Abstract
Given the general acceptance of the importance of the therapeutic alliance in alcohol and other drug (AOD) treatment, it becomes vital to understand factors contributing to the creation and sustainability of the therapeutic relationship. This study explores one aspect: the treatment approaches of AOD counselors’ towards mandated and self-referred clients. This qualitative, exploratory study uses grounded theory and a social constructivism philosophical approach. Phenomenological content analysis using latent and manifest coding was applied to the interviews. The subjects were nine AOD counselors currently employed in the field for at least two years in Yolo, Sacramento, and Alameda counties. Three themes emerged: 1) all AOD clients are coerced into treatment, whether or not by the criminal justice system; 2) counselors frequently employ a different approach to clients mandated by the criminal justice system during the initial stages of treatment; and 3) counselors perceive that employment and structure in the client’s life have an impact on treatment outcomes. Implications for social work practice and policy are discussed.