Whereas reluctant referrals simply drop out of therapy, coerced
referrals are more likely to continue to attend. Faced with serious consequences
such as loss of their children or criminal charges if they fail to comply with
an order for therapy, these parents, like Anna Ryan, feel they have no real choice
but to attend. Nevertheless, they are often unwilling to discuss their situations
openly. Although the coercion they experience ensures their physical presence
in the room, it also overshadows any potential motivation to address individual
or family issues, as these parents revealed:
The judge said that
I had to return to court myself on July 30th, which I did, and I was allowed to
have my son back if, this is where it stinks, if I would have counseling for 2
years through some little upstart named Teresa. Shes 26. I dont know
what shes done in the way of training. Shes not at all sympathetic,
or empathic, or whatever the word is.
How did I end
up coming here? This is what I have to prove, see? Theyre making
me. Ive got a choice. Either come here and see Ken and do all these sorts
of things or they take the kids away. Thats the choice!
just said he would see us again and we would have to come Ito therapy, otherwise
there are ways of making you come if you dont want to come!
Parents who are coerced referrals to therapy perceive therapy to be
an extension of the CP Department and therapists, therefore, as untrustworthy.
They expect that the therapist is allied with the CP Worker against them, an expectation
that exists even when CP Workers and therapists describe themselves as in conflict
with each other. Issues concerning confidentiality of information and the possibility
of renotification often loom large for both therapists and parents.
describe coerced referrals as unmotivated and resistant, and may conclude that
by ordering the family to therapy, the CP Department is shifting the burden of
responsibility for the childs safety to the therapist. Therapists know all
too well that therapy is not a magical solution, particularly for those clients
who have no interest or desire to be there. As one therapist described it:
Im afraid that we take on a family into therapy prematurely and
the court doesnt have full information. All the information they have is
that the family is in therapy, and they write it off. I think there is a general
feeling that therapy is magic and fixes everything up. Its just the buck-passing
process that concerns me. In some cases it can be a very risky situation.
It is difficult and stressful, on the one hand, to have unmotivated clients,
and on the other, to feel significant responsibility to come up with the
goods. Therapists want clients who want to be there and who
show some interest or desire to talk about their difficulties. This expectation,
however, feeds into the evolving difficulties between therapists and parents,
as one mother described:
They [therapists] expect things of you;
they shouldnt expect things of you. For a start, they shouldnt expect
you to be happy or anything like that when obviously the situationthey expect
you to be cooperative ... they expect you to be willing to be there when they
know darned well youre not.. . before you even walk in there, before theyve
even seen you, they must know youre not going to be quite as cooperative,
you know? Well, there you go, why do they expect you to be cooperative and willing?
In the case of coerced referrals, there is sufficient leverage to ensure
the parents physical presence in the room. But the transition from physical
presence to open and active involvement in the process of therapy is difficult
and often just does not happen. Parents remain in a defensive position and see
little to gain in changing their behavior. Without a sense of choice, without
the ability to define the problem in their own terms or have their definition
of their relationship between themselves and the Department stick, these parents
do the only thing left to do while preserving a sense of their own integrity:
They resist. This resistance is sometimes subtle and sometimes overt, but always
it is with such tenacity that child abuse cases are infamous among therapists
for their difficulty.
And so we are left with the question Why? Why do parents find the situation so threatening that they resist us with
such tenacity despite our genuine and often altruistic desire to help them? Why
do they resist us so much more than other clients? The answers to these question
are complex and multilayered, but in the next chapter, we will deal with the reason
the parents themselves most often give: They see therapists as aligned with CP
Workers and they feel blamed, stigmatized, and oppressed by their experiences
of Department intervention. When parents have been referred from the Department
to therapy, the background context that informs the parents relationship
with the therapist is their prior and ongoing relationship with the Department.
This was the case with Anna Ryan, whose story of coercion into therapy began this
The article above contains foundational information. Articles below contain optional updates.
Reflection Exercise #6
The preceding section contained information
about coerced referrals to therapy. Write three case study examples regarding
how you might use the content of this section in your practice.
Online Continuing Education QUESTION
What court viewpoint contributed to MacKinnons stress regarding
coerced referrals? Record the letter of the correct answer the .