Good practice guidelines on the use of psychological formulation

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Division of Clinical Psychology
In abroad sense, constructing meaning out of mental distress has a very long history. For example, Freud wrote:
I was trained to employ local diagnoses…and it still strikes me myself as strange that the case histories
I write should read like short stories and that, as one might say, they lack the serious imprint of
science… Case histories of this kind…have, however, one advantage…namely an intimate connection
between the story of the patient’s sufferings and the symptoms of his illness.
(Freud & Breuer,
1895/1974, p.231)
The roots of formulation as a core skill of the profession of clinical psychology can be traced back to the sand the emergence of the scientist-practitioner model. In this,
clinical psychologists are seen as applied scientists, drawing on the science of psychology in order to generate hypotheses about individual clients (Kennedy & Llewelyn, 2001). The presenting problems became a puzzle to solve which engaged the clients in the process.

Influential clinicians such as Hans Eysenck, Victor Meyer, Monte Shapiro and Ira Turkat used the principles of classical and operant learning theory to develop individualised alternatives to psychiatric diagnosis. These summaries later came to include thought processes, inline with the emergence of cognitive-behavioural therapy (see Bruch & Bond Crellin, 1998; Corrie & Lane, 2010, fora more detailed history. The term formulation was first included in clinical psychology regulations in 1969

(Crellin, 1998), and it is now one of the core competencies of the profession, along with assessment, intervention, evaluation, audit and research, personal and professional skills,
communication and teaching skills, service delivery skills and transferable skills (Division of Clinical Psychology, 2010). Formulation is also practised by health, educational, forensic,
counselling, and sports and exercise psychologists, as described in the Health Professions
Council regulations (Health Professions Council, 2009). It features in the curriculum for psychiatrists training in the UK (Royal College of Psychiatrists, 2010), although, as discussed below, there are some differences of emphasis in psychiatric as compared to psychological formulation.

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