Mahler’s examples of the Practice Model Assignment, Fall 2003
Task Centered Casework- a planned short-term approach of 6-8 sessions in which a sharp focus and continuity are maintained. TCC follows a problem-solving model. The client must show a willingness to work on a specific problem(s) and the problem must be manageable to the worker and client.
TCC’s theoretical base draws heavily from the ego analytic model in which the person’s capacity to function can be built upon by helping him/her use problem-solving skills, and by keeping the person goal-directed and focused. Psychological and external obstacles that interfere with carrying out the intervention plan require additional problem solving tasks for the worker, client and significant others. TCC shares many common tenets with crisis theory and intervention. Peoples’ motivation and capacity to deal with their own life problems are increased by being an active participant in short-term therapeutic process.
The goals are directed at problem resolution. By identifying the target problem and working with the client to set realistic goals and strategies/tasks to reach these goals, the client is more likely to attain his goal and to feel increased self-efficacy.
I. Identify the target problem/issue to focus upon. Highlight the goal the client wants to work toward.
II. Classify the type of problem the client is experiencing.
a) interpersonal conflict-with specific persons who are frequently interacting with each other
b) dissatisfaction in social relations- general social difficulty that occurs with many persons
c) role performance problem- e.g. parent, student, worker
d) problem of social transition- life or role change adjustment problem
e) reactive emotional distress- having difficult feelings in reaction to specific event
f) decision-making problem- specific decision is pressing and client feels stuck &/or overwhelmed
g) inadequate resources- lack of tangible resources or insufficient environmental supports
III. Develop an intervention plan which includes the worker and client's tasks in chronological order. This could involve brainstorming possible intervention strategies/tasks with the client.
Follow the steps suggested in the Task Implementation Sequence (TIS)
a) Enhance the client's commitment to carry out a task (for each task)
Consider the advantages and risks of each task. To increase client commitment, employ rewards (better if relationship based) e.g. self-reward and make sure to reward small changes.
b) Plan the details of carrying out each task- who will do what, where and when. Make sure the individual knows how to carry out the task. If not, this is an obstacle that can be overcome. See next step.
c) Analyze and resolve obstacles to carrying out each task-- draw out any apprehension (pay attention to non-verbals), misconceptions or fears that might keep the client from task accomplishment. Discuss these and try to help the client overcome anxiety. If anxiety is high, you may need to use relaxation training, modeling, rehearsal, cognitive restructuring or even abandon the task. Certainly do not start with a difficult task. Ask the client how ready they feel to carry out the task (on a scale from 1 to 10, they should be 7 or higher)
d) Have clients rehearse or practice new or insufficiently learned behaviors. Bandura writes about ways to increase self-efficacy, another word for empowerment. (Let's discuss this!)
e) Summarize the plan, including any steps to cope with anticipated obstacles, and show interest in hearing about their experience with the task(s) next session. This conveys an expectation that sessions are action-oriented.
IV. Implement the intervention plan- each week review the client's progress with carrying out his/her tasks and make sure to carry out your (worker) tasks or ensure that other helpers are following through as agreed. If obstacles arise, try to understand and resolve them (see step C above in TIS).
V. Evaluate the task accomplishments and make sure the client can take credit for his/her achievements. This is empowering and shows them that goals were attained through their efforts.
VI. Re-contract to work on another target problem/goal or terminate. Review accomplishments and remind the client of the new behaviors, skills, resources they obtained that helped in this situation and could be helpful in the future. Some workers suggest anticipating problems that could occur in the immediate future and ways that they could deal with them (anticipatory guidance).
The problems addressed by TCC include: See II a-g, above. The model does not work as well when the client does not recognize a problem or the problem involves a chronic psychological disorder, e.g. a psychotic disorder.
TCC can be effective with individual, couple, family, and group client systems. Sessions one and two are focused on assessment which includes a listing, and prioritizing of the target problems into achieveable goals. The goals are then broken into smaller more specific objectives (partializing), and strategies and tasks which could be useful toward goal attainment.
TCC can be useful with any size client system as long as their problems can be identified, prioritized and adapted into achievable goals. TCC does not stress client strengths although building upon the client’s resources and skills is an important dimension of the intervention plan. TCC would be more difficult to apply effectively with particular cultures that believe “Fate” must be accepted. TCC would also be difficult to apply in multiple client systems in which shared and reciprocal goals need to be negotiated.