The Case Formulation - Longitudinal A worksheet explores factors which might precipitate and prolong a difficulty.
Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.
A copy of the worksheet in PDF format.
An editable Microsoft PowerPoint version of the resource.
Case conceptualizations (formulations) help therapists and clients come to a shared understanding of a problem. This case formulation worksheet is a thorough outline of the factors which might trigger and prolong a difficulty. It incorporates the 5 'P' factors: presenting, predisposing, precipitating, perpetuating, and protective factors. It also includes a cross-sectional analysis of thoughts, feelings, behaviors, and physical sensations related to specific situations.
Case formulation is vital in cognitive behavioral therapy (CBT) for understanding the origin and maintenance of a client's difficulties. This resource supports:
Explains the origins and factors that contribute to low mood.
Offers insights into issues related to self-worth and provides historical context.
Explores whether anxiety comes from and how it is maintained.
Suggest developing a formulation with the client.
Review and complete each section of the formulation diagram.
Help the client reflect on the completed formulation and make further revisions.
Use the insights to inform and direct therapeutic interventions.
Formulation is a key component of cognitive behavioral therapy (CBT) and is considered essential to effective practice (Beck, 2011; Dudley & Kuyken, 2013; Muse et al., 2016). According to Kennerley and colleagues (2017), cognitive behavioral formulation seeks to describe clients’ current problems, explain how and why they might have developed, and identify processes that are hypothesized to maintain them using the cognitive behavioral model. In this way, formulation represents a bridge or crucible that combines CBT theory, research, and clients’ lived experiences (Kennerley et al., 2017; Kuyken et al., 2009).
Formulation in CBT is an active and dynamic process that begins at the outset of treatment and continues throughout (Beck, 2011). CBT therapists draw on different sources of information to inform and modify formulations during treatment, including client feedback and self-report, questionnaire responses, in-session interactions, responses to interventions, and awareness of the client’s sociocultural political context (Butler, 1998).
The Case Formulation - Longitudinal A is a longitudinal CBT case formulation which addresses the crucial 5 'P' factors (presenting, predisposing, precipitating, perpetuating, positives). This diagram also includes a cross-sectional component (thoughts, feelings, behaviors, and physical sensations associated with a specific here-and-now situation). This style of formulation can help draw client's attention to the links between their underlying beliefs (schemas), and their patterns of thinking and behaving in the here-and-now.
