Working
With Involuntary Clients
In representing the interests of
children, courts and society generally, social workers are often faced
with imposing conditions. Sometimes these conditions also include
therapy on unwilling clients. Where this involves drug-related issues
(eg. neglect, violence) motivational interviewing has been used to
manage client resistance.
However, the first step often required in what is a conflict of
interests generated by imposition of the state's will on an unwilling
client is conflict resolution. Subsequently, negotiation around the
bottom-line of intervention, options and consequences for adherence and
non-adherence of intervention options need to be explored.
If indicated, motivational interviewing should be used once the air
is cleared, the ground rules are set and the client has experience in
participating with negotiation.
The six steps described below and developed by Barber (1991), outline
a practical method for negotiated casework with the involuntary client. Notes
on dealing with involuntary clients follow the six steps below.
These steps are also available as a PowerPoint presentation @ Managing
the Involuntary Client pp
Statutory
referral form as Word 6 document also available.
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Contents
Six
Steps for Dealing With Involuntary Clients
Notes
on Dealing With Involuntary Clients
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Six
Steps For Dealing With
Involuntary Clients
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1 Clear the air
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Set
the stage of negotiation by stating the statutory framework
(including any court order) under which casework is being conducted
(eg. protection of children, drug-relate offences, domestic
violence, self-harm) |
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Encourage
the client to express their feelings and thoughts about the
situation - the worker should use their reflective listening skills
at this stage |
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Worker
express her/his thoughts and feelings about the constraints of the
intervention while being respectful of the client |
The aim of this step is to begin to deal with the
emotional content of 'conflict' and for the worker to make clear their
role as negotiator between the court/society/statutory issues and the
client. |
2
Identify legitimate client interests
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Worker
inquires about the reasons for client resistance - ie what exactly
does the client stand to loose by engaging in the change process or
adhering to court orders? Notes are taken for use later. |
| Worker explains that
they will subsequently negotiate a treatment plan which will aim to
minimise these negative consequences.
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3
Identify non-negotiable aspects of intervention
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Sit
side-by-side with the client and go over the basis of the
intervention (eg. a court order, child protection allegation, etc) |
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Reframe
directives to be of interest to both worker and client (eg. rather
than, "if you don't cooperate, we will have to take your
child from you", "we will be happy when we are
reasonably sure that your child is safe and has reasonable
opportunities to grow and develop".) |
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Client
and worker both invited to question aspects of the bottom line and
the worker should be prepared to negotiate where appropriate. For
example, the worker would need to be specific about what "reasonably
sure that your child is safe" means. |
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In
the case of drug use by a parent, specific connections relating to
child protection (such as managing supervision of a young child
while intoxicated) should form the basis of the bottom line. (see Risk
Assessment for Parental Drug Use) |
| By the end of this
step, both client and worker have agreed on bottom-line limits of
intervention and the client has experienced a process of empowerment
in their involvement of interpretation of the statutory issue or
court order. |
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4
Identify negotiable aspects of intervention
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Having
agreed on the bottom-line, brainstorm a broad range of possible
interventions and treatment goals which might meet the bottom line. |
| While step three
requires worker and client to be precise and pay attention to
detail, step four calls for creativity and imagination. It may even
be fun.
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5
Negotiate the case plan
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Negotiate
a case plan taking into account the legitimate client interest, the
bottom-line and the brainstorm of negotiable aspects of
intervention. Keeping written notes from the former steps will be
helpful here. |
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Worker
may express her/his legitimate interests (eg. amount of time for the
case, availability of transport, etc.) to enable the fairest plan
for both client and worker. |
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Where
there is ambivalence around choosing a particular course, the worker
may use a modified motivational interviewing to help with decision
making. In this modified version, both worker and client progress
through the decisional balance of costs and benefits. |
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The
main points of an initial plan are drawn up while you are both
there. |
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Set
a short-term goal with the client. |
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6
Agree on criteria for progress
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Determine
with client, answers to the following:
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How
will the treatment plan be monitored? |
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How
will worker and client know that the treatment plan is working |
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What
will happen if the client fails to comply with one or more of
the terms? |
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Precisely
what is required before Departmental services are
terminated or renegotiated? |
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Document agreed criteria
for monitoring and contingencies
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Notes
on Dealing With Involuntary Clients |
The
skills most social workers are taught in developing relationships with
their clients are based on the humanistic school of unconditional
acceptance and self-determination (eg. Egan, 1985). However, where the
reason for contact is based on statutory grounds; where the client is
not seeking intervention; and where the primary concern relates to a
third party (eg. child protection), this non-directive model is
generally inappropriate in the first instance.
James Barber (1991) in his acclaimed book Beyond Casework,
states;
"Work with involuntary clients must begin
with the recognition that the interaction between worker and client is
based on conflict rather than cooperation, that social work with
involuntary clients is a political, not a therapeutic process
involving the socially sanctioned use of power." (p 45)
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Barber
(1991) outlines a process of negotiation which differs from two common
approaches:
'Casework by concessions' where the worker is
uncomfortable and apologetic about constraints and tries to avoid
conflict by 'going with the client'. This can leave both worker and
client bitter and resentful when, in the end, the worker still has to
carry out statutory obligations - by force.
'Casework by oppression' where the worker uses rigid tactics
to force (punish) the client to submit to the worker's authority.
'Casework by negotiation and conflict management' differs
from the above two styles offering a model of intervention based on the
principles of conflict resolution with the social worker taking on the
role of negotiator or conflict manager. This
process has three aims:
- Maximising self-determination within statutory constraints
- Operationalising clinical goals and orders through client
involvement
- The behaviour of skilled negotiations, models peaceful, conflict
resolution
The overall goal of casework by negotiation is an initial development
of a working relationship rather than a therapeutic relationship.
While a therapeutic relationship may follow, this may not be essential
as a working relationship will allow for brokerage of treatment options
and supervision of case management.
Where direct therapy by the social worker is indicated, the six steps
outlined above will go a long way in developing a solid foundation of an
honest relationship based on roles, responsibilities and mutual
participation.
Dealing With Involuntary Clients section is
an adapted summary from James Barber (1991) "A slight Digression:
Casework with Involuntary Clients" in his book Beyond
Casework
With Permission MacMillan Press
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Click here
to download a referral form which could assist in the referral process of
statutory clients from statutory agencies to drug specialist agencies.
16 KB
Related Internet Page
Click here
for Insoo Kim Berg's Solution Focused Brief Therapy useful questions to ask
involuntary clients
32 KB
Click here
for the Victorian Eastern Drug & Alcohol Service's,
"An Introduction To Working With Alcohol & Other Drug Issues" (2002).
Go to p. 21 for Involuntary Clients section from their manual.
640 KB
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