Topic > an - 1066

Creating therapeutic alliances in service of clinical practice with involuntary clients presents a challenging task, for which a “mindful participation environment” should be developed to achieve productive outcomes. Clinicians often encounter resistance when working with clients in an assignment capacity, as the requirement to attend counseling on an involuntary basis can negatively affect the process. According to Goldstein (1995), resistance arises in treatment within the client's conscious or unconscious actions that interfere with therapeutic progress. Assessing the complex dynamics that cause a client's resistant behavior during clinical treatment is a challenging task, but essential to achieving goals. Goldstein (2001) states: “It is essential for the practitioner to create a therapeutic support environment that helps stabilize clients, allows them to feel safe, assists them in containing and verbalizing their feelings, mobilizes their motivation, and facilitates their cooperation with and trust of the worker” (p.155). The “meaningful relationship” developed with the clinician during the initial stages of treatment is essential to the client's well-being (Ripple, 1964). Furthermore, providing a safe space to explore internal and external issues that influence the client's ability to feel empowered is vital in therapeutic practice. My internship is at the Bronx Studio School for Writers and Artists (BSSWA), a middle and high school in the South Bronx. In this position I found several involuntary clients exhibiting resistant behavior. According to Zayas and Katch (1989), “…during the initial stages of involuntary treatment, adolescents typically refuse or resist involvement with the doctor.” (page 3). My entire interaction...... half of the article ......nt motivation is a key element in the progression of treatment, hence the importance of client and doctor being on the same page regarding treatment. Establishing an effective working relationship with Steve during mandatory counseling sessions involved activating interest while working with his lack of desire to meet with me. In Woods and Hollis (2000), "The absence of motivation can make case work with committed clients extremely difficult... Almost everyone who has been ordered to see a doctor has something to complain about and understanding to operator part of the client's reactions can initiate a commitment process” (p. 329) Engaging Steve, a male, Hispanic ninth grader with mandatory counseling once a week for forty minutes was problematic from the start. Steve's current problem was excessive absences, poor grades, and misbehavior at school.