Introduction & Theoretical Background
A formulation, or case conceptualization, is a method for understanding and explaining a person’s problems. Case formulations tie together the difficulties that a person is experiencing and the psychological mechanisms underlying these experiences (Persons, 1989). Formulations have been described as “the lynch pin that holds theory and practice together” (Butler, 1998). Consider a simple example: a young woman experiencing feelings of anxiety about an upcoming work event might hold unhelpful thoughts about her performance, “I’ll humiliate myself in front of everyone”. She might act in ways which prevent her from finding out more about the truth of her belief, such as using avoidance or safety-seeking behaviors. Her unhelpful thoughts and avoidance behavior are mechanisms that maintain her anxiety. Case formulations confer several important benefits:
- They help the client and therapist to understand the problem(s) and how they fit together, instilling feelings of hope.
- They draw the client’s experience together with theories about