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Therapy with Coerced and Reluctant Clients

by Stanley L. Brodsky (2011).  Washington, DC: American Psychological Association. 233 pages.

Distinguished University of Alabama psychologist Stanley Brodsky has written extensively over four decades about the use of psychologists in criminal justice, corrections, and law enforcement systems, starting with Psychologists in the Criminal Justice System (University of Illinois Press, 1973). In his most recent volume, Brodsky observes that when people think of "coerced clients" they think of criminal defendants or prisoners behind bars. Then, there are those people with strong-willed reluctance to enter into therapeutic relationships with counselors, psychologists, or social workers. But Brodsky notes, "Coercion may be applied more broadly than just to offenders. Pure coercion requires two components: People in authority require a person under their control to enter treatment, and the person experiences it as coercive."

But "treating offenders" is at the heart of Brodsky's career-long psychotherapeutic work. Having started his career working with felons at the military prison at Fort Leavenworth, Kansas, Brodsky never drifts far from his roots, and thus he offers a multitude of case studies and illustrations of work with coerced clients in criminal justice or correctional settings. "Coerced and reluctant clients," who are at the center of this assessable account, are certainly not always offenders. They can be found in many segments of society. But successful therapy shares a certain set of skills or repertoire of modalities for offenders and non-offenders alike.   

"Coercion can be legal or interpersonal," Brodsky says. And reluctance may actually be a characteristic - or a barrier - of therapists as much as legally mandated offenders or socially pressured persons. As Brodsky observes, "Therapists in total institutions typically have little choice about whom they treat. They are assigned the next person in line, the next person who is admitted. The emotions experienced by reluctant and involuntary therapists include fear of clients, anger toward clients, anxiety about the treatment and the clients, and efforts toward maintaining an emotional distance."

Therapists (and others) tend to ask offenders (and others) why they do particular things. "With coerced clients," Brodsky notes, "asking questions has the potential to make clients feel they are being cross-examined and challenged, even when questions are asked in kind and gentle ways."  The matter of "not asking questions" is at the core of this engaging volume. Asking "why" is particularly thorny. Brodsky states, "By asking why, therapists do two things. First, they indicate that attempting to search out why clients have acted in defined ways is the pathway toward correcting behavior problems. Indeed, the opposite may be true. Looking for the why distracts therapists and client from putting behaviors in context and from moving the therapy along more meaningful dimensions of when a problem occurs, with whom, what form it takes, and when the client manages well."

Brodsky does not suggest "not asking questions" as a primary form of intervention, but rather as an important tool in a repertoire of therapeutic skills. Brodsky admits that the alternative to "asking questions" is not necessarily clear, but he recommends "moving to an active, more directive intervention style with objective self-awareness constructionalism, and personal construct therapy." Other approaches, all intended to get clients involved at an early stage, include behavioral rehearsals, unconditional neutral regard, spontaneity and humor, positive psychotherapy, group conversation, and paradoxical therapy. Still, therapy in prisons or other coercive settings can be tricky, and even counterintuitive. Brodsky notes that "with coerced clients who absolutely do not want to be in therapy, the therapy itself can serve as an aversive contingency for inappropriate behavior. For it to be effective, treatment must be a clear and unequivocal negative experience for clients."




Posted Thu, Aug 4 2011 4:40 PM by Tracey Vessels

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