Artikel: Linking assessment to treatment: case formulation
Case formulation = hypothesis (precipitants, causes and maintaining influences)
- Helps organizing information (inconsistencies in behavior, emotion and thought content).
- It serves as a blueprint guiding treatment
- Strengths and weaknesses
- Problem and potential solution in context of the whole person
- Extra: enhances the therapeutic relationship, deeper understanding and responsiveness to the
client
Information client à lens: theoretical and empirical literature à case formulation
- Coupling between diagnostic assessment information and clinical decisions about treatment
Behavioral case formulation: functional analysis
- Hypothesis-driven approaches to identify: function of a given behavior
- It involves the identification of important, controllable, causal functional relationship applicable
to a specified set of target behaviors for an individual client.
Causal variables
- Important (explain a large proportion of variance)
- Controllable (history for example is NOT controllable)
The aim is not to ‘explain’ behavior, but to identify the important causal variables that can be
manipulated
The three main components of a functional analysis:
1) Antecedents and setting
- Distal an proximal factors
- Originating and maintaining factors
- Moderators and mediators
2) Behaviors
- Frequency, topography, temporal sequence, intensity, duration, history, relationship to other
behavior
3) Consequences
- Punishment, negative reinforcement, positive reinforcement, response cost
Limitation of function analysis: it does not make reference to the cognitions that may occur between the
antecedents and the consequence.
Cognitive behavioral case formulation
= an approach to case formulation upon the functional analysis + assessment of cognitive beliefs and
attitudes
1. Problem list
Analogues to the Behavior of ABC
2. Assign DSM diagnosis
3. Selecting a nomothetic formulation of the anchoring diagnosis
Investigate literature surrounding the anchoring diagnosis
4. Individualizing the template
Collect additional data concerning cognitive, behavioral emotional and somatic aspects
5. Propose hypothesis about the origins of the mechanisms
i how the client had developed cognitive schemata that underlie
ii how the dysfunctional behavior was learned
, iii how functional behavior was not acquired
iv emotional regulation deficits
v genetic and biological vulnerability
6. Describe precipitants of the current episode
Artikel: Maintaining confidentiality
Wanneer er vertrouwelijke informatie gedeeld moet worden met derden, is de regel dat er zo min
mogelijk wordt gedeeld om tot het doel te komen.
Je gebruikt hierbij consent-formulieren,
- Therapeut naar derden
- Derden naar therapeut
- Beide kanten op
Beter te weinig dan teveel informatie vermelden
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