The Wiley Handbook of Anxiety Disorders by Paul Emmelkamp Thomas Ehring

Author:Paul Emmelkamp, Thomas Ehring
Language: eng
Format: epub
Published: 2018-07-09T16:00:00+00:00

33

Case Formulation

Peter Sturmey

Queens College and The Graduate Center, City University of New York

Introduction

A case formulation is “a hypothesis about the causes, precipitants, and maintaining influences of a person's psychological, interpersonal and behavioral problems” (Eells, 2011, p. 7). Case formulation can be made from many theoretical approaches (Sturmey, 2009), all of which agree that case formulation abstracts the key features of a case to inform idiographic treatment design. Thus, formulations of the same diagnosis might be quite different and result in very different treatments for each person and formulations of cases with different diagnoses might share functional features and result in functionally similar treatments. Many authors contrast case formulation with diagnosis; it is often described as “going beyond diagnosis.”

Many professional organizations and professional training recognize case formulation as a core clinical skill that takes a clinician beyond the mechanical application of technocratic rules to the level of a skilled and creative clinician that is both personally satisfying to the clinician and results in additional benefits to the client. Some have suggested that case formulation may have benefits to clients such as educating them about their problem, giving them insight, and facilitating participation in therapy. Some authors have described very simple, standard case formulation with clients which they progressively modify with client input that is respectful of the client. Several authors have speculated that sharing case formulations should improve satisfaction with therapy (Kinderman & Lobban, 2000), but two studies reported both positive and negative client reactions (Chadwick, Williams, & MacKenzie, 2003; Morberg Pain, Chadwick, & Abba, 2008).

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