Case Formulation and Disorder-Specific Models

“[Formulation is] The lynch pin that holds theory and practice together” (Butler, 1998).

Cognitive behavioral therapists use individually tailored formulations as a framework with which to understand their patients’ difficulties and to plan effective treatment. A case formulation helps therapists and patients to understand the origin, current status, and maintenance of a problem. Formulations are developed collaboratively between therapists and patients during the assessment phase of therapy and are revised as new information is gathered during the course of treatment. Jacqueline Persons wrote an influential account of individualized case formulation (1989). Her current case formulation approach (2008) describes how a complete CBT case formulation ties together all of the following parts:

all of a patient’s symptoms, disorders, and problems;
hypotheses about the mechanisms causing the disorders and the problems;
proposes the recent precipitants of the current problems and disorders;
describes the origins of the mechanisms.

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100 of 108 resources

Window Of Tolerance

The window of tolerance concept was coined by Dan Siegel in his 1999 book The Developing Mind. Siegel proposes that everyone has a range of intensitie ... https://www.psychologytools.com/resource/window-of-tolerance/

Therapy Blueprint (Universal)

A therapy blueprint is CBT tool which summarizes the work a therapist and patient have completed together. It represents the past (the problems, what ... https://www.psychologytools.com/resource/therapy-blueprint-universal/

Values

Meaningful activity is value-driven. This ACT-informed worksheet explores the key domains of values and encourages clients to reflect upon what is imp ... https://www.psychologytools.com/resource/values/

Vicious Cycle - Responses And Consequences

Formulation is a key component of talking therapies and vicious cycles have long been recognized in psychotherapy as key mechanisms that perpetuate ps ... https://www.psychologytools.com/resource/vicious-cycle-responses-and-consequences/

Obsessive Compulsive Disorder (OCD) Formulation

Cognitive behavioral models of obsessive compulsive disorder (OCD) suggest that it is the client’s interpretation of normal intrusive thoughts, imag ... https://www.psychologytools.com/resource/obsessive-compulsive-disorder-ocd-formulation/

Theory A / Theory B

Human beings actively try to understand their world and what happens to them. However, these understanding can be inaccurate or unhelpful. Worse, unhe ... https://www.psychologytools.com/resource/theorya-theoryb/

Motivational Systems (Emotional Regulation Systems)

At the heart of Compassion Focused Therapy (CFT) is an evolutionary model of human motivational systems. Developed by Paul Gilbert it is a helpful len ... https://www.psychologytools.com/resource/motivational-systems-emotional-regulation-systems/

Social Anxiety Formulation

People suffering from social anxiety disorder (previously known as social phobia) experience persistent fear or anxiety concerning social or performan ... https://www.psychologytools.com/resource/social-anxiety-formulation/

Post-Traumatic Stress Disorder (PTSD) Formulation

This Post-Traumatic Stress Disorder (PTSD) Formulation is designed for use in trauma-focused cognitive therapy for PTSD (CT-PTSD): an empirically supp ... https://www.psychologytools.com/resource/ptsd-formulation/

Cross Sectional Formulation

Case conceptualizations (formulations) help therapists and clients come to a shared understanding of a problem. This Cross Sectional Formulation explo ... https://www.psychologytools.com/resource/cross-sectional-formulation/

Low Self-Esteem Formulation

Fennell’s cognitive behavioral model of low self-esteem proposes that negative beliefs about the self are maintained by biased information processin ... https://www.psychologytools.com/resource/low-self-esteem-formulation/

CBT Model – Maintaining Processes

Formulation is a key component of cognitive behavioral therapy (CBT) and essential to effective practice. Effective cognitive behavioral formulations ... https://www.psychologytools.com/resource/cbt-model-maintaining-processes/

Emotions Motivate Actions

Many clients find it helpful to recognize the range of actions that are motivated by different emotional states. This worksheet encourages clients to ... https://www.psychologytools.com/resource/emotions-motivate-actions/

CBT Model – Maintaining Processes – Past And Present

Health Anxiety Formulation

Health anxiety is characterized by a preoccupation with having or acquiring a serious illness, and a high level of anxiety about health. People with h ... https://www.psychologytools.com/resource/health-anxiety-formulation/

Vicious Cycle - Costs And Benefits

Formulation is a key component in talking therapies, and vicious cycles have long been recognized in psychotherapy as key mechanisms that perpetuate p ... https://www.psychologytools.com/resource/vicious-cycle-costs-and-benefits/

Panic Formulation

The aim of a formulation is to help the client and therapist to come to a shared understanding of what a client is experiencing. The Panic Formulation ... https://www.psychologytools.com/resource/panic-formulation/

What Keeps Obsessive Compulsive Disorder (OCD) Going?

The "What Keeps It Going?" series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concise, t ... https://www.psychologytools.com/resource/what-keeps-obsessive-compulsive-disorder-ocd-going/

Longitudinal Formulation 2

Case conceptualizations (formulations) help therapists and clients come to a shared understanding of a problem. This longitudinal case formulation wor ... https://www.psychologytools.com/resource/longitudinal-formulation-2/

Friendly Formulation

Case conceptualizations (formulations) help therapists and clients come to a shared understanding of a problem. This simple CBT formulation worksheet ... https://www.psychologytools.com/resource/friendly-formulation/

Cognitive Behavioral Model Of Low Self-Esteem (Fennell, 1997)

Low self-esteem is characterized as a negative sense of the self and co-occurs with many other mental health problems. Although not formally represent ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-low-self-esteem-fennell-1997/

What Keeps Low Self-Esteem Going?

The “What Keeps It Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concis ... https://www.psychologytools.com/resource/what-keeps-low-self-esteem-going/

CBT Appraisal Model

The CBT Appraisal Model worksheet is a transdiagnostic formulation tool. The centrality of appraisals underpins all of the disorder-specific cognitive ... https://www.psychologytools.com/resource/cbt-appraisal-model/

Reciprocal CBT Formulation

CBT therapists often describe finding it difficult to apply CBT skills when clients bring relational problems to therapy. Familiar methods of visu ... https://www.psychologytools.com/resource/reciprocal-cbt-formulation/

What Keeps Social Anxiety Going?

CBT Model – Past And Present

Formulation is a key component of cognitive behavioral therapy (CBT) and essential to effective practice. This CBT Model – Past And Present is a des ... https://www.psychologytools.com/resource/cbt-model-past-and-present/

CBT Model – Here And Now

Formulation is a key component of cognitive behavioral therapy (CBT) and essential to effective practice. The CBT Model – Here And Now worksheet is ... https://www.psychologytools.com/resource/cbt-model-here-and-now/

Therapy Blueprint

NOTE: An improved version of this resource is available here: Therapy Blueprint (Universal). Older versions of a resource may be archived in the event ... https://www.psychologytools.com/resource/therapy-blueprint/

Cognitive Behavioral Model Of Generalized Anxiety Disorder (GAD: Dugas, Gagnon, Ladouceur, Freeston, 1998)

Individuals with generalized anxiety disorder (GAD) report significant worry which they find difficult to control and experience as distressing. Numer ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-generalized-anxiety-disorder-gad-dugas-gagnon-ladouceur-freeston-1998/

Interpersonal Beliefs And Styles

Interpersonal issues and relationship problems form an important part of what clients bring to therapy: they might present as clients’ current conce ... https://www.psychologytools.com/resource/interpersonal-beliefs-and-styles/

Stages Of Change

The Stages Of Change model is helpful for conceptualizing the mental states of individuals at different stages of their change journey. This informati ... https://www.psychologytools.com/resource/stages-of-change/

Schema Formulation

Beck's cognitive model proposes that cognition and perception in the here-and-now are influenced by our 'schemas', which shape our perception and info ... https://www.psychologytools.com/resource/schema-formulation/

ABC Model

ABC is an acronym for Antecedents, Behavior, Consequences. It is used as a tool for the assessment and formulation of problem behaviors and is useful ... https://www.psychologytools.com/resource/abc-model/

Therapy Blueprint For PTSD

A therapy blueprint represents the past (the problems, what maintained them), the present (the therapy itself, new knowledge learned and skills develo ... https://www.psychologytools.com/resource/therapy-blueprint-for-ptsd/

Longitudinal Formulation 1

Case conceptualizations (formulations) help therapists and clients come to a shared understanding of a problem. This case formulation worksheet is a t ... https://www.psychologytools.com/resource/longitudinal-formulation-1/

Therapy Blueprint For OCD

Cognitive Behavioral Model Of Post Traumatic Stress Disorder (PTSD: Ehlers & Clark, 2000)

Anke Ehlers' & David Clark's Cognitive Behavioral Model Of Post-Traumatic Stress Disorder (PTSD) is an influential account of the condition. The ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-post-traumatic-stress-disorder-ptsd-ehlers-clark-2000/

Vicious Flower Formulation

Case conceptualizations (formulations) are designed to help clients and therapists come to a shared understanding of a problem. The 'vicious flower' a ... https://www.psychologytools.com/resource/vicious-flower-formulation/

Developing Psychological Flexibility

Acceptance and Commitment Therapy (ACT) proposes that suffering is associated with psychological inflexibility. ACT suggests that to increase psycholo ... https://www.psychologytools.com/resource/developing-psychological-flexibility/

How Does Emotion Affect Your Life?

Emotions are an essential part of being human. Everyone experiences a wide variety of emotions in response to changes in their thoughts, biology, and ... https://www.psychologytools.com/resource/how-does-emotion-affect-your-life/

What Keeps Death Anxiety Going?

What Keeps Post-Traumatic Stress Disorder (PTSD) Going?

Cognitive Behavioral Model Of Intolerance Of Uncertainty And Generalized Anxiety Disorder Symptoms (Hebert, Dugas, 2019)

Intolerance of uncertainty (IU) has been defined as “an underlying fear of the unknown”. Intolerance of uncertainty is a risk factor for the deve ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-intolerance-of-uncertainty-and-generalized-anxiety-disorder-symptoms-hebert-dugas-2019/

What Keeps Panic Going?

Exploring Problems Using A Cross Sectional Model

A cross-sectional formulation takes a ‘snapshot’ of what is going on during a single moment in time. The Exploring Problems Using A Cross-Sectiona ... https://www.psychologytools.com/resource/exploring-problems-using-a-cross-sectional-model/

What Keeps Perfectionism Going?

Stages Of Social Anxiety

The Stages Of Social Anxiety worksheet is a tool to record unhelpful socially anxious responses to social situations, and to map alternative ways of t ... https://www.psychologytools.com/resource/stages-of-social-anxiety/

Recognizing Obsessive Compulsive Disorder (OCD)

Obsessive Compulsive Disorder (OCD) is characterized by the presence of persistent and repeated obsessions and compulsions. The obsessions are intrusi ... https://www.psychologytools.com/resource/recognizing-obsessive-compulsive-disorder-ocd/

Therapy Blueprint For Social Anxiety

Recognizing Prolonged Grief Disorder

Prolonged Grief Disorder is a disturbance in which there is a persistent and pervasive grief response following the death of loved one. It is characte ... https://www.psychologytools.com/resource/recognizing-prolonged-grief-disorder/

Cognitive Case Formulation

The Cognitive Case Formulation is a CBT case conceptualization tool that aims to help therapists derive core and intermediate beliefs from an analysis ... https://www.psychologytools.com/resource/cognitive-case-formulation/

Motivation and Ambivalence

Motivation is a necessary precursor to change, yet many clients are ambivalent about the process of change. The Motivation And Ambivalence worksheets ... https://www.psychologytools.com/resource/motivation-and-ambivalence/

Belief Driven Formulation

Cognitive behavioral theory proposes that our thoughts, feelings, and behavior in the here-and-now are influenced by our schemas / core beliefs / assu ... https://www.psychologytools.com/resource/belief-driven-formulation/

Cognitive Behavioral Model Of Health Anxiety (Salkovskis, Warwick, Deale, 2003)

Functional Analysis With Intervention Planning

This classic A-B-C functional analysis worksheet can be used to collect information about what came before a behavior (antecedents), the behavior itse ... https://www.psychologytools.com/resource/functional-analysis-with-intervention-planning/

What Keeps Fears And Phobias Going?

Cognitive Behavioral Model of Perfectionism (Shafran, Egan, Wade, 2010)

People with perfectionism pursue high standards in one or more areas of their life, and base their self-worth on their ability to achieve these standa ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-perfectionism-shafran-egan-wade-2010/

Recognizing Complex Post Traumatic Stress Disorder

Complex Post Traumatic Stress Disorder (Complex PTSD) may develop after exposure to an event (or series of events) of an extremely threatening or horr ... https://www.psychologytools.com/resource/recognizing-complex-post-traumatic-stress-disorder/

What Keeps Body Dysmorphic Disorder (BDD) Going?

Process Focused Case Formulation

The Process-Focused Case Formulation encourages clinicians to make hypotheses regarding mechanisms or processes which they believe may be maintainin ... https://www.psychologytools.com/resource/process-focused-case-formulation/

Understanding PTSD

Ehlers & Clark's cognitive model of PTSD outline key maintaining factors. Understanding PTSD is a simple pictorial explanation of the maintenance ... https://www.psychologytools.com/resource/understanding-ptsd/

What Keeps Depersonalization And Derealization Going?

Exploring Problems Using An A-B-C Model

An Antecedent-Behavior-Consequence (ABC) diagram is a form of functional analysis and is a helpful way of conceptualizing a behavior of interest. It e ... https://www.psychologytools.com/resource/exploring-problems-using-an-a-b-c-model/

Therapy Blueprint For Panic

Cognitive Behavioral Model Of Body Dysmorphic Disorder (BDD: Veale, 2004)

Individuals with body dysmorphic disorder (BDD) experience distress associated with their body image. The Cognitive Behavioral Model Of Body Dysmorphi ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-body-dysmorphic-disorder-bdd-veale-2004/

Transdiagnostic Processes

A ‘transdiagnostic process’ is the label given to a mechanism which is present across disorders and which is either a risk or maintaining factor f ... https://www.psychologytools.com/resource/transdiagnostic-processes/

Recognizing Generalized Anxiety Disorder (GAD)

Generalized anxiety disorder (GAD) is characterized by marked symptoms of anxiety that persist, more days than not, for at least several months. Peopl ... https://www.psychologytools.com/resource/recognizing-generalized-anxiety-disorder-gad/

Cognitive Behavioral Model Of Panic (Clark, 1986)

The Cognitive Behavioral Model Of Panic identifies catastrophic misinterpretation of body sensations as a criticial maintenance factor which serves to ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-panic-clark-1986/

Cognitive Behavioral Model Of Clinical Perfectionism (Shafran, Cooper, Fairburn, 2002)

People with perfectionism pursue high standards in one or more areas of their life and base their self-worth on their ability to achieve these standar ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-clinical-perfectionism-shafran-cooper-fairburn-2002/

Problem List

An important task during the assessment phase of therapy is to identify client difficulties. The Problem List worksheet is a helpful way of gatherin ... https://www.psychologytools.com/resource/problem-list/

Cognitive Behavioral Model Of Social Phobia (Clark, Wells, 1995)

Alternative Action Formulation

The Alternative Action Formulation is a CBT case conceptualization (formulation) worksheet. Formulations help a client and therapist come to a shared ... https://www.psychologytools.com/resource/alternative-action-formulation/

Making Sense Of Your Panic (Psychology Tools For Overcoming Panic)

Psychology Tools for Overcoming Panic takes a cognitive behavioral therapy (CBT) approach to this common anxiety problem. This chapter brings tog ... https://www.psychologytools.com/resource/making-sense-of-your-panic-psychology-tools-for-overcoming-panic/

Cognitive Behavioral Model Of The Relapse Process (Marlatt & Gordon, 1985)

Marlatt & Gordon’s cognitive behavioral model of relapse (1985) conceptualizes relapse as a “transitional process, a series of events that unf ... https://www.psychologytools.com/resource/cognitive-behavioural-model-of-the-relapse-process-marlatt-gordon-1985/

Cognitive Behavioral Model Of Fear Of Body Sensations

Fear of bodily sensations is present in a number of conditions, most notably panic disorder. The Cognitive Behavioral Model Of Fear Of Bodily Sensatio ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-fear-of-body-sensations/

Recognizing Post Traumatic Stress Disorder (PTSD)

Post Traumatic Stress Disorder (PTSD) may develop after exposure to an extremely threatening or horrific event, or series of events. It is characteriz ... https://www.psychologytools.com/resource/recognizing-post-traumatic-stress-disorder-ptsd/

Recognizing Social Anxiety Disorder

Social Anxiety Disorder is characterized by excessive fear regarding one or more social situations. People with social anxiety are concerned about bei ... https://www.psychologytools.com/resource/recognizing-social-anxiety-disorder/

Daily Monitoring Form

Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ... https://www.psychologytools.com/resource/daily-monitoring-form/

Treatment Planning Checklist

Some clients find it difficult to generate treatment goals for therapy. This simple handout presents problems that some people bring to therapy. It ca ... https://www.psychologytools.com/resource/treatment-planning-checklist/

Functional Analysis

Functional analysis examines the causes and consequences of behavior. This classic A-B-C Functional Analysis worksheet can be used to collect informat ... https://www.psychologytools.com/resource/functional-analysis/

Cognitive Behavioral Model Of Insomnia (Harvey, 2002)

Insomnia is a highly prevalent sleep disorder characterized by difficulty initiating or maintaining sleep, or having non-restorative sleep for at leas ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-insomnia-harvey-2002/

Emotion Focused Formulation

The Emotion Focused Formulation was developed by Isabel Clarke in an acute mental health context but this approach also has wider applicability. It pl ... https://www.psychologytools.com/resource/emotion-focused-formulation/

What Keeps Anorexia Going?

Cognitive Behavioral Model Of Depersonalization (Hunter, Phillips, Chalder, Sierra, David, 2003)

Depersonalization is an experience where an individual feels a sense of detachment from themselves, or estrangement from their perceptions, actions, a ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-depersonalization-hunter-phillips-chalder-sierra-david-2003/

Recognizing Binge Eating Disorder

Binge Eating Disorder is characterized by frequent and recurrent episodes of binge eating, which is defined as a period of time in which the individua ... https://www.psychologytools.com/resource/recognizing-binge-eating-disorder/

Recognizing Specific Phobia

Specific phobia is characterized by marked and excessive fear or anxiety concerning a particular object or situation, and which is out of proportion t ... https://www.psychologytools.com/resource/recognizing-specific-phobia/

Transdiagnostic Cognitive Behavioral Model Of Eating Disorders (Fairburn, Cooper, Shafran, 2003)

Fairburn, Cooper & Shafran (2003) argue that eating disorders such as anorexia and bulimia share common maintenance mechanisms despite difference ... https://www.psychologytools.com/resource/transdiagnostic-cognitive-behavioral-model-of-eating-disorders-fairburn-cooper-shafran-2003/

Recognizing Depersonalization-Derealization Disorder (DPD)

Depersonalization-Derealization Disorder is characterized by experiences of unreality and detachment from oneself and the world. Experiences of depers ... https://www.psychologytools.com/resource/recognizing-depersonalization-derealization-disorder-dpd/

Recognizing Panic Disorder

Panic attacks are discrete episodes of intense fear or apprehension which are accompanied by the rapid onset of characteristic physiological and cogni ... https://www.psychologytools.com/resource/recognizing-panic-attacks-and-panic-disorder/

Recognizing Body Dysmorphic Disorder

Body Dysmorphic Disorder is characterized by the persistent preoccupation with defects or flaws in one’s appearance that are either unnoticeable or ... https://www.psychologytools.com/resource/recognizing-body-dysmorphic-disorder/

What Keeps Bulimia Going?

Recognizing Agoraphobia

Agoraphobia is characterized by marked and excessive fear of situations such as open or public spaces where escape or help might not be available, and ... https://www.psychologytools.com/resource/recognizing-agoraphobia/

Cognitive Behavioral Model Of Tinnitus (McKenna, Handscombe, Hoare, Hall, 2014)

The Cognitive Behavioral Model Of Tinnitus identifies cognitive, behavioral, and perceptual changes which operate to maintain tinnitus perception and ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-tinnitus-mckenna-handscombe-hoare-hall-2014/

Cognitive Behavioral Model Of Anorexia Nervosa (Fairburn, Cooper, Shafran, 2003)

Anorexia nervosa is an eating disorder characterized by restriction of energy intake and intense fear of gaining weight. For women, the lifetime preva ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-anorexia-nervosa-fairburn-cooper-shafran-2003/

Classical Conditioning

Classical conditioning is a process by which stimuli become associated with responses. This information handout describes key principles of Classical ... https://www.psychologytools.com/resource/classical-conditioning/

Recognizing Hoarding Disorder

Hoarding Disorder is characterized by the ongoing accumulation of possessions that result in living spaces becoming overwhelmed to the point that thei ... https://www.psychologytools.com/resource/recognizing-hoarding-disorder/

Operant Conditioning

Operant conditioning / instrumental learning is a mechanism by which behaviors can be strengthened or weakened over time. This information handout des ... https://www.psychologytools.com/resource/operant-conditioning/

Recognizing Insomnia Disorders

Insomnia is characterized by persistent difficulty with sleep initiation, duration, consolidation, or quality that occur despite adequate opportunitie ... https://www.psychologytools.com/resource/recognizing-insomnia-disorders/

How Does This All Add Up To A Panic Attack? (Psychology Tools For Overcoming Panic)

Psychology Tools for Overcoming Panic takes a cognitive behavioral therapy (CBT) approach to this common anxiety problem. This chapter discusses the ... https://www.psychologytools.com/resource/how-does-this-all-add-up-to-a-panic-attack-psychology-tools-for-overcoming-panic/

Cognitive Behavioral Model Of Bulimia Nervosa (Fairburn, Cooper, Shafran, 2003)

Bulimia nervosa is an eating disorder characterized by binge eating followed by purging. Among young women, the point prevalence of bulimia is about 1 ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-bulimia-nervosa-fairburn-cooper-shafran-2003/

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Links to external resources

Psychology Tools makes every effort to check external links and review their content. However, we are not responsible for the quality or content of external links and cannot guarantee that these links will work all of the time.

Assessment

Collaborative Case Conceptualization Rating Scale (CCC-RS) | Kuyken, Padesky, Dudley | 2009
Primary Link Archived Link
- Kuyken, W., Beshai, S., Dudley, R., Abel, A., Görg, N., Gower, P., … & Padesky, C. A. (2016). Assessing competence in collaborative case conceptualization: Development and preliminary psychometric properties of the Collaborative Case Conceptualization Rating Scale (CCC-RS).Behavioural and Cognitive Psychotherapy,44(2), 179-192.
  Primary Link Archived Link
- Rating scale & coding manual
  Primary Link Archived Link
- Score sheet & feedback form
  Primary Link Archived Link

Case Conceptualization / Case Formulation

Formulation in Compassion Focused Therapy | Paul Gilbert | 2007
Archived Link
Maxi formulation | Helen Moya
Primary Link Archived Link
A case formulation approach to cognitive-behavior therapy | Jacqueline Persons | 2015
Primary Link Archived Link
The “Blobby” formulation | Helen Kennerley | 2015
Primary Link Archived Link
Good practice guidelines on the use of psychological formulation | British Psychological Society: Division Of Clinical Psychology
Archived Link
A quick guide to ACT case conceptualization | Russ Harris | 2009
Archived Link
Outline of ACT assessment / case formulation process | Jason Luoma
Primary Link Archived Link
ACT simple case formulation | Julian McNally
Primary Link Archived Link
Team formulation: key considerations in mental health services | Association of Clinical Psychologists UK | 2022
Primary Link Archived Link
DBT Case Formulation Format | Comtois
Archived Link
The case formulation approach to cognitive behavior therapy | Jacqueline Persons | 2014
Primary Link Archived Link

Information Handouts

Cycle vs. Heart Illustration for EFT | Paul Sigafus | 2013
Primary Link

Information (Professional)

Working with Schemas, Core Beliefs, and Assumptions | Frank Wills | 2008
Primary Link Archived Link

Presentations

The role of a case conceptualization model and core tasks of intervention | Donald Miechenbaum | 2014
Primary Link Archived Link
Cafe formulation in cognitive-behavioral therapy | Caleb Lack
Primary Link Archived Link

Video

CBT case formulation | Jacqueline Persons
Primary Link

Worksheets

Case Formulation Template
Archived Link

What Is Case Conceptualization / Case Formulation?

Types of Case Formulation

Case formulations can vary according to their purpose, and according to the information they attempt to convey. A number of types of formulation have been described:

A cross-sectional formulation presents information relevant to a short time period, as though an event were sliced open at a particular moment in time to reveal the triggering event, thoughts (interpretations/appraisals), emotions, body feelings, and behaviors or reactions. One of the most popular formats for a cross-sectional formulation is Padesky and Mooney’s ‘hot cross bun’ (1990).
A longitudinal formulation presents information relevant to the origin and maintenance of a problem. Weerasekera’s “Multiperspective model” popularized the use of the “5 Ps” approach (presenting, predisposing, precipitating, perpetuating, and protective) to case formulation (Weerasekera, 1993). Judith Beck’s cognitive conceptualization (1995) links longitudinal factors (including relevant childhood data, core beliefs, conditional assumptions, coping strategies) to cross-sectional breakdowns (situation, automatic thought and appraisal, emotion, behavior).
Micro-formulations have been described as a helpful way of understanding the origin and effects of troubling imagery (Hackmann, Bennett-Levy, & Holmes, 2011). In this approach problematic images are explored along with their origin, associated appraisals, current impact, maintenance factors, and cognitive consequences.
Disorder-specific models describe the critical presenting, predisposing, precipitating, and perpetuating factors relevant to a condition. Disorder-specific cognitive behavioral conceptualizations have been published for most conditions including low self-esteem, panic, obsessive-compulsive disorder, psychosis, post-traumatic stress disorder.

References

Beck, J. S. (1995). Cognitive behavior therapy: Basics and beyond. New York: Guilford Press.
Butler, G. (1998). Clinical formulation. In A. S. Bellack and M. Hersen (eds) Comprehensive clinical psychology. New York: Pergamon Press
Hackmann, A., Bennett-Levy, J., & Holmes, E. A. (2011). Oxford guide to imagery in cognitive therapy. New York: Oxford University Press.
Padesky, C. A., & Mooney, K. A. (1990). Presenting the cognitive model to clients. International Cognitive Therapy Newsletter, 6, 13–14.
Persons, J. B. (1989). Cognitive therapy in practice: A case formulation approach. New York: WW Norton.
Persons, J. (2008). The case formulation approach to cognitive-behavior therapy (guides to individualized evidence-based treatment).
Weerasekera, P. (1993). Formulation: A multiperspective model. Canadian Journal of Psychiatry, 38(5), 351–358.

Case Formulation and Disorder-Specific Models

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Generalized Anxiety Disorder

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