cunningham, and Ryan (2006) gathered data from adults seeking substance abuse treatment.
About 20% of the participants were classified as mandated clients. They found that mandated
clients are, in fact, motivated in therapy, which is noteworthy since many clinicians perceive
mandated clients as being unmotivated and demonstrating no interest in treatment. The authors
suggested these negative beliefs held by therapists are largely not true. Lastly, Wild,
Cunningham, and Ryan (2006) found that client engagement is based on their perceptions of the
overall treatment. Participation was positively influenced if clients decided to commit to the
program and the goals were appropriate.
Solution Focused Therapy with Mandated Clients
Several elements of SFT provide potentially useful ways of working with difficult
populations such as mandated clients. For instance, SFT’s focus on strengths and resources
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promotes a more constructive and encouraging perspective of mandated clients, therefore,
creating a therapeutic environment conducive for change. Furthermore, many court-ordered
clients circumvent conversations about the past such as questions surrounding their feelings or
why they were mandated to therapy (Corcoran, 1997). Although these topics can be discussed in
therapy, SFT takes advantage of mandated clients’ unwillingness to discuss the past by working
with them to resolve their problems from a future orientation. This includes finding solutions
from clients’ beliefs of how they see their future and what they would like to be different in their
own lives? (Berg & Schafer, 2004). Lastly, some therapists may find it taxing to work with these
individuals who are characteristically uncooperative and have little motivation in therapy.
Therefore, therapists may benefit by working from the brief therapy modality (Corcoran, 1997).
The SFT framework offers several guidelines in working with a mandated population.
First, the therapist values working with clients more than focusing on the problem and evaluates
how they function within their own environment. This consists of specifically attending to the
clients’ knowledge of the legal situation that ordered them into therapy, which communicates
that the clients’ opinions are important; focusing in on clients’ perceptions of the events leading
up to their current lifestyle, excluding the adjustment of their responses in order to help them
understand the severity of their difficulties; and identifying the clients’ wants, goals, values, and
attitudes of themselves and in therapy (Berg & Shafer, 2004). Also, relationship questions can
help solution focused therapists increase their maneuverability during sessions by allowing them
to ask clients about sensitive subject matter without endangering the therapeutic relationship
(DeJong & Berg, 2002). For example, therapists might ask, “If your probation officer were here,
what would he say that you needed to work on in therapy?” Furthermore, exception questions
identify instances when the problem did not occur, occurred less frequently, or less intensely.
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Eliciting exceptions with mandated clients helps to build on small successes by having them
recognize how they previously managed their behaviors. Lastly, the miracle question helps
clients create or envision a different lifestyle away from their recent difficulties by asking them
how they would know when their problems have been resolved (Berg & Shafer, 2004). On the
other hand, Rosenberg (2000) suggested that using the customary miracle question with
involuntary clients draws attention to the differences between their goals and the court’s. In
addition, the question may be perceived as insensitive to clients, which emphasizes their
vulnerability in the situation. An alternative miracle question may have a more effective
outcome, such as:
Suppose that one night, while the [insert the referring agency or person] was asleep,
a miracle happened in your life and [the referring agency] recognized that you never
had to go back to see them again. The next day this person says that he or she could
not believe it, but you never have to come back again. The case was closed. What
would the person notice that is different in your lives that would allow he or she to
say that? (Rosenberg, 2000, p. 94).
Lipchik (2002) warns that solution focused therapists must be very careful in their use of
techniques when working with mandated clients. The careless use of solution focused questions
can damage the therapeutic relationship and lead clients to believe that their feelings are of little
importance and this may decrease the chances of fostering change. For example, a solution
focused therapist may make matters worse in trying to elicit exceptions with a mandated client
who could care less about coming to therapy to begin with. Moreover, mandated clients’
aggravation with the legal system, coupled with the improper use of interventions, may cause
them to have greater disdain and distrust for the therapeutic process. Finally, therapists should
refrain from using techniques until it is evident that clients are willing to talk about what is
helpful (Lipchik, 2002).
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Treatment Context
The Community Counseling Service (CCS) was started almost 17 years ago as a primary
training clinic for masters and doctoral counseling psychology students at Our Lady of the Lake
University (OLLU) in San Antonio. CCS is located in an underserved area of San Antonio and
offers mental health services such as psychotherapy, psychological assessments, and biofeedback
to the general public based on a sliding-scale fee. Licensed psychologists, marriage and family
therapists, professional counselors, and doctoral and master’s students provide counseling in
both English and Spanish. Usually, appointments are scheduled over the phone after completing
an intake procedure. CCS also has walk-in hours everyday during which clients can meet with
counselors almost immediately.
The training model at CCS is based on providing live supervision to graduate trainees
with the use of one-way mirrors and closed circuit television (CCTV) monitors while they see
clients. As part of our practical training at CCS, counseling psychology graduate trainees work in
teams comprising of four to six team members who meet with clients at scheduled times every
week under the supervision of an assigned supervisor. Two trainee therapists from the team meet
with the clients while the rest of the team along with the supervisor remains behind the mirror or
observes the session through the CCTV. While the therapists are in session with the clients, the
rest of the team observes the case and engages in brainstorming alternate and probable
interpretations, descriptions, and interventions to the problem which they share with the
therapists during the consultation break. Sometimes, the supervisors may phone-in to suggest
ideas to the therapists in the room with clients that may be beneficial for the clients. Near the end
of the session, the therapists in the room with the clients take a 10 minute consultation break to
meet with the rest of the team and share their impressions of the case with them. During the
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consultation break, the team also formulates feedback for the clients which frequently comprises
of reinforcing client strengths and homework tasks for the clients. After the consultation break,
the therapists take back the ideas generated by the team and deliver the feedback to the clients.
Background and Presenting Problem
The following case study presents the case of an adolescent boy who was referred to
Community Counseling Services for anger management and family counseling. Pedro, a 17 year
old of mixed ethnicity (Hispanic and White) had been placed on probation for six months for
domestic violence and had been mandated to seek therapy by the juvenile justice department.
Pedro’s mother, Melissa, a single, 40 year old White woman who worked in a fast food
restaurant participated in the therapy sessions. He lived at home with his younger brother and
mother and attended the ninth grade in an alternative school. He also worked part time in a fast
food restaurant in the evenings. Their father had left home about a year ago and visited Pedro
and his brother infrequently and did not have a good relationship with them. Pedro’s older cousin
Juan, who shared a close relationship with Pedro and had been a source of support for the family,
accompanied them in the first session.
Melissa told us that she believed Pedro’s anger problem started when his father left home
a year ago. She said that Pedro would frequently become angry and get verbally abusive with
her. She also expressed her concern for Pedro staying out of the house frequently for long hours.
They told us that Pedro got involved with the legal system and was put on probation when, on
one occasion, Pedro grabbed and hit Melissa and the police had to be called. She expressed that
they did not communicate much with one another and she would usually stay out of Pedro’s way
and left him alone when she sensed he was in a bad mood until he calmed down. Pedro talked
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about how anger had got him into trouble with the law and agreed that he needed to work on
controlling his anger.
Case Illustration
In this case illustration, we begin with the description of the problem by the clients and
start goal formation. In the first session, the family was primarily focused on describing past
events that led them to be in the clinic on that particular. Although goal formation typically
begins in the first session the family was still not ready to be a customer in the therapeutic
process. The identified customer in this session was the probation officer who wanted the family
to attend counseling to work on Pedro’s anger problem. This session consisted primarily of
joining with the family and gathering information about family resources.
Here we begin with the second session where concrete goal formation begins with Pedro
and his mother, Melissa. In this session, the therapists work with Pedro and his mother to set
goals in concrete, behavioral terms. The therapists are identified as T1 and T2 in the following
dialogue for easier reading.
T1: Well, we met with the team and they had lots of questions and they seemed
kind of confused as to how we can specifically help you with the anger problem that you have.
And so we were wondering how the probation officer will know when you don’t need to come to
therapy anymore? How will she be able to tell, that OK, this has been helpful? Coming to
therapy has been helpful for your anger problems.
Pedro: Um, she said it’s up to y’all.
T2: OK, it’s up to us?
Pedro: Yeah
Melissa: Um-hm.
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T2: So what would we need to see?
Melissa: Cause that’s what I ask her when she told us we first had to come. I told her,
well, how, you know, how many sessions does he need? How often does he have to come? She
said well it’s really up to the ones that do the counseling. They decide if he still needs more
counseling or if he’s OK with the way he’s doing now. If he’s doing OK, or that is what she told
me. She’s says it depends on the ones who are doing the counseling with y’all.
T2: And how will we know you are learning how to control your anger?
Pedro: By seeing it, I guess.
T2: What will see, instead of the anger?
Pedro: I don’t know.
T1: Yeah, since we see you, like every couple of weeks, for an hour, it’s really hard for
us to imagine that. I wish we could, you know, just follow you around every day of the week,
every hour…
T2: Right.
T1: with a video camera and record what you are doing and see for ourselves how this is
different. How when are at a one, this is what you look like, maybe when you are at an eight, this
is what you look like. So, if we were doing that, what kinds of things would we see that we could
report back to the probation officer because right now I’m not really sure?
Pedro: Probably things that we were saying earlier.
As this excerpt from the second session illustrates, it was very difficult for this client and
his mother to verbalize their goals for therapy. At this point, both Pedro and his mother were still
focused on what the probation officer wanted from counseling. The therapists were attempting to
illicit their goals by asking questions regarding what he would be doing when his “anger”
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problem was solved. At the end of the session, the therapists suggested the following homework
assignment with the expectation that the family would be able to identify strengths and move
toward the goal of controlling the anger.
Supervisor: Excuse me, hi, I’m Monte Bobele, I’m one of the team members back there.
How are you doing? You know what would be really helpful; it just occurred to us because this
is a real problem, being able to tell the probation officer how well he is able to control his anger
because it sounds like to some extent, you’re being a little bit more careful about how you deal
with him so that you don’t provoke his anger.
Melissa: More patient. Before I didn’t have any patience with him. That’s my problem.
Yeah.
Supervisor: Right, ok, so you’ve been trying to work on your patience.
Melissa: Yeah.
Supervisor: And you’ve been trying to do some other things like listen to your music and
go for walks and things like that. The problem, I’m thinking, is that if we call the probation
officer and say, well, his mom is trying to be more patient with him and he’s listening to his
music, that won’t be a test of whether he’s got his anger under control; that will just be a test that
things are going smoothly.
Melissa: Um-hm.
Supervisor: So, I’m wondering, if in addition to what you’ve ask him to do this coming
week is to maybe think about all the things that he’s doing instead of getting angry, if it might be
helpful if his mom did some small thing that might irritate him like maybe be just a little less
patient than you’re being to kind of test whether he’s got some little control over his anger. Do
you have a sense of what you might do?
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Melissa: Yeah, I know what you mean.
Supervisor: Now nothing that is going to make him get really angry and storm out of the
house or hurt you or anybody else, but kind of a little test of his anger control. Do you have some
idea…now, don’t tell us.
T2: And don’t talk about it with him during the week either.
Supervisor: Yeah, don’t tell him. But maybe do a couple few tests of how well he can
control his anger between now and then, so that when you come back you can tell these folks
what kinds of things you did and what kinds of things you saw him do to try to manage his
anger. Could you do that?
Melissa: Um-hm.
Supervisor: OK. And if you noticed your mom do one of those things, you just need to
handle it whatever way you can, ok, and if you see that maybe you pushed him a little bit too far,
then you might need to back up and be a bit more patient. But let’s give it a couple of little tests
to see if he’s kind of ready for the big leagues yet.
Melissa: OK.
Supervisor: OK.
T1: Thank you. So, did that make sense?
Melissa: Yeah.
T1: OK.
Melissa: I know what he’s saying.
T1: OK.
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Melissa: He just wants to make sure that like if I’m not, how do you call it, like, like if
I’m not letting him to have too much space. Too much, yeah, where, so he can learn how to,
yeah.
T1: Cause if you’re completely backing off and letting him do his thing and he is doing
his own thing, then you know, ok, things are where they are, but then it really doesn’t say much
about whether or not he’s working on his anger.
Melissa: Yeah.
T2: Right.
T1: So, this would be practice of having him control his anger, so you can just kind of
help him practice that, you know?
T2: We got to put him in a situation to be angry, so he can control it.
Melissa: So, he can see how far he can control it. Yeah.
T2: Yeah.
T1: Because if you are doing your own thing and he is doing his own thing and both of
you are happy, then there is no situation for him to be angry or for you to be dealing with his
anger, so….
T2: And that is not always realistic to always be keeping each other’s space; something is
going to happen eventually. So it’s good to test it.
Melissa: Yeah
At this point, the therapists wrap up the session and leave Pedro and his mother with this
homework assignment. The rationale for this homework assignment was to change the pattern of
interaction between Pedro and his mother. The premise until the next session was that Pedro
would be inclined to change the way he reacts to his mother, when she is being less patient with
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him, so that he passes his “test.” When such an interaction occurs between Pedro and his mother,
they would become aware of his strengths in dealing with the anger. He would learn that he is
capable of controlling his anger and exhibiting alternative behaviors instead of his current “angry
behavior.” The identification of alternative behaviors allows for the discovery and exploration of
exceptions. The homework is followed up with in the next session.
T1: So, what’s gotten better?
Melissa: Same thing. He’s doing ok.
T1: So, did you get a chance to do what we asked?
Pedro: Yeah.
T1: Ok, so tell us about that.
T2: Really. I see a smile coming to your face.
T1: A-ha
Melissa: No, well a, uh one time me and his brother tricked him. We tricked him. We told
him that his dad had gave him money and didn’t give Pedro junior money to see if he would get
mad. And he didn’t get mad.
T2: Oh!
T1: Wow!
Melissa: He said he was going to wait to when he saw his dad to ask his dad for money
and before he would have gotten mad. And he didn’t get mad.
T1: Oh, so…
T2: So you kind of worked with…
Melissa: With my other son.
T2: Oh, OK.
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T1: Oh, wow! And so what did you tell him?
Melissa: Well I, we just told him like my son told him dad gave me money, but dad
didn’t send you no money with mom. And that, and I told Brian, tell me if he gets mad or not,
and Brian said he didn’t get mad. He just told him that he was going to tell his dad when he sees
him that if he could give him money too.
T1: And normally or before…
Melissa: He would get mad.
T1: Oh, so this is really different for him to be doing that?
T2: That’s great!
T1: What about…
T2: Did you…
T1: Yeah!
T2: Did you know that she was doing that?
Pedro: No.
T1: And so you had no idea that that was your … it was just your reaction, whatever
came out, that you didn’t get angry?
Pedro: Yeah.
T2: Oh!
T1: Did you get angry and you had to control it or just that…
Pedro: It didn’t bother me.
T2: Wow!
T1: And this is the kind of thing that would have bothered you previously?
Pedro: Yeah, in the past.
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21
T1: In the past, it would have and it didn’t. That’s awesome!
T2: So what was different this time?
Pedro: I don’t know. Just thinking what y’all were saying and stuff, so I guess…
T2: About what we were saying?
Pedro: Not to let it get to me and not letting things…
T1: OK. So you had it at the back of your head that….
Pedro: Yeah.
T2: And so this was just the first time that you tried to test him. Is that right? What were
some of the other times throughout the week?
Melissa: Well, the other time was like he got another dog and I was like, I was arguing
with him because I only wanted him to have one dog in the backyard, not two and he had got
another dog from his friends and I was arguing with him about that and he was like, “Well, let’s
wait and see you know what happens” because one of his other friends was going to pick up the
other dog. And before he would have got mad if we argued with him abut what he wanted…
T2: Oh!
Melissa: and he didn’t.
T2: OK.
Melissa: So then his friend didn’t end up coming over and he didn’t take the dog after all,
so my husband had came and my husband was like, “Well, just leave him there. He’s not doing
nothing there together. They’re use to each other. Just leave him there.” But before he would
have got mad and argued with me about him wanting another dog.
T2: OK.
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22
T1: And so, he just reasonably talked it out with you and he was rational about it. Oh, and
this is, like you said, it’s different for him, right?
Melissa: Um-hm. Because before he would have jumped at me and “I’m gonna keep it
anyway whether you like it or not.” And he didn’t.
T2: And if I heard you correctly, he said let’s wait and talk about it or wait to the….
T1: Uh-ha.
Melissa: No, he said, um, cause he said that his friend was supposed to come and pick it
up,
T2: Uh-ha.
Melissa: but then his friend decided he didn’t want it after all.
T2: OK.
Melissa: So, I told him, well, you are going to have to find someone else who, you know,
wants it because I only want one dog in the back. And then when my husband came over and I
was telling my husband and he’s like, he’s like, “No mom, they’re already used to each other.
Both of them, the two dogs play together, they lay together, sleep together and all that. So just
leave them there cause they’re not doing nothing. Just leave them there.
T1: So, just by talking that way to your mom, do you have two dogs now?
Melissa: Um-hm.
T1: Or so you agree?
T2: Oh wow!
T1: That’s something!
Mandated Clients
23
In this example, the difference in Pedro and his mother’s interaction is noticeable by
them and the therapists. The therapists continued to find what else is different to illustrate how
small changes lead to bigger changes.
T1: How did you do that?
Pedro: Do what?
T1: To be able to talk to your mom even when she was arguing with you? How were you
able to do it back then, when she was arguing with you and you were able to tell to her, well,
let’s just talk about it? Let’s see how it goes and if you like it, we can go ahead and keep going?
Pedro: Just to try to ignore the yelling.
T1: What did you do to calm yourself down?
Pedro: Cause I told her and just like walked away.
T1: And did you ever come around to talking about it later? Or it wasn’t an issue?
Melissa: No, I just told him what his dad had said. His dad said that if he couldn’t find
nobody who wanted them to just leave them there because the two dogs are already used to each
other.
T1: OK. OK. And were there other times that you…
Melissa: Just….
T1: tried to being less patient with him and he passed the test?
Melissa: just those two times. And the other time it was just regular things with him and
his brother. Like they use to argue a lot and now they don’t.
T2: Hmm.
T1: Really!? What’s different with that?
Melissa: Hahahaha. We look at each other!
Mandated Clients
24
T2: Hahahaha. Maybe Pedro could tell us?
T1: Yeah. Are things between you and your brother different now?
Pedro: Getting along better.
T2: How so?
Pedro: We’re not fighting anymore.
Pedro tells the therapists that he is controlling his anger better because he is not fighting
with his brother as much. The therapists continue to explore how else he knows that things are
different for him. They do this by exploring different patterns of behavior that Pedro is
demonstrating. In doing so we are also able to make both Pedro and his mother aware of the
changes in the pattern of their interactions.
T2: What are you doing instead of fighting?
Pedro: Go to malls or something.
T1: So you go out with your brother, what else do you do? What kinds of things do you
do?
T1: And if Brian was in here and we were to ask him if he’s seen anything different about
the way Pedro has been reacting, what would he say? Would he be able to tell the difference?
Melissa: I think he would because before he used to lash out a lot Pedro Jr. but now he
doesn’t. Lots of times he’ll just walk off or go to his room or something.
T1: So what would Brian say has been different about Pedro the past few weeks?
Melissa: I guess that he’s more calmer I guess.
T1: Would you agree with what Brian would have to say?
Pedro: Yeah.
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25
T1: Yeah, what kinds of things would Brian notice about you that would tell him that you
were being calmer?
Pedro: That I’m not yelling a lot and not always mad.
T1: What are you doing instead that would tell him that you are much calmer now? What
would you do and what would he see you do?
Pedro: I’d be talking to him in a regular voice.
T1: And that would tell him that you’re calmer? What else?
Pedro: I don’t know.
T1: (Pointing at Melissa) And have you noticed the same?
Melissa: Yeah, he’s more calmer and before he used to yell a lot and now he doesn’t.
The purpose of the later and termination sessions is to continue building exchanging
ideas about what is going well and getting better in the clients’ lives. In the final session, the
therapists use the scaling question and exception questions to measure progress and to elicit
things that the client is doing well. The therapists continue to encourage Pedro and his mother on
the changes they are making and discuss ways to ensure that they are long-term.
T1: Pedro you made some remarkable progress and um like mom is saying and your
brother and your saying that your brother would notice that you’ve been much calmer whose
helped, whose helped you through this because its not a very easy job to be able to control your
emotions especially when your mad and so who’s been helpful to you in this?
Pedro: My grandma
T1: Your grandma?
T2: How has she been helpful?
Pedro: She keeps telling me that I don’t need to be like my dad like getting mad all fast.
Mandated Clients
26
T1: So you’ve been talking to your grandmother a lot lately.
Pedro: Yeah.
T1: Okay. Did you always do that or you started doing that now?
Pedro: Started doing that.
T1: Started doing that.
T2: Since when?
Pedro: Since, like four weeks ago.
T2: Four weeks ago.
Pedro: Yeah.
T2: And how often do you talk to your grandma?
Pedro: Like mostly everyday.
T2: Everyday.
Pedro: Yeah, mostly everyday.
T2: So, she has been giving you this advice, something new everyday that you go see
her?
Pedro: Yeah.
T2: Wow. So what are the other things she tells you to help out?
Pedro: Just to help my mom because my dad ain’t there a lot, to like finish school, try to
do good in school.
T1: That’s a really nice piece of advice…
T2: Yeah.
T1: that I think your grandmother is giving you and you actually go and talk to her and so
it seems like your even listening to the advice, that’s really good.
Mandated Clients
27
T2: That shows your strength Pedro, making that decision to go talk to your grandmother.
T1: We met with the team and they pretty much agree with Pedro and you and they also
see the change in Pedro, the way he’s been able to handle all these situations that you’ve thrown
at him and we’ve asked you to do and it’s pretty impressive! They were really impressed that
Pedro has been able to handle it so well, the way that he’s handled it. And he’s found grandma as
a big source of strength for him, going for advice to her and actually listening to her, because a
lot of people give advice and get advice and not do anything…
T2: Not listen to it.
T1: Don’t do anything with it. And they just thought it might be such a different feeling
for you to be and you did say you were surprised that the probation officer was complimenting
you.
T2: Yeah.
T1: And your brother is noticing a difference about you, the way your handling yourself,
and you look calmer to people, and to your mom, just in the way that you handle everything. So
they were really impressed! They said they’re confident, as well, that you will be able to take this
further and continue working on this and you will be able to handle the anger better in the future
as well. So they were pretty confident, as well, that you will be able to do that. And mom is
pretty confident that you will be able to do that pretty much.
T2: I wanted to compliment you Michelle for caring so much about Pedro, for you going
through all these tests; it’s not all easy. You know to test him like that. It shows that you care
about him and want him to get off of probation early and it’s amazing.
T1: How confident are you that this change is going to stay or he’s going to continue
making the changes that he’s making in a positive way, and continue to work on his anger
Mandated Clients
28
management skills, and be calmer like if you were to give a number, maybe a percentage or
something on how confident you are?
Melissa: Well because he has an anger streak, like he gets angry real quick, and the last
two months he’s been really calm he hasn’t been really, like if he starts getting angry he’ll go to
his room or something or he’ll find something else to do. Before he wouldn’t he would stay there
arguing with me but now he doesn’t, so I think he’s trying to control it by himself.
T2: So if you had a number like a percentage…
Melissa: Um, 60 to 70 percent.
T2: OK, so you’re 70 percent sure that this will continue?
Melissa: I think so.
T2: OK.
T1: What about you Pedro, how confident are you that this is going to continue?
Pedro: 80%.
T2: Wow, you’re higher than mom!
After the exploration of the changes that have been made by Pedro and his mother the
therapists measured how confident the clients were that these changes will endure. Both of them
appeared very confident that Pedro has learned to manage the anger. The therapists ask Pedro
and Melissa if they felt the need to come back and they agreed that they will come back in the
future should Pedro need a refresher course in controlling his anger.
Discussion
Mandated clients are most often coerced into therapy by the legal system. Frequently,
these clients assert that they do not need help, are reluctant to work on goals, or establish a
relationship with the therapist during the therapeutic process. Additionally, therapists may show
Mandated Clients
29
some reluctance when working with mandated clients due to common beliefs that this population
may be resistant, unmotivated, and uncooperative in therapy. Solution-focused therapy offers
mental health professionals an effective alternative to work with this difficult population. Some
of the SFT guidelines include putting mandated clients in the expert role, setting future oriented
goals, and focusing on their strengths and resources. SFT techniques such as the miracle,
relationship, and exception questions can help clients to construct a reality away from their
problematic issues, increase therapist maneuverability during the session, and build on the
successes of the clients.
SFT views the origin of problems in an interactional context that is, problems occur
between people and are not within them. Problems are seen as being an extension of everyday,
ordinary difficulties that persist due to unsuccessful solution attempts by people involved in the
situation. In the above case, several factors contributed to our success in working with the
mother and son who came to therapy to handle possibly aggravating and anger situations
between them better. It was apparent that what they had done so far to attempt change had not
worked for them and instead, worsened the situation due to the involvement of the legal system.
During therapy, we did not pathologize or blame either of them for their problems. Instead, our
focus was always on how we could best utilize what they brought to therapy.
When working with clients we are always conscious of Asay and Lambert’s (1999)
research on the four common factors that are responsible for improvement in therapy and focus
on how we can tap into these factors to maximize our success with clients: extratherapeutic
change (40%), therapeutic relationship (30%), techniques (15%), and expectancy/placebo effects
(15%). The philosophy of SFT is consistent with these findings since by exploring the clients’
resources, abilities, and support systems in a non-judgmental and collaborative way we are
Mandated Clients
30
making the most of the extratherapeutic and therapeutic relationship factors that are mostly
responsible for the variance in outcomes. For example, Pedro’s cousin was present in the first
session and this was viewed and communicated as a positive thing since we saw him as the
family’s resource and support. Also, exploring and encouraging support systems outside therapy
enabled Pedro to find a confidant and mentor in his grandmother, whom he started visiting
frequently and looking for advice by the fourth and final session. Working from this strength
based model allowed us to see beyond Pedro’s legal offenses and this promoted a trusting and
safe environment. As a result, Pedro willingly participated in sessions and followed through on
the homework tasks that we gave resulting in early termination of both therapy and probation.
We can only imagine how unproductive therapy might have been for the family and frustrating
for us, as therapists, had we created a hostile and blaming environment. Delving too much into
his past and hypothesizing about why he got into legal troubles would not have enabled us to
focus on his successes and build on solutions.
When Pedro and Melissa came back for the second session, they reported that Pedro had
been handling his anger well by the second session. On further inquiry, we realized that while
Pedro was engaging in various activities that kept him busy, he and his mother were barely
interacting with one another. Both of them worked separate shifts and did not see each other for
most of the day. When they were together, Melissa attempted to be extra cautious about not
upsetting Pedro so that he would not get angry. Therefore, while they were able to avoid
situations that would make Pedro angry by not interacting with each other, we were unconvinced
that he would be able to handle his anger better if such a situation were to arise. Hence, our
suggestion that Melissa test Pedro’s ability to control the anger by being a little less patient with
him on several occasions during the week was an attempt to get them to do something different
Mandated Clients
31
interactionally that would achieve resolution of the problem. According to de Shazer (1988), any
really different behavior in a problematic situation can be enough to initiate change. All that is
required is that the people involved in the troublesome situation do something different than
what they have previously done in the past even if the behavior is seemingly irrational,
irrelevant, bizarre, or even humorous (de Shazer, 1988). On making this suggestion, Melissa
appeared willing to follow through since she felt relieved of the pressure to continuously monitor
her behavior in her son’s presence. Pedro, although not so excited initially, agreed to go along.
When they returned for their third session two weeks later, Melissa told us that she had
deliberately tried to be less patient with Pedro on several occasions and Pedro had been
successful at controlling his anger. We believe that this intervention was successful with the
family since asking Melissa to be less patient with Pedro, as part of a homework task for therapy,
had a different meaning for Pedro as it now occurred in a different context. As a result, when
Melissa tried to provoke Pedro, he viewed his mother’s behavior in a different light and was able
to successfully engage in new and different behaviors. Similarly, Melissa’s perspective shifted
when she saw Pedro behaving differently to her being less patient with him and this resulted in a
different kind of interaction between them. These new behaviors between them allowed us to
build on their exceptions and extend them to the future. We terminated successfully after a total
of four sessions that spanned over two and half months.
Some might contend that such an intervention, which we believe was the turning point in
therapy, was putting Melissa’s safety at risk considering the nature of the problem. We were
always mindful of our ethical obligations to the clients. Therefore, while delivering the task we
asked Melissa to do only one small thing to be less patient with Pedro and nothing that would
risk her safety. Also, this task was delivered in the presence of Pedro so that he would be aware
Mandated Clients
32
that his mother was being less patient with him as part of a homework task for therapy. This
awareness in itself changed the meaning of Melissa’s behavior for Pedro and minimized any
chances of Pedro becoming violent with her. Also, it is our view that this task was welcomed by
Melissa since it put her in charge of the relationship with her adolescent son by preventing her
from fearing his temper all the time. Pedro appeared to enjoy the task as well since he felt
challenged by it. We feel that not only was Pedro able to control his anger better as a result of the
intervention but also developed a congenial relationship with his mother. The support and
creativity of our supervisor and other therapists on the team was crucial in this case since we
were all able to weigh the pros and cons of the interventions we developed and delivered in this
case.
Mandated Clients
33
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