Early removal of resistance in task-centered casework

Abstract

Dean H. Hepworth, Ph.D., is Pro fessor, Graduate School of Social Work, University of Utah, Salt Lake City, Utah. Dean H. Hepworth In attempting to produce changes, studies were also conducted, disclosing social workers and their clients are with unanticipated consistency that constantly beset with countervailing brief therapies were as effective as forces. Until the past two decades, long-term therapies and, in some in these obstacles were imputed to unstances, more effective.4 conscious resistances, inertia, and fears The findings of one such study un of the unknown, as well as to nuances dertaken in social work ultimately of the helping relationship, including led to the formulation of a new model negative transference and counterof practice, task-centered casework transference. Resistance was viewed (TCC).3 This article will briefly re as a powerful force that, at best, review the emergence of this model and quired a lengthy phase devoted to highlight the elements of the model working through the resistance and, at that avoid the defects of prolonged worst, precipitated premature terminatreatment. The primary purpose of the tion. Successful treatment, therefore, article is to discuss a major refinement was understandably viewed as requirof TCC, the task implementation se ing an extended period of time. Ironiquence (TIS), and to delineate guide cally, rapid progress in therapy was lines for the use of TIS. This re viewed with suspicion; indeed, if pafinement enhances and accelerates tients did not remain in therapy for therapeutic change by anticipating and an extended time, the therapist's comresolving barriers before rather than petence was suspect. after they become impediments to In the 1960s, authors began to chaiprogress, lenge the prevailing views of resistance In keeping with the trend toward and to posit the view that the proshort-term intervention, Reid and longed time required for successful Shyne designed and conducted a rig treatment was often a result of defecorous empirical study that compared ive treatment methods. Masserman, the efficacy of traditional, open-ended for example, took the position that casework with planned short-term ser resistance may be a healthy response vice (PSTS).7 Consistent with findings to poor treatment technique.1 Hoch from related studies, their findings maintained that prolonged psychoshowed that the outcomes of the short therapy tended to foster resistance term treatment group equaled or sur that required long stretches in treatpassed those of the open-ended, con ment to overcome.2 Wolberg specifitinuous service group, both at the cally criticized the practice in longpoint of termination and six months term therapy of permitting the patient later. Impressed by the results of this to wallow in resistance until he someresearch, Reid and Epstein subse how muddles through. Noting that quently conceived the task-centered where time is of no object, the theramodel of casework, incorporating the pist can settle back comfortably and major research findings. In brief, the let the patient pick his way through key elements of this model are planned the lush jungles of his psyche, Wolbrevity, usually eight to twelve inter berg further implied that long-term views over a period of two to four therapists should be faulted for their months; sharp focus and specificity in passivity and their failure to provide defining target problems and treatment direction to treatment.3 goals; the use of explicit agreements or Recognizing that the sources of recontracts that are negotiated with the sistance included defects in the treatclients; an emphasis on action in ac ment process was a theoretical milecomplishing mutually determined be stone, for it opened the door to major havioral tasks integrally related to the changes in the treatment process that treatment goals; and the organization held promise of accelerating the rate of interventions into a sequence of of progress by clients. Short-term thersteps or phases.8 apies subsequently evolved rapidly, A major strength of TCC, which achieving in the 1960s a strong momade its debut in 1972, is that it is mentum that has continued to the presrooted in empirical research. Refine ent. Numerous concurrent research ments of the model have been a pro