Mandated clients are often navigating many systems at once. These systems include their families, their schools, the Department of Juvenile Justice (DJJ)/Juvenile Services Department (JSD), etc. In addition to navigating multiple systems, mandated clients may be experiencing levels of trauma (or Adverse Childhood Experiences – “ACEs”), individually or within the family system.
These traumatic experiences may contribute to barriers that may impede the therapy process and the effectiveness of treatment. Given these barriers to treatment, and the potential for complex trauma histories, it is critical to approach therapy through a systemic and trauma-informed care perspective when treating this population. Assessment and coordinating appropriate services can provide a useful tool, as well as incorporating a trauma-informed care (TIC) lens.
Healing systems: Therapy with mandated clients
My colleague and I, Franchesca Meyers, have worked in the field for over seven years in different capacities. As registered marriage and family therapy interns in South Florida, we have worked in different settings providing direct services (outpatient, in-home, telehealth, etc.) to children and their families, either within the DJJ/JSD or dependency (foster care) system. Most of our clients include mandated youth between the ages of 4-19. Although from different backgrounds, there is a common thread—mandated clients are all individuals navigating the system in hopes of moving forward with their lives.
In a typical setting, these are individuals who would never seek services of their own volition—mandated—who also have committed a crime—offenders (Reddick, 2004). Realizing that these are individuals who do not have the luxury of exploring various therapists for the right fit and would not typically seek services, it must be taken into consideration that our standard approach to clients may differ.
Mandated clients
Mandated clients are required by the courts—through a post-release diversion program—to attend some sort of mental health or substance abuse service. Their cases range from substance abuse to grand theft auto. We have had the privilege of being our client’s mentor, case manager (at times), as well as their therapist. According to the Florida Department of Juvenile Justice (2020):
Between 2018-2019, 54,827 juveniles (aged 10-17) were arrested in the state of Florida. Of that number, 11,181 were sent to diversion programs, and 11,549 were placed on probation. When broken down by race, Black juveniles made up 49.9% of the total number and White juveniles made up 33.2%, with 16.4% as others. In terms of diversion programs, Black juveniles were diverted at 39.5%, while White juveniles were diverted at 42%.
Children—or even adults—who may or may not have any insight into their problems, or have not had the chance to process the trauma they have experienced in their household(s), are often faced with meeting many of our colleagues within these various systems. Oftentimes, mandated clients may show “resistance” when they are required to attend outside services. This increases the urgency for us to discuss and understand the importance of our roles as clinicians as well as the system as a whole. As systemic thinkers, it can often become difficult to navigate within systems that tend to ignore trauma when assigning mandated clients to mandated treatment. These issues, and many more, affect our communities in more ways than we often think.
Therapeutic alliance
Children within the DJJ/JSD system are often required to participate in post-release services. Services include individual or family therapy, rehabilitation care (for substance/alcohol use), and so forth. Within the systems we are working, the relationships we are working to maintain with our clients can be crucial to their growth and longevity. Research has consistently shown that the therapeutic alliance is the strongest predictor of whether or not therapy will be successful (Knobloch-Fedders, 2008).
Research has shown that court-mandated clients have expressed gaining something valuable from therapy, citing that the experience was more enjoyable than anticipated.
It is essential to understand how the mandated therapy relationship differs from traditional voluntary therapy relationships in working with mandated clients. Hachtel, Vogel, and Huber (2019), state “while mandated therapy provides external motivation to attend treatment, voluntary clients are normally believed to be intrinsically motivated” (p.1). The literature suggests that mandated clients are more resistant than voluntary clients (Hachtel et al., 2019). However, research has shown that court-mandated clients have expressed gaining something valuable from therapy, citing that the experience was more enjoyable than anticipated (Forte, 2018; Mee-Lee, 2017). The quality of the therapeutic relationship (provider-client relationship) is as important, if not more, than specific psychotherapy techniques applied (Hatchel et al., 2019). This also speaks to the effectiveness of treatment and barriers that prevent treatment from being provided and/or effective.
Barriers to treatment
While examining and exploring the effectiveness of treatment, it is important to explore the barriers to treatment that include family dysfunction, trauma (that manifests itself as maladaptive behaviors), and lack of access to resources. The family unit (and family dysfunction) can be seen as a crucial part when exploring the root cause of what is happening with clients. Papero (2017) refers to systemic dysfunction as “a deterioration in the process of coping with adversity that promotes the maintenance of the family’s ability to meet the needs of its members” (p. 584). When the equilibrium is unbalanced, the family system is often responding to internal and external pressures; external pressures mirror a need for the family to respond to conditions that are changing and challenge the family’s capacity to maintain its lifestyle and ways of functioning (Papero, 2017).
This barrier, or wall, can be seen as resistance. These walls are often a manifestation of the traumatic experiences they have experienced, as well as a system that has not often afforded them the opportunity to explore some of that hidden trauma. Being exposed to trauma can present itself as many symptoms. Ford, Chapman, Hawke, and Albert (2007) posit that this includes “not just internalizing problems, such as depression or anxiety, but also externalizing problems like aggression, conduct problems, and oppositional or defiant behavior” (p. 1). Trauma can impede a child’s thinking and learning, as well as interfere with the levels of development (Ford et al., 2007).
Racial disparities also exist amongst minorities within the community. Mcguire and Miranda (2008) note “As documented in Mental Health: A Report of the Surgeon General and its supplement, Mental Health, Culture, Race and Ethnicity, racial and ethnic minorities have less access to mental health services than do whites, are less likely to receive needed care and are more likely to receive poor quality care when treated” (p. 3). Moreover, in the United States, minorities are most likely to not seek, or wait, for services (Mcguire & Miranda, 2008). Understanding the complexities that exist in our client’s lives and allowing for open exploration of proper, achievable goals is important even in the midst of constraints that exist in everyday life.
Setting goals
When working with mandated clients, it is imperative to establish a unified goal outside of the goal that the referring system has for them, meaning that although mandated clients can appear resistant to changing or uninterested in therapy, they are in an action stage for something they may want (Mee-Lee, 2017). Some of the actions may include “staying out of jail; getting people off their back; getting housing or a job, or getting their children back” (Mee-Lee, 2017, p.3).
In finding a common treatment goal, it is best to meet the client where they are. Clients may not always acknowledge the circumstances that have led to them being in their current position. In these situations, ask them how they would like to spend their time here, or variations of this question. Forte (2018) highlighted that by giving mandated clients the ability to identify the goals they want to focus on, their motivations go from being solely externally motivated by the legal system to internally motivated.
From here, there is the ability to eventually tie the goals they have come up with to changes in their behaviors and how they make decisions. An aspect of leading from behind, utilizing our role as a systemic therapist, is to discover an area where we can combine what is essential to the client and the referral source. In considering our roles as therapists with mandated clients, there is the need to highlight the differences in our role as their therapist in comparison to their probation officer, or even the judge. Forte (2019) stated “my job is not to ‘catch’ them if they mess up. Our role is to help them make better decisions so that they do not mess up in the first place, and to support them and help them learn from any mistakes they might make” (p. 4).
Systemic framework
By using a systemic framework, we have shifted our thinking from the “individual unit” to the larger system that allows us to focus on “facts” instead of “cause and effect” (Bowen, 1978, p. 416). Thinking systemically opens the door for clinicians to explore the family unit as a whole, while simultaneously considering each person’s individual differences. Spronck and Compernolle (1997) write “Thinking ‘systemic’ means that one is willing to take into account information about the other levels, the higher as well as the lower ones” (p. 153). Bowen (1978) posits that the function of any system is dependent on the functioning of larger systems of which it is a part, and also on its subsystems. Systemic framework pulls from culture when working with families (Spronck & Compernolle, 1997). In certain cultures, there are conversations that many may not want to have within their family unit. This can bring on shame, guilt, or even regret.
Trauma-informed care
The National Child Traumatic Stress Network (NCTSN; 2021) defines trauma-informed care as a system where everyone involved in working with children, caregivers, and so forth, is capable of recognizing and responding to the impact of traumatic stress. Many times, the first line of contact with clients who clinicians work with are police officers (POs) and/or probation officers (JPOs). The continuation of care and concern can often go unexpressed if JPOs are unaware of a youth’s previous mental health disorders and/or trauma that a youth has experienced.
It is important to take into consideration the complexities of adolescence and teen years.
It could be noted that a youth needs mental healthcare, while not having enough information about how to refer out accordingly based upon the displayed symptoms. Holloway, Brown, Suman, and Aalsma (2013) state that “although POs may be more sensitized to mental health, they may be less sensitive to specific subsets of mental health care” (p. 372). JPOs/POs are often seen as the “gateway” to mental health services for this population (Holloway et al., 2013). As mentioned, with JPOs/POs oftentimes being the first line of contact, a trauma-informed care approach may also provide an added layer of comfort for youth that offers the opportunity to allow for care and concern.
In healthcare settings, healthcare providers and staff are trained to be aware that trauma can be hard on individuals with whom they come in contact (Koetting, 2016). Utilizing the 6-key principles of trauma-informed care (See figure 1.1): 1. Safety, 2. Trustworthiness and transparency, 3. Peer support, 4. Collaboration and mutuality, 5. Empowerment, voice, and choice, 6. Recognition of cultural, historical, and gender issues, individuals in all settings (not just the healthcare systems) can incorporate an environment with the “goal to guide patients from a state of trauma to one of healing…” (Koetting, 2016, p. 212).
According to the Substance Abuse and Mental Health Services Administration (SAMHSA; 2021), “A trauma-informed approach to services or intervention acknowledges the prevalence and impact of trauma and attempts to create a sense of safety for all participants, whether or not they have a trauma-related diagnosis” (p. 1). When an agency or system utilizes trauma-informed care, it can help to assist with re-examining policies that would not offer individuals the feeling of comfort as well as re-examining the training of the staff. One of the main goals of trauma-informed care is to avoid re-traumatization, as well as provide a welcoming environment for individuals who may or may not be experiencing trauma.
Mandated clients are often viewed as harder to work with, at times. This population faces several barriers that range from familial stress to trauma. As we continue to explore, and literature continues to emerge, it is important to take into consideration the complexities of adolescence and teen years. It is highly encouraged that we consider the severity of trauma when working with this population, as well as provide the necessary best course of treatment that would provide the youth with the needed services. Our role as clinicians is often seen as an important part of many of our clients’ lives.
Our role within these family systems offers us the opportunity to explore their worlds and work to process the trauma or life stressors for which they may, or may not, have had the opportunity. It is through the work we do that we can fully grasp the understanding of systems and acknowledge the importance of support, guidance, and homeostasis. Ford et al. (2007) notes “traumatic stress symptoms may worsen as a result of juvenile justice system involvement” (p. 3).
From our experience, the relationships with voluntary clients differ from the relationships with mandated clients. We may find ourselves spending an extensive amount of time in the joining stage, figuring out ways to gain these individuals’ trust, and letting them know we are here for them, to help them, as they navigate their time within the system to move on with their lives. Work with mandated clients is not a walk in the park; there is navigating and balancing work with the client and the referral source, in many cases, the probation officers. But, through it all, there are significant rewards related to the work. These rewards come in the form of a meaningful career, inherent challenges of the field, and standing up for the underdog.
The awareness of the therapeutic relationship is important for many reasons. One of these motives is the increase in the recommendation of mandatory services for clients, as many judiciary systems are noting that psychotherapy is a more practical approach to rehabilitation than incarceration (Razzhavaikina, 2007). As there is an increase in mental health services being recommended by the judiciary system, there is an expectation of positive outcomes for those clients and/or cases.
Research has shown a correlation between successful therapy and the therapeutic relationship; it is no different in the case of therapy with mandated clients. Ultimately, the therapeutic “relationship has been conceptualized as a working alliance, founded on trust, openness, genuineness, and congruence” (Honea-Boles & Griffin 2001, p. 150). As cited by Razzhavaikina (2007), the therapeutic relationship awareness can be beneficial in effective … interventions with mandated clients (p. 4).
A court mandate can alter the therapeutic relationship. Focus on that relationship. Maintaining it is of great importance.

Edmound M. Davis, MS, is an AAMFT Professional Member and a doctoral student at Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, Department of Family Therapy.

Franchesca Meyers, MS, is an AAMFT Professional Member and a doctoral student at Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, Department of Family Therapy.
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