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Determining what is important in a good formulation

Lookup NU author(s): Alyson Flitcroft, Professor Mark FreestonORCiD, Amy Wood-Mitchell


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Research suggests that there is low inter-rater reliability between therapists when asked to formulate the same case and that there may be discrepancies in what is considered an essential part of a formulation. The present study aimed to explore the diversity of therapists' viewpoints regarding the purpose and essential features of a cognitive-behavioural therapy (CBT) case formulation of depression. A Q-sort methodology was used in order to render these beliefs operational. Seven experienced CBT therapists participated in the construction of 86 statements, capturing concepts considered relevant to a CBT formulation of depression. This Q-sort was then administered to 23 therapists, who rated these statements in terms of their importance using a Q-sort procedure. Three factors emerged, suggesting three dominant opinions as to the importance of features of a formulation. A "state" CBT factor, focusing on the "here and now", accounted for most variance; followed by a second factor emphasizing "function and process" and a third factor emphasizing "trait" components. Whilst there was some agreement between what was considered to be least important in a formulation, the emergence of three distinct viewpoints suggests a lack of complete consensus amongst the therapists. © 2007 British Association for Behavioural and Cognitive Psychotherapies.

Publication metadata

Author(s): Flitcroft A, James IA, Freeston M, Wood-Mitchell A

Publication type: Article

Publication status: Published

Journal: Behavioural and Cognitive Psychotherapy

Year: 2007

Volume: 35

Issue: 3

Pages: 325-333

ISSN (print): 13524658

ISSN (electronic): 1469-1833

Publisher: Cambridge University Press


DOI: 10.1017/S135246580600350X


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