Introduction to Social Work



Chapter 5. Crisis and Task-Centered Theory

Crisis intervention and task-centered appears attractive to some practitioners due to the use of brief, structured models of intervention that addressed clearly definable problems and respond to active interventions. The use of defined positive aims and action sequences makes them easy to understand and apply. By giving priority to the main issues identified by clients, these models encourage commitment by practitioner and client, thus supporting professional working alliance and the shared principles of human rights. Finally, there is an evidence base for their efficacy. Taking all into account, both models are easy to justify in busy agencies. However, the some of the reasons for their popularity also point to issues that lead to criticisms of the use of these theories.

Terminology

Crisis is used in two ways: to refer to a process of events in people’s lives that provides a focus for practitioners to work with clients and to refer to commonly occurring elements in life that presents a series of maturational tasks to complete.

Brief interventions are used by both crisis and task-centered practice interventions.

Structured, planned and directive programs of intervention are used in crisis and in task-centered practice interventions.

Tasks are structured elements of intervention in task-centered practice, but are also important challenges in life that have to be overcome in order to achieve emotional satisfaction and to maintain positive social relationships within crisis intervention.

Contracts or agreements with clients help them to participate in and structure treatment plans.

Key Ideas

Crisis intervention began in preventive mental health work.

Crisis intervention began in preventive mental health work. Traditional crisis intervention draws from ego psychology from a psychodynamic perspective while recently a wide range of theoretical perspectives have been incorporated. The primary focus is on emotional responses to external events and how people can be helped to control them to allow them to move on and resolve the difficulties that they are facing.

Task-centered work originated in social work with some cognitive-behavioral influences.

Task-centered practice began with the discovery that shorter-term psychotherapeutic treatment was as effective as longer treatment as well as short-term treatment focused on specific problems. Task-centered practice continues to be influential due to well defined procedures and good fit within social work roles as well as proven effectiveness in a variety of countries and situations. The primary reason for effectiveness is that the basic elements of the approach help to gain clients’ commitment through a clear focus on the specified outcomes as they are concerned about and a limited time commitment—an example of ‘alliance’. Compared with more therapeutic approaches, task-centered practice is a practical, advice-giving style of work valued by clients who prefer more direction rather than exploration. Other brief approaches such as cognitive-behavioral and solution-focused practice as well as task-centered social work are the most widely used examples of a range of ‘brief treatment’ approaches.

Crisis intervention and task-centered practice models have some common features.

Both stress brief interventions, are highly structured, and use explicit agreements (sometimes called contracts). Contracts or explicit agreements between worker and client are used in both models.

They also have some differences.

Task-centered work deals with a wider range of problems and emphasizes clear definitions of target problems, tasks, client self-direction, time limits, and having a clear structure and focus in the process of work.

Both are attractive to public agencies.

Both theories are attractive to public agencies as they provide technical responses to immediate problems as well as being attractive to supporters of problem-solving views of social work compared with those favoring the explicit political focus of critical theories. Also, people approaching agencies for help often do so when they are experiencing crisis in their capacity to manage their own lives.

Both have shared values principles.

Both focus strongly on the shared value principles of transparent and accountability to clients as they are strongly focused on clearly specified, positive outcomes and specified outcome sequences. XXX

The most important applications of crisis management is in emergencies.

The most important ones include suicide prevention, rape, domestic violence, etc. The use of crisis intervention in these services reflects the current inclusion of psychological and mental health responses to serious events.

Issues

The major areas of debate about these models regard their short-term focus and structured programs.

Some practitioners criticize both models as they believe the success of the models may detract from other ways in which they are not effective. These models’ highly structured nature and the short-term focus mean they are not the first choice for many situations (such as long-term psychological problems) while they may be used when a specific problem or particular crisis occurs. Even then, however, supportive work, further services, and long term efforts will be required. Finally, neither model works well with people who do not accept the right of the worker or agency to be involved in helping them.

The simple nature and clarity of the models may oversimplify the complexity of issues in peoples’ lives.

The models’ structured nature and focus on ‘crisis’ and ‘task’ may define social problems in behavioral terms according to the practitioner’s assumptions, thus leading to a failure to identify broader social issues and structural failings. But they may help a practitioner get a foot in the door in a complex situation or where a short timescale is useful where clients have limited capacity or commitment to the intervention.

However, they represent a trend toward clearer, more focused activity.

This trend has been criticized for an overemphasis on emotional reactions. However, by focusing on the present and the resolution of specific issues rather than an overall cure the interventions address immediate issues.

This clearer, more focused activity is associated with problem-solving.

In both approaches, this reflects a liberal or neo-liberal problem-solving philosophy and social order perspective. Problems are treated much like an illness and thus these approaches are oriented to achieving problem solving. Crisis intervention places more emphasis on emotional responses and irrational or unconscious behaviors than task-centered work that assumes clients exhibit greater rationality.

The problem solving use of ‘contracts’ is criticized for promoting an artificial equality.

Some argue that the talk about ‘contracts’ with clients implies an equality that conceals the hidden power in the relationship due to the practitioner’s official role and professional status. This power imbalance may prevent the mutual cooperation implied by the theories. On the other hand, contracts make the relationship more specific as well as promoting shared desired ends. While potentially beneficial, contracts may make a client feel pressured by the practitioner or agency.

There is a political critique around agencies’ potential misuse of these models of practice.

The very success of the models when used by agencies in dealing with presenting problems may result in society avoiding longer term and more deeply seated responses to social oppression. As a result, these approaches may conceal resource inadequacy and the failure of political will to respond realistically to keep-seated problems of poverty and social equality.

The research-based effectiveness of the theories provides support for managers & funders.

Managers and funders tend to find task-centered work more politically acceptable because of its research-demonstrated effectiveness. This is particularly important given the degree of criticism faced by social work at times regarding ineffectiveness of interventions applied while using public funds.

Final thoughts…

Many agencies and practitioners use concepts of crisis intervention and task-centered practice to create practical, short-term interventions. Crisis intervention theory provides a process for exploring and understanding events that seem to have disrupted people’s ability to manage situations such as danger, victimization, loss and developmental crises. For example, crisis intervention is widely used in emergencies such as suicide prevention, rape, domestic violence, and the mentally ill who are losing their ability to function. A wide range of practical therapeutic interventions can be built on that understanding using other practice theories. Even where an agency does not deal with emergencies, crisis intervention may offer a helpful set of concepts at the assessment stage. Task-centered practice offers a useful process when specific action to address a problem is needed within a situation where the practitioner’s main role is ongoing care and support. Task-centered practice is particularly helpful because it respects clients’ priorities, can be clearly explained and justified to clients, families, and communities as well as to agencies and politicians. [pic]

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