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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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Case Formulation and Disorder-Specific Models

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100 of 102 resources

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

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

Obsessive Compulsive Disorder (OCD) Formulation

An important treatment implication of the cognitive behavioral model of OCD is that clinicians can work at the level of the meaning of the intrusion. ... 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

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

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

PTSD Formulation

This PTSD Formulation is designed for use in trauma-focused cognitive therapy for PTSD (CT-PTSD): an empirically supported treatment for post-traumati ... https://www.psychologytools.com/resource/ptsd-formulation

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

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

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

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

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 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

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

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

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

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

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

What Keeps Social Anxiety 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-social-anxiety-going

Therapy Blueprint For OCD

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-ocd

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

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

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

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

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

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

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

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

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

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

What Keeps Death Anxiety 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-death-anxiety-going

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

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

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 Post-Traumatic Stress Disorder (PTSD) 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-post-traumatic-stress-disorder-ptsd-going

What Keeps Panic 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-panic-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

Therapy Blueprint For Social Anxiety

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-social-anxiety

What Keeps Perfectionism 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-perfectionism-going

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

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

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

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

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/cognitive-behavioral-model-of-health-anxiety-salkovskis-warwick-deale-2003

What Keeps Body Dysmorphic Disorder (BDD) 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-body-dysmorphic-disorder-bdd-going

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

What Keeps Fears And Phobias 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-fears-and-phobias-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

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

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 Depersonalization And Derealization 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-depersonalization-and-derealization-going

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

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

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

Therapy Blueprint For Panic

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-panic

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

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

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/cognitive-behavioral-model-of-social-phobia-clark-wells-1995

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 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

Understanding My Panic

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/understanding-my-panic

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

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

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

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

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

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

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

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

What Keeps Anorexia 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-anorexia-going

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

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

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

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

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

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

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

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

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

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

What Keeps Bulimia 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-bulimia-going

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

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

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

Theory A / Theory B (Archived)

NOTE: An improved version of this resource is available here: Theory A / Theory B . Older versions of a resource may be archived in the event that the ... https://www.psychologytools.com/resource/theorya-theoryb-edition-1

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

What Keeps Tinnitus Going

What Keeps Tinnitus Going is a tinnitus formulation diagram which combines information about neurological-level change (the brain’s ‘filter’) an ... https://www.psychologytools.com/resource/what-keeps-tinnitus-going

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 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

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

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 Persistent Postural-Perceptual Dizziness (PPPD: Whalley, Cane, 2017)

Persistent postural-perceptual dizziness (PPPD) is a form of dizziness which is thought to be maintained by psychological factors. This is a Cognitive ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-persistent-postural-perceptual-dizziness-pppd-whalley-cane-2017

SWOT Analysis

SWOT Analysis is a tool, originally from management theory, which can help to guide action in the face of uncertainty or ambivalence. Clients can be a ... https://www.psychologytools.com/resource/swot-analysis

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

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

Recognizing Anorexia Nervosa

Anorexia Nervosa is characterized by the restriction of energy intake, leading to a severely low weight in the context of an individual’s age, heigh ... https://www.psychologytools.com/resource/recognizing-anorexia-nervosa

Recognizing Bulimia Nervosa

Bulimia Nervosa is characterized by frequent and recurrent episodes of binge eating, which are defined as a period of time in which the individual exp ... https://www.psychologytools.com/resource/recognizing-bulimia-nervosa

Putting It All Together (Psychology Tools For Living Well)

Cognitive behavioral therapy can help your clients to live happier and more fulfilling lives. Psychology Tools for Living Well is a self-help course ... https://www.psychologytools.com/resource/putting-it-all-together-psychology-tools-for-living-well

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
    • 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.
    • Rating scale & coding manual
    • Score sheet & feedback form

Case Conceptualization / Case Formulation

Information Handouts

  • Cycle vs. Heart Illustration for EFT | Paul Sigafus | 2013

Information (Professional)

Presentations

Video

  • CBT case formulation | Jacqueline Persons

Worksheets

Recommended Reading

Cognitive Behavioral Models Of Disorders

  • Morrison, A. P. (2001). The interpretation of intrusions in psychosis: an integrative cognitive approach to hallucinations and delusions. Behavioural and Cognitive Psychotherapy, 29(3), 257-276.
  • Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia.Social phobia: Diagnosis, assessment, and treatment,41(68), 00022-3.

Generalized Anxiety Disorder

  • Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998). Generalized anxiety disorder: A preliminary test of a conceptual model.Behaviour research and therapy,36(2), 215-226.

Cognitive Behavioral Models Of Disorders

  • Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319-345.
  • Espie, C. A. (2002). Insomnia: conceptual issues in the development, persistence, and treatment of sleep disorder in adults. Annual Review of Psychology, 53, 215–243.
  • Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment.Behaviour Research and Therapy,41(5), 509-528.
  • Fennell, M. J. (1997). Low self-esteem: A cognitive perspective. Behavioral and Cognitive Psychotherapy, 25(1), 1-26.
  • Fernie, B. A., Bharucha, Z., Nikčević, A. V., Marino, C., & Spada, M. M. (2017). A Metacognitive model of procrastination. Journal of Affective Disorders, 210, 196-203.
  • Garety, P. A., Kuipers, E., Fowler, D., Freeman, D., & Bebbington, P. E. (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31(2), 189-195.
  • Harvey, A. G. (2002). A cognitive model of insomnia. Behavior Research and Therapy, 40, 869–894.
  • Heimberg, R. G., & Becker, R. E. (1981). Cognitive and behavioral models of assertive behavior: Review, analysis and integration. Clinical Psychology Review, 1(3), 353-373.
  • Mansueto, C. S., Golomb, R. G., Thomas, A. M., & Stemberger, R. M. T. (1999). A comprehensive model for behavioral treatment of trichotillomania. Cognitive and Behavioral Practice, 6(1), 23-43.
  • Marlatt, G. A. (1985). Relapse prevention: Theoretical rationale and overview of the model. In G. A. Marlatt & J. R. Gordon (Eds.), Relapse prevention (1st ed., pp. 280–250). New York: Guilford Press.
  • Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24(4), 461-470.

Social Anxiety Disorder

  • Moscovitch, D. A. (2009). What is the core fear in social phobia? A new model to facilitate individualized case conceptualization and treatment. Cognitive and Behavioural Practice, 16. 123-134

Cognitive Behavioral Models Of Disorders

  • Salkovskis, P. M., Forrester, E., & Richards, C. (1998). Cognitive–behavioral approach to understanding obsessional thinking.The British Journal of Psychiatry,173(S35), 53-63.
  • Salkovskis, P. M., Warwick, H. M. C., Deale, A. C. (2003). Cognitive-Behavioral Treatment for Severe and Persistent Health Anxiety (Hypochondriasis).Brief Treatment and Crisis Intervention, 3, 353-367
  • Vlaeyen, J. W. S., & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain, 85(3), 317–332.

Generalized Anxiety Disorder

  • Wells, A. (1995). Meta-cognition and worry: A cognitive model of generalized anxiety disorder.Behavioural and cognitive psychotherapy,23(3), 301-320

Cognitive Behavioral Models Of Disorders

  • Whalley, M. G., & Cane, D. A. (2017). A cognitive-behavioral model of persistent postural-perceptual dizziness. Cognitive and Behavioral Practice, 24(1), 72-89.

Team formulation

  • Berry, K., Haddock, G., Kellett, S., Roberts, C., Drake, R., & Barrowclough, C. (2016). Feasibility of a ward‐based psychological intervention to improve staff and patient relationships in psychiatric rehabilitation settings. British Journal of Clinical Psychology, 55(3), 236-252.
  • What is the case formulation approach to cognitive-behavior therapy? | Jacqueline Persons | 2008

Case formulation / Case conceptualization

  • Geisser, S., & Rizvi, S. L. (2014). The Case of” Sonia” Through the Lens of Dialectical Behavior Therapy.Pragmatic Case Studies in Psychotherapy,10(1), 30-39.
  • Haynes, S. N., Leisen, M. B., Blaine, D. D. (1997). Design of individualized behavioral treatment programs using functional analytic clinical case models. Psychological Assessment, 9(4), 334-348
  • Kuyken, W., Padesky, C. A., Dudley, R. (2008). The science and practice of case conceptualization. Behavioural and Cognitive Psychotherapy, 36, 757-768
  • Persons, J. B., & Lisa, S. T. (2015). Developing and Using a Case Formulation to Guide Cognitive-Behavior Therapy. Journal of Psychology & Psychotherapy, 5(2), 1
  • Special issue: Team formulation. (2015). Clinical Psychology Forum, 275.
  • Spencer, H. M., Dudley, R., Johnston, L., Freeston, M. H., Turkington, D., & Tully, S. (2022). Case formulation—A vehicle for change? Exploring the impact of cognitive behavioural therapy formulation in first episode psychosis: A reflexive thematic analysis. Psychology and Psychotherapy: Theory, Research and Practice.

Cognitive Behavioral Models Of Disorders

  • Boelen, P. A., van den Hout, M. A., & van den Bout, J. (2006). A Cognitive-Behavioral Conceptualization of Complicated Grief. Clinical Psychology: Science and Practice, 13(2), 109–128.

Generalized Anxiety Disorder

  • Borkovec, T. D., Alcaine, O., & Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder.Generalized anxiety disorder: Advances in research and practice,2004.

Cognitive Behavioral Models Of Disorders

  • Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006).Solving the puzzle of deliberate self-harm: The experiential avoidance model.Behaviour Research and Therapy, 44(3), 371–394.

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, psychosispost-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.