Although the assessment process is ongoing, once the initial assessment is complete a treatment plan is developed that is designed to address the client’s identified issues. I will cover direct practice and counseling techniques appropriate for clients served in particular practice settings in more detail in subsequent chapters, but there are basic techniques involved in generalist practice that apply in a broad way to most counseling and intervention situations.
Many individuals seeking services at a human services agency will need assistance with developing better coping skills. Regardless of whether the problems experienced by the client are pervasive or more limited, most clients can benefit from learning to manage high levels of stress, learning to prioritize the various problems in their lives, and learning how to manage the current crisis in a way that diminishes the possibility of a domino effect of crises. A crisis with one’s child requiring a significant amount of time and attention can quickly result in a job loss, which can in turn result in the loss of housing. Confronting crises effectively, though, can have a positive impact on one’s life, including an increase in self-esteem, the development of new and more effective coping skills, the gaining of wisdom and the development of new social skills, and the develop- ment of a better overall support system.
Most mental health experts recognize that one of the best opportunities for personal growth is a crisis, due to the possibility of shaking up long-standing and entrenched maladaptive patterns of behavior. Park and Fenster (2004) studied stress-related growth in a group of college students who experienced a stressful event and found that the struggle involved in a life crisis produced personal growth. This is true, though, only for those who expend the necessary energy to work through their struggles in a positive way. Those in the study who remain negative and avoided dealing with the problems borne out of the crisis did not take advantage of the growth-producing opportunities and thus did not experience any significant personal growth. Those who worked hard to manage the stress resulting from their crisis and were able to see the crisis as an op- portunity for growth often developed better personal mastery skills and developed a changed and healthier perspective. Recognizing this potential for personal growth
provides the practitioner with a framework for assisting clients in developing better coping skills that not only can better assist them in the management of concrete prob- lems, but can also help them to shift their entire perspective of life struggles in general. For instance, clients who once saw themselves as powerless victims can begin to see themselves as empowered survivors.
Task-Centered Casework
When most individuals are confronted with a crisis, panic sets in, and it becomes dif- ficult to address the problem in a healthy or meaningful way. Most of us can relate to feeling completely overwhelmed when facing a life crisis. We know there are things we need to do to manage the crisis, but all we see is a gigantic mountain looming before us. For some, this has a motivating effect, and they attack the mountain until every issue is resolved. But for some, particularly those with a long history of crises, those with poor coping skills, or those suffering from emotional or psychological problems with dimin- ished personal management skills, the mountain can seem virtually insurmountable, and their response is to shrink away with a feeling of despair and defeat.
A counseling technique called the Task-Centered Approach, an intervention strategy developed by the School of Social Services at the University of Chicago (Reid, 1975), works well with clients who feel paralyzed in response to the challenges of various psy- chosocial problems. Treatment is typically short, lasting anywhere between two and four months, and is focused on problem solving. The client and counselor or caseworker define the problems together and develop mutually agreed-upon goals. Each problem is broken down into smaller and more easily manageable tasks. Goals can be as tangible as finding a new job or as intangible as more effectively managing frustration and anger. Rather than having one broad goal of obtaining a job, a client might have a week-one goal of doing nothing more than looking at the want ads in the local newspaper and a week-two goal of making one phone call to a prospective employer. Dividing large goals into smaller, specific, “stepping-stone” goals diminishes the possibility that clients will allow their anxiety to overwhelm them. By focusing on specific problems and break- ing them into “bite-sized,” manageable pieces, clients not only learn effective problem- solving skills, but also gain insight into the nature of their problems, develop increased self-esteem as they experience success rather than failure in response to meeting goal expectations, and learn to manage their emotions, such as anxiety and depression, with- out allowing such states to overtake and overwhelm them.
The counselor or caseworker assists clients in meeting goal expectations through a variety of intervention strategies specific to the actual problem, but can include plan- ning for obstacles, role-playing (where the client can actually act out difficult situations in the safety of the counselor’s office as a way of practicing communication, etc.), and mental rehearsal (similar to role-playing but involves the client thinking or fantasizing about some specific situation—such as an upcoming job interview or a difficult con- frontation) (Reid, 1975). Revisiting original goals and evaluating client progress are also powerful tools in helping clients experience a sense of personal mastery and empower- ment as they are helped to recognize their progress.