Reciprocal CBT Formulation
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Introduction & Theoretical Background
A CBT formulation helps therapists and clients to understand a client’s presenting problems within the framework of the cognitive behavioral model. Persons (2008) describes how formulations are described at three levels: case, disorder or problem, and symptom. These levels can be embedded in one another: for example, a case-level formulation may contain symptom-level cycles. Therapists use a wide variety of formulation tools, from cross-sectional models, which capture the effect of the environment on an individual’s thoughts, feelings, body, and behavior at a moment in time, to longitudinal models, which also seek to understand the underlying factors that predispose a client to the problems they are experiencing.
CBT theory can be applied to interpersonal problems. For example, Teichman’s reciprocal model of depression describes the constant process by which the behaviour of others can influence one’s internal state (Teichman & Teichman, 1990; Teichman, 1992). Safran and Segal’s cognitive interpersonal model (1996) describes
Therapist Guidance
“One helpful way of thinking about what happens in relationships is to draw out what happens. Would you be willing to use this tool to look at what happens in your relationships?”
Optional step: Identify beliefs about relationships
Beliefs and assumptions about relationships are important because they influence an individual’s perceptions of situations in the here-and-now. They might include beliefs about the self which influence how one is perceived interpersonally, or they might include assumptions, attitudes and rules concerning how one expects relationships to work.
- What are some of your beliefs about relationships?
- How do you expect other people to treat you?
- What do you expect from other people?
- If you do X how do you expect other people to react?
Step 1: Identify a specific triggering event which involved other people
The first step is to identify what triggered
References And Further Reading
- Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). The cognitive therapy of depression. New York: Guilford Press.
- Flecknoe, P., Sanders, D. (2004). Interpersonal difficulties. In: Bennett-Levy, J., Butler, G., Fennell, M., Hackman, A., Mueller, M., & Westbrook, D. (Eds.). 2004. The Oxford guide to behavioural experiments in cognitive therapy, 393-412. New York: Oxford University Press.
- Grimmer, A.G. (2013). The nine-part model: A tool for sharing dyadic formulations. Retrieved from www.bristolcbt.co.uk/publications/the-nine-part-model-dyadic-formulation
- Padesky, C.A. & Mooney, K.A. (1990). Presenting the cognitive model to clients. International Cogntive Therapy Newsletter, 6, 13-14. Retrieved from http://padesky.com
- Persons, J. B. (2008). The case formulation approach to cognitive-behavior therapy (guides to individualized evidence-based treatment). New York: Guilford.
- Safran, J., & Segal, Z. V. (1996). Interpersonal process in cognitive therapy. Jason Aronson, Incorporated.
- Teichman, Y. (1992). Family treatment with an acting-out adolescent. In A. Freeman & F. M. Datillio (Eds.) Comprehensive casebook