Providing Mental Health Services to TANF Recipients: Program Design Choices and Implementation Challenges in Four States. Expansion of Existing Mental Health Services


Two of the study states, Florida and Utah, have used TANF funds to expand community mental services. Florida contracts with a wide variety of community providers to provide the full range of mental health services to TANF recipients, including individual and group counseling, marital therapy, intensive case management, substance abuse treatment, and numerous other nonmedical treatment options. These services are also available to those at risk for TANF involvement. Florida is the only state that provides funding to existing providers to provide long-term therapy for TANF clients. Utah uses a more targeted approach to expanding the services available to TANF recipients. Generally, clients who need extensive mental health treatment are referred to Medicaid-funded providers. However, if the wait for services at a Medicaid provider is longer than two weeks, or if the services needed are not available, the client can be referred to a mental health professional who is not funded through Medicaid. Contracting out mental health treatment also allows the program administrator to determine the treatment model or approach used by the contractor, which they cannot do with a Medicaid-funded service provider.

Tennessees Solution-Focused Brief Therapy

In Tennessee, in-house mental health counselors are trained extensively in solution-focused brief therapy and are expected to use it in providing treatment to TANF clients referred to their program. The objectives of solution-focused, brief therapy are to identify the problems that keep a client from becoming employed and to explore options for resolving those problems. Solution-focused therapy is based on four major concepts:

  1. The overall goal is change. The counselors role is to guide clients through the process of identifying what needs to change to improve their circumstances, and to motivate and encourage clients to make these changes.
  2. There are practical solutions to problems. The counselor helps clients to focus on what is possible and changeable, and to outline a plan for working through barriers.
  3. Clients define their goals and determine how they will reach them. The counselor raises clients consciousness about problems by pointing out discrepancies in their handling of issues, rather than by telling clients what they need to change and how they should do it.
  4. It is important to identify and tap into clients strengths and resources. The mental health counselor helps clients recognize and tap into their own strengths and resources to solve problems.

View full report


"TANF-MH01.pdf" (pdf, 763.2Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®