Sources of Clients for Therapists

As therapists, we are often so consumed with our day-to-day practices that we fail to analyze the sources of our client base and our pattern of responses to them. Lynn Grodzki has been a mentor to many, providing insight into the machinations of referral sources while advocating that therapists make conscious decisions about their practices. In her article, Forks in the Road, Grodzki offers novel conceptions of the paths through which clients come to our door and the ways we work with them. She suggests that we and our clients travel one of three paths: (1) Insurance-driven, (2) Consumer-driven, (3) Belief-driven.

Another Fork in the Road

My experience suggests a fourth path: Court-driven clients. Like the other three sources, these clients come with their own set of motivations, struggles, and potential. In the case of court-driven clients, therapists are actually termed treatment providers. Their job is to challenge errant behavior by identifying its impact on others (“It will do harm. There will be consequences.”), help clients to recognize their destructive thinking and teach them to make healthy choices, creating better relationships and a more accountable life.

Courts are a Source of Clients

Court-driven clients are most frequently referred for drunk driving and other alcohol-related offenses, domestic violence, other-than-partner assault, possession and delivery of illicit substances, sexual abuse, and shoplifting. How many of these clients are sent to therapists each year? Their numbers rival the other groups which Grodzki has identified. It’s hard to get firm figures because each of the many District and Circuit Courts in the United States is an entity unto itself, but we do know that there are almost 3000 Drug and other problem-solving courts across the country with an average of 100 clients each totaling 300,000. Add on the other offenders who get more traditional referrals, and I guess that there are between a million and two million court-driven clients referred to treatment.

Therapists do not often seek out court-driven clients. Why not? Because (1) most private practitioners do not understand the court system and nobody’s told them where to look for clients, (2) they fear them (they are criminals, after all,) and the court system itself with its labyrinthine and convoluted ways, and (3) they assume that clients who are mandated for counseling will not be motivated. In fact, my experience is that the elders in treatment groups quickly help new referrals adopt a positive attitude and get with the program. Most make genuine change and are grateful for the experience.

Make Court-Referred Clients Part of Your Successful Therapy Practice

Some therapists make the assumption that they need to be associated with a licensed/accredited agency in receive court-referred clients. At the present time, there is no commonly accepted requirement. If you haven’t looked into making court-driven clients a part of your practice, you owe it to yourself to make the conscious decision Lynn Grodzki advocates. Find out how your local Drug Courts works, and investigate the availability of clients in your community. If you don’t, you may be missing out on a steady flow of clients who are required to pay for your services. You’ll also pass up rewarding teamwork with the courts and the gratification of helping clients make dramatic change.

As a treatment provider I received training by the Federally-funded National Drug Court Institute. In the book Restorative Treatment for Drug Court and Domestic Violence Clients, I describe the drug court movement and other court-driven client programs. Restorative Treatment details how social workers and therapists can prepare themselves to enter the fastest growing specialty in counseling. It also shows how working with a clientele that may initially appear to be resistant to treatment can in fact be rewarding both personally and financially.