Some authors make the distinction between people who have been mandated or legally required to participate in AOD treatment and people who are in treatment non-voluntarily or involuntarily as a result of varying degrees of pressure from organizations, agencies, or other people. Other authors make the distinction between mandated and coercion, with mandated being the referral source, while coercion refers to the client’s perception that they are being encouraged or required to participate in treatment.

However, it should be noted that even in mandated situations, people are rarely required to accept AOD treatment as a part of criminal sentencing, employment, or some other contingency. Rather, in most situations, individuals are given a choice of treatment in lieu of alternative consequences for their AOD use. If individuals refuse the treatment option - or do not comply with the conditions of treatment - then alternative sanctions or actions (i.e. loss of job, incarceration) are imposed. While technically so-called mandated clients are being encouraged to enter treatment, in one sense they are “choosing” AOD treatment over other options. (47)

The completely voluntary client rarely appears for any type of treatment. There is evidence that many so-called “self-referred” clients feel they are being encouraged or coerced into treatment by people around them. At the same time, many mandated clients report they do not resent being forced into treatment.

Whether a client is voluntary or involuntary may also vary according to whether the client views the treatment as desirable or undesirable. Therefore, coerced treatment can include individuals who “volunteer” to enter treatment usually as a result of informal pressure from family, friends, the court, or their employer, as well as individuals who are essentially forced into treatment because they have few other available options. It is probably best to look at how a client comes to treatment on a continuum from the voluntary client, to the client who feels varying degrees of informal pressure, to the legally mandated client.

Review Questions for Section II

Is it true or false that completely voluntary clients rarely appear for DOA treatment?

Is it true or false that many mandated clients report they do not resent being forced into treatment?