Assessment and formulation (Kennerly)
21 important questions on Assessment and formulation (Kennerly)
What is a formulation or case conceptualisation?
In what ways is CBT used to develop a case conceptualization? (3)
2. Develop an account of why and how the client's problems develop
3. Develop an analyses of the key maintaining processes
What are the steps in developing a description of each aspect of the problem? (5)
2. Emotions/affects (some people have difficulty distinguishing between emotions and thoughts. Emotions can generally be expressed in words)
3. Behaviors
4. Physiological changes or bodily symptoms
5. Environment (domestic circumstances, work pressure)
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What are the most common triggers and modifiers? (6)
2. Social/interpersonal variables (particular people)
3. Cognitive variables (topic)
4. Behavioral variables (specific activities)
5. Physiological variables (alcohol, hunger & tiredness)
6. Affective variables (mood)
Some clients report feeling always depressed or anxious: they lost the ability to objectively evaluate
What is the main maintenance cycle for safety-seeking behaviors? (3)
2. Safety-seeking behavior
3. Failure to disconfirm the threat
What is the maintenance cycle for escape/avoidance (specific safety-seeking behavior)? (3)
2. Escape/avoidance
3. No change to fear beliefs (no copings strategies learned and no exposure of beliefs to disconfirmation)
What is the maintenance cycle of reduction of activity? (4) - Depression
2. Negative thoughts
3. Reduced activity
4. Loss of positive rewards
What is the maintenance cycle of catastrophic misinterpretation? (3) - Panic Disorder or OCD
2. Misinterpretation
3. Increased anxiety
What is the maintenance cycle of scanning or hypervigilant behavior? (3) - phobias, health anxiety, PTSD
2. Scanning/checking
3. Sensations noticed (or produced)
What is the maintenance cycle of self-fulfilling prophecies? (4) - Social anxiety or hostile behavior
2. Changed behavior toward others
3. Changes in behavior elicit consistent behavior from others
4. Apparent confirmation of predictions
What is the maintenance cycle of fear of fear? (3)
2. Aversive anxiety symptoms
3. Anticipatory fear of becoming anxious
What is the maintenance cycle of short-term reward? (3) - eating, substance, aggression, escape/avoidance & reassurance
2. Short-term reward (cycle with 1)
3. Longer-term negative consequences
(Operant conditioning)
What is important when assessing past history and problem development?
What is a mini formulation?
What is the aim of a formulation?
What are vulnerability factors?
What is important when building a formulation? (4)
2. The therapeutic relationship is an essential vehicle for change
3. Around two-session assessment (not too fast, not too slow)
4. Use diagrams and draw up a formulation as collaborative as possible
What is the blobby formulation?
What are the elements of the template of a formulation? (4)
2. Precipitants and beliefs or assumptions influencing the problem
3. The problem (thoughts, emotions, behavior, and physiology) influencing and being influenced by maintenance processes)
4. Current triggers and modifiers influencing the problem
What are the elements of the Blobby formulation? (3)
2. The inner world (self/others/future, rules/predictions/assumptions & automatic thoughts/images) influencing the problem
3. The problem
What is the 'vicious flower' formulation?
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