Mental Health Case Formulation
ASSIGNMENT PROMPT
Case formulations are a more in depth type of case study. It is a conceptualization of the client and describes the contextual environment that shaped how they came to be who they are as they present to you. It is the application of theory to the biopsychosocial assessment. This is where we strive to uncover the whole picture, as many aspects as possible of the client. This detail conceptualization is rich in detail and enhances the treatment plan process with the client. It all comes together here!
- Review Biopsychosocial Model and Case Formulation on the following website: Case Formulation (Links to an external site.) Be sure to review the case formulation method 3 (advanced) near the middle of the webpage, this is the format for the assignment. This section presents a much more advanced and more comprehensive formulation that integrates the 4Ps formulation through multiple lenses (e.g. – Eriksonian developmental stages (Links to an external site.), psychodynamic defenses (Links to an external site.), and dialectical behavioural (Links to an external site.)). This webpage also offers many examples.
- (Links to an external site.)Review the journal article titled Formulation for beginners- easily located in google scholar and also in Module 2. Selzer, R., & Ellen, S. (2014). Formulation for beginners. Australasian Psychiatry, 22(4), 397-401. (Originally found in module 1)
- Read the case study for Vlad in Chapter 13 listed and complete a Case Formulation Paper and Chart based on this Vlad. The directions for the case formulation are listed below. Be sure to use your reading resources in module 1 as a guide.
- Create and fill out a 4P Case Formulation chart using the cell titles below. Don’t forget some factors may overlap and should be listed in multiple cells. Use short and brief bullet descriptors as modeled in examples provided on the website and other articles including those from module 2. Do not write full sentences.
- As you are writing your narrative include the application of theories to your case. This is your chance to demonstrate you understand that theory links to actual case details. There are 3 example paragraph narratives below to help you understand the depth of the assignment expectation regarding apply theory to your case.
Biological Psychological Social Predisposing Precipitating Perpetuating Protective case formulation-1.pptx
Voice Over Slide Presentation
Write a narrative using the following outline (you may add other sub headings if you desire).
Patient ID:
- Include all applicable diagnosis and specifiers (includes medical dx for example; diabetic, cancer remission x2 years, eczema etc., )
- Current stressors, plus salient developmental history
Non-psychological factors:
- Genetics, temperament, medical history, substances, medications
Early developmental and pathogenic psychological factors:
- Include application of developmental theories where applicable
Precipitating and perpetuating factors
- Don’t forget these could include personality traits, coping skills, etc.
Prediction of response to treatment and interventions:
- Be sure to discuss factors that you might include in initiating treatment – like addressing readiness to change (stages of change for specific issues), areas to engage the client, and potentiation targets for change to address in the treatment planning including potential barriers where applicable.
EXAMPLES OF USE OF THEORY APPLICATION IN CASE FORMULATION:
Client 1
Multiple theories and frameworks can used to conceptualize Gregory’s case. Using a social learning lens Gregory’s alcohol use could be indicative of modeling as well as a biological link through genetics. Gregory’s father abused alcohol while he was in his care, which he witnessed and thereby modeled the maladaptive behavior. Additionally, as his mother with Borderline personality disorder diagnosis, genetics could explain his later development of the disorder which has a strong genetic component. From a systems perspective it is clear Gregory’s early experiences and interactions within his home and low SES community (victim of domestic violence, witness to interpersonal violence, murder, “ghetto”) presented him with a wide range of maladaptive adult interactions. The extended roots of Psychodynamic theory informs us that Gregory’s early childhood neglect and home discord would most likely result in a disorganized/disoriented attachment style.
Client 2
During these years, Donald may have struggled with Erik Erikson’s identity vs. role confusion as he struggled to identify his role in society and as a result, he experienced thoughts of suicide. Donald’s suicidal ideation also demonstrates emotion dysregulation skills as a teenager. (if emotion dysregulation is used to describe the client you would most likely write about DBT as a theoretical framework for treatment in the appropriate section of the paper)
Client 3
Using the transtheoretical model of behavior change helps to determine appropriate interventions for how the client might be motivated or not motivated to makes changes. Using this model, the patient appears to be in the contemplation stage of change regarding her anxiety and her depression. She recognizes her symptoms of anxiety and depression and has taken a small step by reaching out and speaking to someone. This shows her readiness to change, as well as her ambivalence towards changing her behavior. The clinician will need to target motivational interviewing strategies by rolling with her resistance and helping her to clarify her goals and figure out what she wants to achieve.