Vicious Flower Formulation
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Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.
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Introduction & Theoretical Background
The Vicious Flower Formulation is a deceptively simple case conceptualization (formulation) tool. By encouraging a focus on the maintenance cycles which (often unintentionally) prolong a difficulty it is a tool which targets the mechanisms serving to prolong an individual's difficulty. In this graphical representation maintenance cycles form the 'petals' of a flower.
Therapist Guidance
As with many formulation tools it is most helpful to complete this as a collaborative exercise with clients.
- Start by identifying one of the client's beliefs and write it in the center of the flower.
- Now think about what the client does (behaviors) to prevent the feared belief from coming true, or to protect themselves from the potential consequences of the belief. Write these around the belief.
- In many cases client's actions can inadvertently be serving to reinforce the beliefs. Think with the client about the consequences of their behavior. If the behavior serves to strengthen the belief then drawing an arrow from the belief to the behavior, and then back to the belief forms a 'petal' of the flower.
- Using the vicious flower formulation as the foundation for therapy the tasks of 'treatment' can be conceptualized as plucking the petals of the flower to reduce the strength of
References And Further Reading
- Moorey, S. (2010). The six cycles maintenance model: Growing a “vicious flower” for depression. Behavioural and cognitive psychotherapy, 38(2), 173.
- Salkovskis, P. M. (1998). The devil is in the detail: conceptualising and treating obsessional problems. In N. Tarrier, A. Wells, and G. Haddock (eds) Treating Complex Cases: The Cognitive Behaviour Therapy Approach. Chichester: Wiley.