When people seek psychological support, formulation is the theory-driven methodology used by many practitioners to guide identification of the processes, mechanisms, and patterns of behaviour that appear to be contributing to the presenting difficulties. However, the process of formulating – or applying psychological theory to practice – can often seem unclear. In this volume, we present multiple demonstrations of formulation in action – written by applied psychologists embedded in clinical training, research, and practice. The volume covers a range of contemporary approaches to formulation and therapy that have not been considered in extant works, and includes unique sections offering critical counter-perspectives and commentaries on each approach (and its application) by authors working from alternative theoretical positions.
The first edition of Formulation in Psychology and Psychotherapy caught the wave of growing interest in formulation in a clinical context. This completely updated and revised edition summarises recent practice, research, developments and debates while retaining the features that made the first a leading text in the field. It contains new chapters on personal construct formulation, formulation in health settings, and the innovative practice of using formulation in teams. The book sees formulation as a dynamic process which explores personal meaning collaboratively and reflectively, taking account of relational and social contexts. Two case studies, one adult and one child, illustrate the use of formulation from the perspectives of expert clinicians from six different theoretical positions. The book encourages the reader to take a constructively critical perspective on the many philosophical, professional and ethical debates raised by the process of formulating people’s problems. Among the issues explored are: The social and political context of formulation Formulation in relation to psychiatric diagnosis The limitations of formulation Controversies and debates about formulation This readable and comprehensive guide to the field provides a clear, up to date and thought-provoking overview of formulation from a number of perspectives, essential for clinicians working in all areas of mental health and social care, psychology, therapy and counselling.
Individual Case Formulation presents formulation as a process that can be taught systematically to trainee therapists. The book begins by discussing assorted theories of case formulation, and critiques their ability to be applied in real world situations. The individual case formulation approach is then defined and discussed as a way to integrate the best of what different theoretical orientations have to offer in conjunction with the expertise and clinical judgment of the therapist. The book proposes a systemic/functional framework that focuses on difficulties as defined by the client and emphasizes constructive solutions to problems rather than symptom reduction. Moving from theory to application, the book then guides therapists in how to conduct assessment interviews, how to reach a provisional formulation, how to test that formulation for accuracy and reformulate if necessary, how a therapist can make explicit what their clinical reasoning was in making the case formulation, and provides case examples and transcripts so readers will better grasp the concepts in action. Intended both for the starting or trainee therapist and the experienced clinician, Individual Case Formulation provides a practical guide for those looking to improve their case formulation skills. - Reviews, critiques and compares multiple theories on formulation - Identifies benefits of utilizing the individual case approach - Guides trainee therapists how to conduct assessment interviews and reach a provisional formulation - Presents a conceptual framework for developing and testing a formulation - Helps trainees make explicit their clinical reasoning - Field-tested for several decades - Provides case examples with annotated transcripts to illustrate the process of formulation
Formulation as a Basis for Planning Psychotherapy Treatment utilizes a step-by-step structure and copious case illustrations to teach psychiatrists, residents in psychiatry and psychology, social workers, and marriage and family counselors how to plan treatment after the initial diagnosis. This new edition arrives two decades after the first, with revised content, updated case studies, and new insights gleaned over the author's noteworthy career. Clinical formulation, also known as case formulation and problem formulation, is a theoretically-based explanation or conceptualization of the information obtained from a clinical assessment. Although formulation systems vary by different schools of psychotherapy, the author has adopted and here explores a systematic approach based on an integrative effort. This system of configurational analysis combines concepts derived from psychodynamic, interpersonal, cognitive-behavioral, and family system approaches. After an overview of psychological change processes, each of the five steps of configurational analysis is covered systematically: Step one involves selecting and describing the patient's currently most important symptoms, signs, problems, and topics of concern. For example, symptoms may consist of trouble sleeping or feelings of depression; signs may include discordant verbal and physical expression; problems may include reluctance to go to work or care for family members; and topics of concern might be unresolved grief the patient feels helpless to process without assistance. Since both patient and therapist want to know if these observable phenomena are changing, this list is modified as treatment progresses. Step two entails describing states in which the patterns of phenomena do and do not occur, with attention to patterns of shifts in states, especially maladaptive state cycles. The therapist is taught how to aggregate and organize this information by describing states of mind -- for example, undermodulated (e.g., unthinking rage) or overmodulated (e.g., numbness and lack of affect). Step three involves describing the challenging topics that patients may both approach and avoid because they are conflicted or unresolved, as well as the obstacles patients may create to divert attention from those topics. For example, patients may avoid a topic or shift attention from it by changing the subject and so forth. Step four entails describing the organizing roles, beliefs, and scripts of expression and action that seem to organize repetitions in each state, with an effort made to identify dysfunctional attitudes and how these may have evolved from past attachments and traumas. Finally, step five involves figuring out how to stabilize working states by enhancing the therapeutic alliance and helping the patient contain and master emotional attitudes. At this point, the clinician plans how to counteract avoidances by direction of attention and promotes adaptive social cognitive capacities. From surface observation to deeper inferences, Formulation as a Basis for Planning Psychotherapy Treatment transcends DSM diagnoses, helping clinicians to use information gleaned in the immediacy of the moment to make sound, sensitive, and effective psychotherapeutic decisions.
A major contribution for all clinicians committed to understanding and using what really works in therapy, this book belongs on the desks of practitioners, students, and residents in clinical psychology, psychiatry, counseling, and social work. It will serve as a text in graduate-level courses on cognitive-behavior therapy and in clinical practica.
This is a thorough and well-structured piece of work, which brings in the recent work of excellent authorities such as Barbara Ingram. It is well arranged, with many examples and case vignettes, which bring the material to life in an engaging way. I enjoyed reading it, and would recommend it unreservedly.’ John Rowan, humanistic therapist, private practice ‘This is a must-read book for students on courses in counselling, psychotherapy, clinical psychology and psychiatry.’ Heather Fowlie, Head of the Transactional Analysis Department, Metanoia Institute, London Conducting a competent assessment and case formulation can be a daunting task for trainee therapists engaging in clinical assessment for the first time. This book is designed to help, by unpicking the many aspects involved in assessment and case formulation across modalities, practice settings and client groups. The book: · Explores key elements of clinical assessment including diagnosis, risk assessment, ethical considerations and accounting for difference. · Highlights the necessary skills, techniques and legal requirements at each stage of the process. · Takes into account the impact of culture, context and theoretical and practical considerations. · Uses case studies and reflective questions to illustrate difficult concepts in context. Equipping you with the knowledge and tools to make successful assessments and case formulations, this is an essential read for trainees and for qualified practitioners wishing to brush up on their understanding. Dr Biljana van Rijn, Faculty Head of Applied Research and Clinical Practice, Metanoia Institute.
"The evidence-based practice (EBP) movement has always been about implementing optimal health care practices. Practitioners have three primary roles they can play in relation to the research evidence in EBP: scientists, systematic reviewers, and research consumers. Learning EBP is an acculturation process begun during professional training that seamlessly integrates research and practice"--Provided by publisher.
Written by recognized experts in their respective fields, the books of the Series in Specialty Competencies in Professional Psychology are comprehensive, up-to-date, and accessible. These volumes offer invaluable guidance to not only practicing mental health professionals, but those training for specialty practice as well.
This practical guide for occupational therapists introduces a tried and tested method for moving from assessment to intervention, by formulating plans and measurable goals using the influential Model of Human occupation (MOHO). Section 1 introduces the concept of formulation – where it comes from, what it involves, why it is important, and how assessment information can be guided by theoretical frameworks and organised into a flowing narrative. Section 2 provides specific instructions for constructing occupational formulations using the Model of Human Occupation. In addition, a radically new way for creating aspirational goals is introduced - based on a simple acronym - which will enable occupational therapists to measure sustained changes rather than single actions. Section 3 presents 20 example occupational formulations and goals, from a wide range of mental health, physical health and learning disability settings, as well as a prison service, and services for homeless people and asylum seekers. Designed for practising occupational therapists and occupational students, this is an essential introduction for all those who are looking for an effective way to formulate plans and goals based on the Model of Human Occupation.
Since the original publication of this seminal work, acceptance and commitment therapy (ACT) has come into its own as a widely practiced approach to helping people change. This book provides the definitive statement of ACT--from conceptual and empirical foundations to clinical techniques--written by its originators. ACT is based on the idea that psychological rigidity is a root cause of a wide range of clinical problems. The authors describe effective, innovative ways to cultivate psychological flexibility by detecting and targeting six key processes: defusion, acceptance, attention to the present moment, self-awareness, values, and committed action. Sample therapeutic exercises and patient-therapist dialogues are integrated throughout. New to This Edition *Reflects tremendous advances in ACT clinical applications, theory building, and research. *Psychological flexibility is now the central organizing focus. *Expanded coverage of mindfulness, the therapeutic relationship, relational learning, and case formulation. *Restructured to be more clinician friendly and accessible; focuses on the moment-by-moment process of therapy.
