Formulations in Cbt

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Formulations in CBT Introduction This essay discusses what we understand by case conceptualization which is also called case formulation ( this paper refers to it in that term) in Cognitive Behavioral Therapy (CBT), and reminds us of some historical background and conceptual underpinnings of CBT case formulation. It then discusses why it’s important, as well as how we use it, in CBT approach. Further the paper draws some differences with Psychiatric Diagnosis. The essay includes some critics from different disciplines and what they say about CBT formulation. It discusses its strengths and weaknesses, and how we work with these. It offers an opinion when and how a case formulation is helpful. Following that, the essay points to…show more content…
Persons (1989) suggested that a case formulation may explain how current problems are being precipitated and how they actually make sense in the light of the hypothesised underlying beliefs and current triggers. These also may suggest origins of the underlying beliefs in the client’s early life. Judith Beck (1995), Melanie Fennell (1989) and others have expanded this view of the cognitive formulation to include Core Beliefs and Assumptions which are linked to the Automatic Thoughts specific to a given situation. In clinical setting, the case formulation guides a therapist how to structure the sessions and by prioritising the client’s core problems, give rise to a plan and choice of intervention. Case formulation is an element of an empirical hypothesis testing approach to clinical work and has three main elements which are assessment, formulation and intervention. The process of case formulation starts with an unstructured ‘problem list’ (Persons, 1989), then proceeds to look for common themes which could suggest underlying beliefs, schemas and early life experiences. This supports CBT in standing up against criticisms made by psychodynamic theorists which states that CBT deals only with symptom reduction, having no underlying rationale (Persons et al., 1996). Therefore rational for the use of case formulation is that it improves practice by linking theory, research and
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