Good practice guidelines on the use of psychological formulation

Appendix 3: Formulation and research

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Appendix 3: Formulation and research

teams. Research on the use of formulation in teams has so far been limited to relatively small practice-based studies in inpatient settings. For example, Kennedy et al. (evaluating anew inpatient service in which a key intervention was the collaborative production of a formulation, concluded that it was a powerful systemic intervention in itself which was regarded positively by both service users and staff. Summers (explored staff views of the impact of introducing psychological formulations to a high dependency rehabilitation service and found that they believed that formulation benefited care planning, staff-patient relationships, staff satisfaction and team-working, through increasing understanding of patients, bringing together staff with different views and encouraging more creative thinking. Wainwright and Bergin (2010) provided a similar assessment of staff views on the effectiveness of introducing formulation meetings onto an acute inpatient ward for older adults. Lake (2008) has described a team formulation approach facilitated in regular meetings by a psychologist, which was evaluated very positively by all staff (2008). Berry et al. (2009) found that formulation meetings resulted in staff feeling increased confidence in their work, and perceiving service users more positively and optimistically.
Among the conceptual and methodological hurdles to be overcome in researching formulation are Defining formulation (process versus event).

Separating the effects of the formulation from the therapy of which it is an integral part. (Although team formulations avoid this problem because they are by definition separate from individual therapy in fact therapy may not be a feature of the intervention at all.)

Deciding the terms in which formulation is evaluated. A narrative/personal meaning approach would see usefulness as a more appropriate criterion than
‘truth’, or reliability, validity etc, although usefulness immediately raises the questions useful to whom and how would this be assessed On the other hand, the
‘truth’ perspective implies a consensus on what it means to say that a formulation is
‘valid’, and who makes this judgement. Suggestions for assessing the quality of formulations have been made by Butler (1998) Ten tests of a formulation Lane) ‘Stopthengo’ checklist Kuyken (2006) ‘Evidence-based guidelines and
Persons (2008) Five tests’.
Margison et al. (2000) have recommended that evidence for the effectiveness of therapy,
including formulation, should come from practice-based evidence as well as evidence- based practice. Good Practice Guidelines on the use of psychological formulation

Division of Clinical Psychology
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