Clients' experience of case formulation in cognitive behaviour therapy for psychosis

Abstract

Objectives: Case formulation (CF) is considered essential to the practice of cognitive behaviour therapy, and crucial when working with more complex problems such as psychosis. Several claims are made for the beneficial impact of CF on clients, although little empirical research has been conducted.

Design: The study used content analysis methodology to assess clients' experience of the CF process in cognitive behaviour therapy for psychosis. In addition, therapists ranked seven documented benefits for them of CF.

Method: Thirteen clients and their respective therapists were interviewed 2-3 weeks after shared written formulation.

Results: Overall, clients' reactions to CF were cognitively, behaviourally, and emotionally complex, and subject to change over time. Therapists reported that they found the CF to be most useful in increasing their understanding of their clients.

Conclusions: Formulation is a complex process for clients, and future research into CF faces methodological challenges.