Abstract and Keywords
Task-centered practice is a social work technology designed to help clients and practitioners collaborate on specific, measurable, and achievable goals. It is designed to be brief (typically, 8–12 sessions) and can be used with individuals, couples, families, and groups in a wide variety of social work practice contexts. With nearly 40 years of practice and research arguing for its effectiveness, task-centered practice can rightfully claim to be one of social work’s original “evidence-based practices,” though the relative paucity of research on its effectiveness in this decade suggests that the approach itself may have become increasingly integrated into other brief social work technologies.
Task-centered practice (TCP) is now well into its fifth decade as a social work practice model and has matured as a social work generalist practice tool that can empower clients to solve a wide variety of problems. Originally formulated by Laura Epstein (1914–1996) and William Reid (1928–2003) at the University of Chicago’s School of Social Service Administration (SSA), the approach has been adopted by schools of social work and social work practitioners internationally, and the key textbooks for TCP have been translated into numerous languages. Many popular recent social work brief treatment approaches, such as narrative therapy and solution-focused brief treatment, have incorporated facets of TCP, and many key ideas of TCP are being taught in American, European, and Asian schools of social work generalist practice courses. However, despite the seeming prevalence of the approach in multiple international settings and its potential applicability to a wide variety of problems typically treated by social work practitioners, TCP struggles to gain the recognition and respect it deserves as a social work practice innovation.
Definitions and Descriptions
TCP involves a four-step process that trains social work practitioners to work closely with clients to establish distinct and achievable goals based on an agreed-upon presenting problem, usually called the target problem. Under TCP, a maximum of three target problems are identified by the client, and the social worker collaborates with the client on devising tasks to work on those target problems. The social worker and client co-create a contract that contains the target problem, tasks to be implemented by both client and practitioner to address the target problem, and overall goals of the treatment. At all times through the process, TCP emphasizes client preferences by asking clients what they most want to work on to address their problems. Client priorities and strengths are interwoven into the entire TCP process. Most TCP involves working briefly with clients, typically 8–12 sessions over the course of a 6-month period (Reid & Epstein, 1972).
The phases of TCP are both straightforward and flexible enough to be applied in almost any social work practice context (Marsh & Doel, 2005). After the target problem has been successfully defined (Step 1) and goals have been established to help deal successfully with the target problem (Step 2), a contract is created between the practitioner and the client that includes a schedule to help facilitate the intended changes (also Step 2). After several sessions, in which clients and practitioners share the outcomes of the specific tasks they agreed to carry out (Step 3), the sessions turn to focusing on how well the overall goals have been accomplished and whether another task-centered goal-setting process is necessary or whether the social work intervention has been successful enough to consider termination (Step 4) (Reid & Epstein, 1972). TCP developers Epstein and Reid acknowledged that these steps, while meant to be sequential, can often overlap and require that practitioners be trained to maximize the potential benefit of each step in the process when helping a client.
Main Developers and Contributors
The TCP approach began with Epstein and Reid’s work at SSA, with the major initial research and development of TCP taking place under their direction between 1970 and 1978. During that time, the SSA project had over 100 graduate students helping Reid, Epstein, and their research team test out TCP interventions in a variety of settings common to social work practice—for example, schools, child welfare agencies, and hospitals. Their initial findings demonstrated that TCP was a potentially effective and flexible modality to employ with a wide array of client populations and problems. Since that pioneering era of TCP, over 200 books, articles, and dissertations have been published describing the TCP approach and demonstrating its effects in a host of social work practice contexts. Reid and Epstein have continued to publish on TCP, and have been joined by Cynthia Bailey-Dempsey, Anne Fortune, Matthias Naleepa, Ronald Rooney, and Eleanor Tolson as major academic proponents of TCP (Fortune, McCallion, & Briar-Lawson, 2010).
Statistics and Demographics
TCP has become firmly ensconced in most generalist social work practice textbooks, and most students learn at least the rudiments of TCP in their introductory classes. Reid continued to write about TCP until his passing in 2003, and other TCP leaders continue to emphasize TCP’s benefits in this new era of evidence-based practice. However, despite having TCP adherents in the academy, it is unclear what the perception is of TCP in the larger social work practitioner community. To some extent, TCP may be a victim of its own success in this respect. Many new social workers may just assume that the process of setting discreet measurable goals with clients on the basis of the clients’ ideas about what they would like to change is simply good social work practice rather than being rooted in the principles of TCP.
Similarly, because advocates of TCP have always maintained that it is a social work technology that can be viewed as both a psychotherapeutic and a casework intervention, perhaps the other therapeutic techniques that many social workers favor today (solution-focused brief therapy, narrative therapy) are more prominent more because they emphasize the application of clinical skills over casework methods and thus appeal to the desire of some social workers to be therapists first and social workers second. Interestingly, these other brief therapy methods borrow heavily from the core concepts of TCP (respecting client views of the problem, helping the client set goals that they want to work on), though proponents of these approaches seldom explicitly acknowledge their debt to TCP, preferring instead to emphasize constructivist therapeutic ideas and the importance of cognitive-behavioral therapy research largely conducted in psychology. The comparison with cognitive-behavioral therapy is particularly interesting, as it is slightly older as a treatment technology than TCP, but it has been given far more attention from both researchers and practitioners in social work and other mental health fields. This may be another example of social work not being able to celebrate and further refine one of its own contributions to the knowledge base.
Task-Centered Practice (TCP) is widely taught within school curriculum and can be utilized at the micro (therapist and client), mezzo (administrator and organization), and macro levels (community leaders and community) (Doel & Marsh, 1992).
Many social work practice settings are good fits for TCP: hospital settings with their emphasis on brief treatment and discharge planning; schools, with the increasing emphasis on identifying specific behavioral and social/emotional goals for students to work on; private practice and community mental health settings, wherein clients are encouraged to set concrete goals to fulfill the mandates of managed care and brief treatment; and gerontology settings, wherein older clients and their families need help identifying target problems and marshaling their resources to address those problems in a step-by-step fashion. Practitioners using TCP may be able to increase the effectiveness of their interventions with clients in all of these settings, and may be able to do it in a way that is culturally relevant for their clients. TCP studies have shown that TCP is applicable among culturally diverse clients, in part because it empowers them and honors clients’ right to self-determination (Tolson et al., 2003). Researchers have studied all these areas using TCP and have found that TCP bolsters client participations in treatment planning, increases pro-social behaviors, and empowers clients to accomplish the treatment goals they are most interested in achieving (Reid, 1997).
Current Evidence on TCP and Its Connection to Evidence-Based Practice (EBP)
Like all models of casework and clinical practice, TCP cannot claim to be universally effective for all clients and all problems. However, given the over 200 published works on it, TCP stands as one of the most studied so-called home-grown social work technologies in the profession’s history. Sadly, with the death of Reid, it seems that interest in further establishing the research base for TCP’s effectiveness has slowed considerably. Since 2000, there have been fewer than 20 published works on TCP, and many of those works have been mostly in the form of books, book chapters, and conceptual pieces rather than experimental studies of TCP’s effectiveness (though there was a recent quasi-experimental design published showing that TCP groups helped adults with schizophrenia in India reduce the severity of their symptoms; Verma & Chaudhry, 2017). Though the early developers of TCP research had written consistently of the need for further refinement and adaptation of the model, few current researchers appear to be adding to the empirical research base of TCP. A 2010 book honoring the legacy of TCP described innovative applications of TCP in 10 countries in Europe and Asia, though no new experimental trials of TCP research in the United States were cited beyond the current literature available, and this was supported by the research done in preparing this revision (Fortune et al., 2010).
A book chapter on TCP by Reid and Fortune published posthumously (2004) correctly identified TCP as an “exemplar” of evidence-based practice. Indeed, TCP can claim to be one of social work’s earliest examples of an evidence-based practice that was tested rigorously (including randomized controlled trials) and found to have modest but nonetheless consistently powerful effects for clients when compared with control groups (Reid, 1997). In this respect, supporters of TCP can rightfully claim that there is empirical support for TCP, though they would also readily acknowledge that much more study needs to be done on what clients and problems may benefit most from TCP. However, proponents of even more transparent approaches—for example, the kind of evidence-informed practice that Gambrill, Gibbs, and other EBP proponents favor, may chafe at the implication in TCP that, while social workers using TCP make every effort to include clients in formulating the target problem to work on, they still maintain their authority as the director of the TCP process rather than being equal co-collaborators (Gambrill, 2006).
Distinctiveness and Integrations of the TCP Model
Many of the central principles of TCP are now considered simply good social work practice; its influence has contributed to the theoretical move away by the profession from uniformly subscribing to a psychodynamic long-term treatment model embedded in the medical model to diagnose and treat clients. The client-centered qualities of TCP are congruent with social work’s roots, in that TCP challenges social workers to start where the clients are and stay in that place until the clients feel their problem is solved (Blakely & Dziadosz, 2014). Experts in TCP freely acknowledge that TCP is less a stand-alone model than an approach that can be easily adapted into multiple social work practice frameworks and practice settings (Reid, 1992). This may ultimately be its major contribution to the field of social work practice: a sturdy yet flexible practice technology that contains enough rigor to be consistently effective but also enough space to be adapted creatively to an incredible number of social work practice contexts. As Rooney noted in his review of TCP’s history in the United States, “there are worse outcomes than being absorbed into a general model of good practice” (Rooney, quoted in Fortune et al., 2010, p. 200).
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