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Lookup NU author(s): Helen Spencer, Dr Rob DudleyORCiD, Professor Mark FreestonORCiD, Professor Douglas Turkington
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2022 The Authors. Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of The British Psychological Society. Objectives: Formulation is considered a fundamental process of cognitive behavioural therapy for psychosis (CBTp). However, an exploration into the personal impact of different levels of case formulation (CF) from a service user perspective (SU) is lacking, particularly for those experiencing a first episode of psychosis. Design: This Big Q qualitative design used semi-structured interviews. Methods: Reflexive thematic analysis (TA) was used to analyse 10 participant interviews. NVivo 12 computer-assisted qualitative data analysis software aided data organisation and analysis. Results: One overarching theme ‘CF – A vehicle for change?’ was developed as a pattern of shared meaning across the data set. Three main themes related to the overarching theme: (1) Vicious cycles: ‘I never really thought about it being me maintaining the problems’ (including one subtheme – Self-empowerment: ‘Only you can make the changes for yourself’); (2) Early life experiences: ‘My experiences have shaped the person that I am, therefore, it's not my fault’ (including one subtheme – Disempowerment: ‘[My] core beliefs have been damaged’); and (3) Keep it simple: ‘Don't push it too far over the top in case it becomes like spaghetti’. Conclusions: Maintenance formulations may be experienced as self-blaming, but also self-empowering, which may help to facilitate change. Longitudinal formulations may be experienced as non-blaming, but also disempowering, which may inhibit change. Simple CF diagrams may also facilitate change, whereas overly complex CFs may inhibit change. How CBTp therapists might look to improve the impact of different levels of CF for service users (SUs) in first episode psychosis (FEP) are described.
Author(s): Spencer HM, Dudley R, Johnston L, Freeston MH, Turkington D, Tully S
Publication type: Article
Publication status: Published
Journal: Psychology and Psychotherapy: Theory, Research and Practice
Year: 2023
Volume: 96
Issue: 2
Pages: 328-346
Print publication date: 01/06/2023
Online publication date: 08/12/2022
Acceptance date: 22/11/2022
Date deposited: 06/01/2023
ISSN (print): 1476-0835
ISSN (electronic): 2044-8341
Publisher: John Wiley and Sons Inc.
URL: https://doi.org/10.1111/papt.12442
DOI: 10.1111/papt.12442
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