OVERVIEW OF THE MODEL
The task-centered model was developed by William J. Reid and Laura Epstein. It originally grew out of the short-term psychodynamic model of the early 1960s. The short-term psychodynamic model was an attempt to develop brief interventions because research showed that most clients either abandoned psychodynamic therapy after relatively few sessions or received the maximum benefit within a few months with relatively slow improvement after that. The task-centered model quickly left its origins in psychodynamics behind, but retained some similarities: (1) the course of treatment was brief (approximately 8 sessions), (2) focus was on key problems early in treatment, (3) both models helped the client develop specific goals and achieve them.
The task-centered model early adopted an eclectic, yet empirical, approach. The authors were willing to consider any modality that had both shown results in empirical research and could be adapted to brief interventions revolving around specific problems. The model was most heavily influenced by the behavioral model, the problem-solving approach, and learning theory.
Like the behavioral model, task-centered work takes place in short-term service (6 to 12 weeks). It focuses on problems and behaviors (not emotions). Change in both models comes from changing behaviors using specific tasks--usually performed outside the session by the client. Where the task-centered model differs mainly from behavioral work is that the task-centered therapist does not direct the client (or to a much reduced degree), working instead with the client collaboratively to define problems and possible solutions.
The problem-solving approach also became popular in the late 1960s. It, too, has a short-term focus on problems rather than emotions. Practitioners also believe that change comes through changing behaviors through specific tasks. The task-centered model, however, has a greater reliance on empirical research for suggesting modalities for a particular client. It is in this sense more scientifically rigorous than the sometimes common-sense problem-solving approach.
Finally learning theory contributed some theoretical underpinnings to task-centered practice: It is used to explain some of the value of task completion. Although task-centered practice does not rely as heavily on learning theory as it does on the behavioral approaches, it shares the focus on change through task completion (learning new behaviors).
All task-centered work shares certain key assumptions. Most people have adequate resources to solve their problems. Most people have the innate desire to solve their problems. Problems occur in a context of individual, family and environmental systems that may at times block or facilitate their resolution. Human beings are seen as having inherent capacities to solve their problems or to at least ameliorate them to a tolerable level.
It can be seen readily that this approach differs markedly from psychodynamic and other approaches that assume that problems stem from hidden causes that require the intervention of the expert therapist to discover and eventually resolve. Nor does the task-centered approach necessarily assume that a client will present the therapist with resistance; rather task-centered practitioners take for granted that in the vast majority of their work together clients are willing participants, eager to improve their life.
The task-centered model is split into three phases, with a time limit set for the intervention at the beginning of treatment--in collaboration with the client. Most interventions will last between 6 and 12 sessions.
During the initial phase, the practitioner works with the client to identify problems. The practitioner accepts the client's understanding of the problems at face value, showing respect at all times for the client's concerns and expertise about his or her own life. In fact, the practitioner avoids speculation about the client's behavior and problems. (The practitioner may make a "mental note," however, to explore problems at a later date with the client to ensure that their mutual understanding is complete.) During this phase the practitioner determines all relevant information and explores the problem in detail: their frequency, the client's understanding of the seriousness of the problem, its origins, and the client's attempts to resolve the problem (and the outcome of those attempts). The practitioner usually encourages the client to choose no more than three problems to work on during an intervention and asks her or him to set in what priority they should be tackled. Finally the client, with whatever encouragement necessary from the practitioner, sets goals that will show that progress has been made toward resolution of the problem during the intervention. Assessment, process, and outcome data are collected systematically. Target goals are, to the maximum extent possible, defined by specific measurable behaviors. A practitioner might encourage a client who wishes to reduce the symptoms of her obsessive-compulsive disorder, for example, to keep a daily log of hand-washing with the end goal of reducing the behavior by 50% after the intervention.
It is during the middle phase that the main work of the task-centered model takes place. Both the client and practitioner mutually agree to tasks, planned actions, that will take the client step by step toward a resolution of their problems. The model outlines three kinds of tasks. Session tasks are actions that are taken during counseling sessions to further external progress toward the goals. Good examples of session tasks are reviewing progress since the last session, discussing obstacles or resources, and, when necessary, discussing a client's feelings about their tasks when they experience discomfort attempting them. Client external tasks are the most crucial of all. These are the tasks that the client practices outside of session, attempting to learn and use new behaviors. Finally, practitioner tasks also take place outside of session and might include preparing psychoeducational information on new behaviors (such as training a parent in coping skills), locating resources (such as regional agencies), or preparing a reading list for the client. Throughout the middle or task-oriented phase, the client is engaged in self-directed problem solving. He or she actively participates in setting tasks and goals. Every task should lead to increased independence and the client's sense of control. Potential problems or obstacles are dealt with directly during session. These might include lack of social skills (the practitioner might suggest role-playing), lack of environmental resources (the practitioner might help the client locate government or other support), lack of a social network (the practitioner might encourage the client to rekindle family ties), or lack of motivation (the therapist might explore with the client the goals contracted for and whether the client still found them valid for her or himself).
The termination phase begins in the first session when the practitioner outlines suggested time limits for the intervention. The task-centered model proposes a relatively structured termination session: The practitioner reviews with the client the task accomplishments and what remains to be done, highlights the new life skills learned and being exhibited by the client, and makes recommendations for future plans. Although the task-centered model is based on defined time limits, it is not unusual to recontract during the termination phase for a defined extension of the intervention, to work on goals that were not completed or new problems that arose during the intervention. The emphasis, however, is on ending the treatment when the contracted for problems have been resolved or ameliorated.
The task-centered model is applicable to many populations and practitioners: