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A literature review exploring the efficacy of case formulations in clinical practice. What are the themes and pertinent issues?

Published online by Cambridge University Press:  01 June 2009

Robert Aston*
Affiliation:
Psychology Department, University of Birmingham, Edgbaston, Birmingham, UK
*
*Author for correspondence: Mr R. Aston, Birmingham University, School of Psychology, Edgbaston, Birmingham B15 2TT, UK. (email: robjohnaston@hotmail.com)

Abstract

There is a paucity of research exploring the validity, reliability and impact on clinical outcome of Cognitive Behavioural Psychotherapy (CBP) case formulations. This review considers a variety of literature that relates to formulations and their use, it also draws on other types of psychotherapy where there appears to be a more established and robust research base. The literature review explores the research that has taken place within CBP and considers the themes that emerge from this research. Several themes were identified and these relate to decision-making and experience, specific guidelines to aid quality of formulations and a significant lack of understanding of clients' views on the formulation process and its outcome. It is unclear whether formulations do influence the successfulness of therapy. Recommendations are made as to what further research is needed and the form this should take.

Type
Review
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2009

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References

Recommended follow-up reading

Bieling, PJ, Kuyken, W (2003). Is cognitive case formulation science or science fiction? American Psychological Association 10, 5269.Google Scholar
Chadwick, P, Williams, C, Mackenzie, J (2003). Impact of case formulation in cognitive behaviour therapy for psychosis. Behaviour Research and Therapy 41, 671680.CrossRefGoogle ScholarPubMed
Grant, A, Townend, M, Mills, J, Cockx, A (2008). Assessment and Formulation in Cognitive Behavioural Therapy. London: Sage.Google Scholar
Kuyken, W (2006). Evidence-based case formulation. Is the emperor clothed? In: Case Formulation in Cognitive Behaviour Therapy (ed.Tarrier, N.), pp. 1235. London: Routledge.Google Scholar

References

Alford, B, Beck, AT (1997). The Integrative Power of Cognitive Therapy. New York: Guilford Press.CrossRefGoogle Scholar
APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV-TR). Washington, DC: American Psychological Association.Google Scholar
Beck, AT, Rush, AJ, Shaw, BF, Emery, G (1979). Cognitive Therapy of Depression. New York. Guilford Press.Google Scholar
Bieling, PJ, Kuyken, W (2003). Is cognitive case formulation science or science fiction? American Psychological Association 10, 5269.Google Scholar
Byrne, S, Birchwood, M, Trower, PE, Meaden, A (2006). A Casebook of Cognitive Behaviour Therapy for Command Hallucinations – A Social Rank Theory Approach. London: Routledge.Google Scholar
CASP (2006). Critical Appraisal Skills Programme – Making Sense of Evidence. England: Public Health Resource Unit.Google Scholar
Caspar, F, Berger, T, Hautle, I (2004). The right view of your patient: a computer-assisted, individualized module for psychotherapy training. Psychotherapy: Theory, Research, Practice, Training 41, 125135.CrossRefGoogle Scholar
Chadwick, P, Taylor, KT, Abba, N (2005). Mindfulness groups for people with psychosis. Behavioural and Cognitive Psychotherapy 33, 351359.CrossRefGoogle Scholar
Chadwick, P, Williams, C, Mackenzie, J (2003). Impact of case formulation in cognitive behaviour therapy for psychosis. Behaviour Research and Therapy 41, 671680.CrossRefGoogle ScholarPubMed
Chase Gray, J, Grant, A (2005). Cognitive behavioural therapy: helping the client find her voice. Mental Health Practice 8, 3437.CrossRefGoogle Scholar
Dalgleish, T (2004). Cognitive approaches to posttraumatic stress disorder: the evolution of multi-representational theorizing. Psychological Bulletin 130, 228260.CrossRefGoogle Scholar
Dudley, R, Kuyken, W (2006). Formulation in cognitive-behavioural therapy – ‘There is nothing either good or bad, but thinking makes it so’. In: The Modern Scientist-Practitioner: A Guide To Practice In Psychology (ed.Lane, D. A. and Corrie, S.), pp. 1740. London: Routledge.Google Scholar
Eells, TD (1997). Handbook of Psychotherapy Case Formulation. New York: Guilford Press.Google Scholar
Eells, TD, Kendjelic, MA, Lucas, CP (1998). What's in a case formulation – development and use of a content coding manual. Journal of Psychotherapy Practice and Research 7, 144153.Google Scholar
Emmelkamp, PMG, Bouman, TK, Blaauw, E (1994). Individualized versus standardized therapy: a comparative evaluation with obsessive-compulsive patients. Clinical Psychology and Psychotherapy 1, 95100.CrossRefGoogle Scholar
Flitcroft, A, James, IA, Freeston, M, Wood-Mitchell, A (2007). Determining what is important in a good formulation. Behavioural and Cognitive Psychotherapy 35, 325333.CrossRefGoogle Scholar
Friedman, RS, Lister, P (1987). The current status of psychodynamic formulation. Psychiatry 50, 126141.Google ScholarPubMed
Gabbay, M, Shiels, C, Bower, P, Sibbald, B, King, M, Ward, E (2003). Patient-practitioner agreement: does it matter? Psychological Medicine 33, 241251.CrossRefGoogle ScholarPubMed
Grant, A, Townend, M (2008). The fundamentals of case formulation. In: Assessment and Formulation in Cognitive Behavioural Therapy (ed.Grant, A., Townend, M., Mills, J. and Cockx, A.), pp. 4561. London: Sage.Google Scholar
Grant, A, Townend, M, Mills, J, Cockx, A (2008). Assessment and Formulation in Cognitive Behavioural Therapy. London: Sage.Google Scholar
Herbert, JD, Mueser, KT (1991). The proof is in the pudding: a commentary on Persons. American Psychologist 46, 13471348.CrossRefGoogle ScholarPubMed
Jacobson, NS, Schmaling, KB, Holtzworth-Munroe, A, Katt, JL, Wood, LF, Follette, VM (1989). Research-structured vs clinically flexible versions of social learning-based marital therapy. Behaviour Research and Therapy 27, 173180.CrossRefGoogle ScholarPubMed
Johnstone, L, Dallos, R (2006). Formulation in psychology and psychotherapy. In: The Modern Scientist-Practitioner: A Guide to Practice in Psychology (ed.Lane, D. A. and Corrie, S.), pp. 116. London: Routledge.Google Scholar
Kinderman, P, Lobban, F (2000). Evolving formulations sharing complex information with clients. Behavioural and Cognitive Psychotherapy 28, 307310.CrossRefGoogle Scholar
Kuyken, W (2006). Evidence-based case formulation. Is the emperor clothed? In: Case Formulation in Cognitive Behaviour Therapy (ed. Tarrier, N.), pp. 1235. London: Routledge.Google Scholar
Kuyken, W, Fothergill, CD, Meyrem, M, Chadwick, P (2005). The reliability and quality of cognitive case formulation. Behaviour Research and Therapy 43, 11871201.CrossRefGoogle ScholarPubMed
Lane, DA, Corrie, S (2006). The Modern Scientist-Practitioner: A Guide to Practice in Psychology. London: Routledge.Google Scholar
Lincoln, YS, Guba, E (1985). Naturalistic Enquiry. California: Sage Publications.Google Scholar
Luborsky, L, McLellan, AT, Woody, GE, O'Brien, CP, Auerbach, A (1985). Therapist success and its determinants. Archives of General Psychiatry 42, 602611.CrossRefGoogle ScholarPubMed
Mumma, GH (1998). Improving cognitive case formulations and treatment planning in clinical practice and research. Journal of Cognitive Psychotherapy: An International Quarterly 12, 251274.CrossRefGoogle Scholar
NICE (2004 a). Anxiety: management of anxiety (panic disorder, with or without agoraphobia, and generalised anxiety disorder) in adults in primary, secondary and community care (http://guidance.nice.org.uk/CG22/guidance/pdf/English). Accessed 1 April 2008.Google Scholar
NICE (2004 b). Depression: management of depression in primary and secondary care (http://guidance.nice.org.uk/CG23/guidance/pdf/English). Accessed 1 April 2008.Google Scholar
NICE (2005 a). Obsessive-compulsive disorder: core interventions in the treatment of obsessive disorder and body dysmorphic disorder (http://guidance.nice.org.uk/CG31/guidance/pdf/English). Accessed 1 April 2008.Google Scholar
NICE (2005 b). Post-traumatic stress disorder: the management of PTSD in adults and children in primary and secondary care (http://guidance.nice.org.uk/CG26/guidance/pdf/English). Accessed 1 April 2008.Google Scholar
NICE (2007). The competences required to deliver effective cognitive and behavioural therapy for people with depression and anxiety disorders. London: Department of Health.Google Scholar
Osborn, CJ, Dean, EP, Petruzzi, ML (2004). Use of simulated multidisciplinary treatment teams and client actors to teach case conceptualisation and treatment planning skills. Counselor Education and Supervision 44, 121134.CrossRefGoogle Scholar
Palmer, RL (2002). Dialectical behaviour therapy for borderline personality disorder. Advances in Psychiatric Treatment 8, 1016.CrossRefGoogle Scholar
Pankey, J, Hayes, SC (2003). Acceptance and commitment therapy for psychosis. International Journal of Psychology and Psychological Therapy 3, 311328.Google Scholar
Perry, S, Cooper, AM, Michels, R (1987). The psychodynamic formulation: its purpose, structure, and clinical application. American Journal of Psychiatry 144, 543551.Google ScholarPubMed
Persons, JB, Bertagnolli, A (1999). Inter-rater reliability of cognitive-behavioral case formulations of depression: a replication. Cognitive Therapy and Research 23, 271283.CrossRefGoogle Scholar
Persons, JB, Curtis, JT, Silberschatz, G (1991). Psychodynamic and cognitive behavioral formulations of a single case. Psychotherapy 28, 608617.CrossRefGoogle Scholar
Persons, JB, Mooney, KA, Padesky, CA (1995). Interrater reliability of cognitive-behavioral case formulations. Cognitive Therapy and Research 19, 2134.CrossRefGoogle Scholar
Persons, JB, Roberts, NA, Zalecki, CA, Brechwald, WAG (2006). Naturalistic outcome of case formulation-driven cognitive-behavior therapy for anxious depressed outpatients. Behaviour Research and Therapy 44, 10411051.CrossRefGoogle ScholarPubMed
Schulte, D (1996). Tailor-made and standardized therapy: complementary tasks in behavior therapy – a contrarian view. Journal of Behavior Therapy and Experimental Psychiatry 27, 119126.CrossRefGoogle ScholarPubMed
Schulte, D, Kunzel, R, Pepping, G, Schulte-Bahrenburg, T (1992). Tailor-made versus standardised therapy of phobic patients. Behavioural Research and Therapy 14, 6792.CrossRefGoogle Scholar
Snyder, CR, Michael, ST, Cheavens, JS (1999). Hope as a psychotherapeutic foundation of common factors, placebos, and expectancies. In: The Heart and Soul of Change: What Works in Therapy (ed.Hubble, M. A., Duncan, B. I. and Miller, S. D.), pp. 179200. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
Svensson, B, Hansson, L (1999). Therapeutic alliance in cognitive therapy for schizophrenia and other long-term mentally ill patients: development and relationship to outcome in an in-patient treatment programme. Acta Psychiatrica Scandinavica 99, 281287.CrossRefGoogle Scholar
Tarrier, N (2006). Case Formulation in Cognitive Behaviour Therapy – The Treatment of Challenging and Complex Cases. London: Routledge.Google Scholar
Tarrier, N, Calam, R (2002). New developments in cognitive-behavioural case formulation. epidemiological. systematic and social context: an integrative approach. Behavioural and Cognitive Psychotherapy 30, 311328.CrossRefGoogle Scholar
Townend, M, Grant, A (2008). Assessment in CBT: the idiographic approach. In: Assessment and Formulation in Cognitive Behavioural Therapy (ed.Grant, A., Townend, M., Mills, J. and Cockx, A.), pp. 721. London: Sage.Google Scholar
Wells, A (2003). Cognitive Therapy of Anxiety Disorders – A Practical Manual and Conceptual Guide. Chichester: John Wiley & Sons.Google Scholar
Westmeyer, H (2003). On the structure of case formulations. European Journal of Psychological Assessment 19, 210216.CrossRefGoogle Scholar
Zuber, I (2000). Patients' own problem formulation and recommendations for psychotherapy. Journal of Psychotherapy Integration 10, 403414.CrossRefGoogle Scholar
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