Formulations
Offer complex multi-factorial descriptions
of psychological processes
Inform therapy planning and risk
management
Consider the social context of a person
and is based on personal meaning
Based on analogue logic (more or less
continuum)
Used in psychotherapy / less suitable for...
formulations offer complex multi factorial descriptions of psychological processes inform therapy planning and risk management consider the social context of a perso
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TMA04 NOTES DD310-19J
Formulations
Offer complex multi-factorial descriptions
of psychological processes
Inform therapy planning and risk
management
Consider the social context of a person
and is based on personal meaning
Based on analogue logic (more or less
continuum)
Used in psychotherapy / less suitable for
healthcare/CJS needs
The aim with a formulation is to make sense of a client’s problems by considering multiple
contexts, from biological and psychological factors to the social and relationship context and life
events. The term is used in varying ways, and there doesn’t seem to be a universally agreed
definition. The BPS Division of Clinical Psychology (2011) defines a psychological formulation as
‘a hypothesis about a person’s difficulties, which links theory with practice and guides the
intervention’ (p. 2). Formulations draw on the information collected from the client at the
assessment and during therapy and consider how they make sense of their difficulties. They offer
a theoretically based explanation or conceptualisation of the information that is available to the
therapist.
Apart from explaining the cause and nature of the problems, the main aim with formulations is to
provide a framework and guidance for the next steps and interventions in therapy. In most of the
therapeutic approaches introduced in this block, the therapist works together with the client to
develop a shared understanding of the problem(s) and shares the resulting formulation with the
client.
As you will see in the coming weeks, the therapeutic approaches covered in this block differ in
the way that they develop and use formulations, as the content and structure of a formulation will
depend on the underlying theoretical concept (e.g. a CBT formulation will include content on
dysfunctional cognitions and beliefs, whereas a systemic case formulation will provide a
conceptualisation of the relational context).
· What has caused the problems?
· What factors are maintaining the problems?
· What might facilitate change?
, Table 1 Attachment styles in the ‘Strange Situation Test’ (Mary Ainsworth)
Security class At play Towards On On reunion
stranger separation
B: Secure Plays freely; Curious; uses Follows Cries; reaches
explores mother as mother to up; clings;
room and safe base; door, calls or stops crying
toys; looks checks with cries; may be soon; re-
back at mother if slightly engages in
mother; engaging in comforted by play
shows toys play with stranger
to her stranger
A: Physically Initially wary Watches Watches
Anxious/Insecure: distant from but may mother go mother return;
Avoidant mothers; engage in but does not does not
seems play; may follow or approach or
confident but move subtly protest; does protest; seems
explores closer to not cry but occupied with
less; does mother play is play
not approach inhibited and
mother there are
physical
signs of
stress
C: Anxious Stays close Wary; Follows Approaches
/Insecure: to mother; anxiety mother; with angry or
Ambivalent may not clearly cries; distressed
play; checks raised; stays distressed; cries; clings;
back close to not not soothed or
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