We would anticipate when engaging in treatment, the patient may have difficulties with using primitive defense mechanisms. Cognitive behavioral therapists use individually tailored formulations as a framework with which to understand their patients’ difficulties and to plan effective treatment. Understanding how each factor contributes to a disease can better guide treatment decisions.
Thus, formulating a case is developing a theory of a client. The “4 Ps” formulation table can be a very rigid and systematized way of presenting a formulation. Precipitating and perpetuating factors: the stressor of losing her job has reactivated these defense mechanisms. These symptoms have been maintained by [psychological factors/personality factors], and [social/environmental factors] “We would anticipate when engaging in treatment, the patient may have [resistance/transference/countertransference].
Fern Lowry (1936) described this process as similar in form to a rope woven of multiple strands. Her ongoing alcohol use is another example of a maladaptive coping strategy. Here is one potential example of a psychological formulation of psychosis (again, there are no right or wrong ways to formulate, it depends on the patient you have in front of you!) The case formulation approach to cognitive-behavior therapy is a framework for pro- viding cognitive-behavior therapy (CBT) that flexibly meets the unique needs of the patient at hand, guides the therapist’s decision making, and is evidence based. Case Studies.
I posted on some of the other ways formulations can be developed, and today I’m going …
- depression, self-harm, mania/psychosis, anxiety, etc.) The UK’s largest database of information and research on all
Has GP, psychiatrist, social, or case worker; Presenting your Formulation. Fig. In this post, I outline and explain the sections of the case summary assignment.
For example, here is a sample formulation for someone with schizophrenia. We'll leave the predisposing social factor and psychological factors for the end.
Most learners will use this method as it is the most “simple.” It is usually presented as Predisposing → Precipitating → Perpetuating → Protective factors. You will need to interview the client and other significant parties knowledgeable about the client's background and current needs. She has also previously responded well to psychotherapy and appears to be psychologically-minded. The cognitive behavioral theory advances the belief that social learning can aid in the formulation of individual behaviors and that the personal beliefs, attitudes and emotions of individuals also influence their behavior in the social system. How do you present all this information and data? However, patient has the following [protective factors], which may be a good prognostic factor.
Hooray!
The focus on changing systems will allow the social worker to determine the impacts of family changes on individual behaviors. Here is an example of a set of treatment recommendations for Jane Doe: She has the following protective factors, including a supportive psychiatrist and friend. A case formulation helps therapists and patients to understand the origin, current status, and maintenance of a problem. But the most important thing about formulation is that it should be intuitive and flow logically. Ideally, each step should flow logically and intuitively into the next based on your framework, as you'll see in our case of Jane Doe. As she was unable to develop a sense of self and personal identity, these psychological factors are reflected in her adulthood with unstable relationships, and fears of abandonment. Yet another way to present a formulation is in chronological order, starting from birth until present time: Case formulation-driven CBT is not a new therapy.