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5 P’s Formulation (Friendly Formulation)

Case conceptualizations (formulations) help therapists and clients come to a shared understanding of a problem. This simple CBT formulation worksheet explores the origin and maintenance of a problem in an approachable and engaging format.

A case formulation (case conceptualisation) can be thought of as any way of helping a client to understand what their difficulties are, where they originated, and what keeps them going. CBT case formulations often have 5 ingredients:

  • Presenting problem(s)
  • Predisposing factors which made the individual vulnerable to the problem
  • Precipitating factors which triggered the problem
  • Perpetuating factors such as mechanisms which keep a problem going or unintended consequences of an attempt to cope with the problem
  • Protective factors

This Friendly Formulation diagram presents all of the these 5 p’s in an accessible way, framed by the question “How did the problem develop?”.

This is a Psychology Tools case formulation (case conceptualization) diagram. Put simply, case formulation is one method of a client and therapist coming to shared understanding of a difficulty. The formulation contextualizes the difficulty, making its origin and maintenance understandable. Case formulations are best completed collaboratively, with clients positioned as the ‘experts in themselves’.

  • Eells, T. D. (Ed.). (2011). Handbook of psychotherapy case formulation. Guilford Press.
  • Johnstone, L., & Dallos, R. (2013). Formulation in psychology and psychotherapy: Making sense of people’s problems. Routledge.
  • Kuyken, W., Padesky, C. A., & Dudley, R. (2008). Collaborative case conceptualization: Working effectively with clients in cognitive-behavioral therapy. Guilford Press.
  • Persons, J. B. (2012). The case formulation approach to cognitive-behavior therapy. Guilford Press.
  • Tarrier, N., & Johnson, J. (Eds.). (2015). Case formulation in cognitive behaviour therapy: The treatment of challenging and complex cases. Routledge.

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