What is case formulation?
Have you ever wondered what a case formulation is? Or why it is such an integral part of the mental health professional - client relationship?
Our very own head of science Katri Kanninen, PhD and CAT psychotherapist trainer, explains what a case formulation is, how it is made, which elements it includes, and why it is such an important aspect in the everyday work environment for any mental health provider.
Structures and more coherent understanding
It is sometimes quite a puzzle to understand which bits and pieces belong where in the client's story. Case formulation contains structures that permit the clinician to understand and summarize the information about the person. It is a process of developing a hypothesis about the causes, precipitants, and maintaining influences of a person’s psychological, interpersonal, and behavioural challenges, as well as a plan to address these problems. The use of case formulation is seen as a central part of good clinical praxis. When compared to assessment as usual, high-quality case formulation ensures a more coherent understanding of the client's goals, tasks and commitment to change. It simply helps to treatment to be more focused.
The purpose of case formulation
The purpose of case formulation is, together with the client, build an understanding of what brought the client to therapy and for this understanding to serve as a blueprint guiding the treatment. Overall, the tone of case formulation demonstrates overt sympathy and understanding for the current plight of the client. Case formulation is also a way to find a common language to discuss challenging issues.
The case formulation
states clearly the current target problem
states triggering events and issues in the life that may have taken place
makes connections between past challenging experiences of neglect, abuse and trauma and current patterns of functioning
identifies the typical dysfunctional roles that the client takes up in the present and links these to past events
may help to reflect upon and predict how the client may rely on old maladaptive patterns even in the mental health professional - client relationship
Moreover, it offers a realistic notion of what may be achieved during therapy and states the identified goals of the work. Its role in strengthening the alliance is especially important through making the goals and tasks more transparent. This, in turn, gives more agency to client, promoting the experience of “I can, I will” make this change happen.
Benefits of case formulation
The use of case formulation is seen as a central part of good clinical praxis. However, there is scarce research on its importance. Formulating is a challenging and time-consuming task. Case formulation increases patient-centered care and all the valuable outcomes of it. When compared to assessment as usual, high-quality case formulation ensures a more coherent understanding of the client's and the employee's goals, tasks and commitment to care.
It is widely accepted that what shows early in treatment plays also vital part later on. The faster one gets to the core of problems, the more useful and meaningful client experiences therapeutic interventions. This is related to success of therapy as well.
References
Eells, T. D. (2015). Psychotherapy case formulation. American Psychological Association.