Preface to Case Formulation

By: PETER STURMEY

When mental health practitioners are faced with a new client they have to predict the best treatment for this particular person. This is not an abstract question concerning the efficacy of treatments in general, but a highly specific question about one particular person and his or her unique set of circumstances right here and now.

Many mental health practitioners answer this question by using psychiatric diagnosis as a predictor of best treatment. But for many reasons, mental health practitioners often reject this approach. Rather, the clinician takes the information he or she has concerning this specific person’s unique set of problems, assets and circumstances, and using the clinician’s experience, knowledge of the outcome literature, theoretical perspective creates a hypothesis or series of hypotheses that will guide them to the most effective treatment for this person.

Case formulation is a commonly taught clinical skill and many clinicians use it routinely. Although there is some agreement about the general features and common general principles that underlie case formulation, the content of different formulations is often quite different depending upon the theoretical orientation of the clinician. Clinicians may make formulations from cognitive, cognitive-behavioural, behavioural, psychodynamic, psychiatric and eclectic approaches. Even within each of these orientations, the specific technologies and concepts used to develop a formulation may vary considerably.

Case formulation is a basic clinical skill for many mental health professionals. It is often included in professional training (Page and Strizke, 2006; Page, Stritzke and McLean, 2008) and continuing education for many mental health professionals (Kendjelic and Eells, 2007; Kuyken et al., 2005; Sim, Gwee and Bateman, 2005). Various professional bodies, such as the British Psychological Society (British Psychological Society Division of Clinical Psychology, 2000, 2001), the American Psychiatric Association (2004) and the American Psychological Association (APA) (2005), identify this as a professional competency that practitioners should have and the professional training courses should teach. Within cognitive-behavioural approaches to mental health, case formulation is seen as a core skill for all practitioners.

References

Peter Sturmey, Clinical Case Formulation; Varieties of Approaches, 2009, John Wiley Ltd.

Read Also

Rationale and importance of case formulation

The Psychiatric Evaluation
Evolution of Psychiatric Diagnosis
The Clinical Interview
Diagnostic Principles
The Need For A Clear Boundary Between Assessment And Treatment
Completing the Diagnostic Assessment
The Comprehensive Diagnostic Assessment and Evaluation

Definitions of case formulation