Vicious Cycle - Responses And Consequences

Formulation in talking therapies

Formulations (also known as case formulations, case conceptualizations, and working hypotheses) are a central component of most talking therapies and a key skill for mental health professionals (DCP, 2010; RCP, 2017; Sperry & Sperry, 2012). In essence, a formulation is a way to make sense of an individual’s difficulties. It is a provisional account or hypothesis, informed by psychological theory, about what an individual is struggling with and why (Johnstone & Dallos, 2014). A formulation is also a tool that therapists use to relate theory to practice (Butler, 1998). Sperry and Sperry (2012, p. 4) describe formulations as:

A method and clinical strategy for obtaining and organizing information about a client, understanding and explaining the client’s situation and maladaptive patterns, guiding and focusing treatment, anticipating challenges and roadblocks, and preparing for successful termination.

Formulation is a fundamental part of most (if not all) therapeutic orientations and serves several common

"I’d like to explore with you what might keep this issue going. One way we can do that is by drawing a diagram. Can we give it a try?" 

Step 1: Explore the client’s experience

Problem

Ask the client to describe the problem they are struggling with. Problems can be defined as a diagnosis, or in other ways, such as in terms of troubling beliefs, behaviors, feelings, physical sensations, or patterns of interaction. While diagnoses are clear and succinct, other descriptions are more personalized and capture clients’ subjective experiences of the problem. Encourage the client to describe the problem in the most meaningful way possible, such as: 

"Let’s start by describing the problem you are experiencing. How would you put it in your own words?"

Response

Ask the client to describe the typical ways they respond to the problem or try to cope with it. These responses might include ways of:

• Behaving, such as escaping from the

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• Butler, G., Fennell, M., & Hackmann, A.