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David L Dawson & Nima G Moghaddam Formulation in Action. Applying Psychological Theory to Clinical Practice

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David L Dawson & Nima G Moghaddam Formulation in Action. Applying Psychological Theory to Clinical Practice David L Dawson & Nima G Moghaddam Formulation in Action. Applying Psychological Theory to Clinical Practice David L Dawson & Nima G Moghaddam Formulation in Action Applying Psychological Theory to Clinical Practice Managing Editor: Aneta Przepiórka Published by De Gruyter Open Ltd, Warsaw/Berlin This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 license, which means that the text may be used for non-commercial purposes, provided credit is given to the author. For details go to http://creativecommons.org/licenses/by-nc-nd/3.0/. © 2015 David L Dawson & Nima G Moghaddam and chapters’ contributors ISBN: 978-3-11-047099-4 e-ISBN: 978-3-11-047101-4 Bibliographic information published by the Deutsche Nationalbibliothek. The Deutsche Nationalbibliothek lists this publication in the Deutsche Nationalbibliografie; detailed bibliographic data are available in the Internet at http://dnb.dnb.de. Managing Editor: Aneta Przepiórka www.degruyteropen.com Cover illustration: © YasnaTen Complimentary copy, not for sale. Contents List of contributing authors XII Acknowledgments 1 David L Dawson & Nima G Moghaddam 1 Formulation in Action: An Introduction 3 1.1 The Current Volume 5 1.2 Chapter Structure 6 1.2.1 Model Overview and Application 6 1.2.2 Critical Commentary and Author Response 6 References 7 David L Dawson & Nima G Moghaddam 2 Case Description 9 2.1 Introducing Molly 9 2.1.1 Childhood and Early Adolescence 9 2.1.2 Early Adulthood 10 2.1.3 Adulthood 11 2.1.4 Current Difficulties 12 2.1.5 Psychological Therapy 12 2.1.6 Therapeutic Goals 14 David L Dawson, David M Gresswell, Ray St Ledger & Nima G Moghaddam 3 Clinical Behaviour Analysis 15 3.1 Defining Features 15 3.2 Historical Origins and Key Principles 17 3.3 Empirical Evidence 20 3.4 Critique 20 3.5 Formulation in Action 21 3.5.1 Initial Formulation 22 3.5.1.1 Sex and Relationships 22 3.5.1.2 Depression 23 3.5.1.3 Social Interaction 24 3.5.2 Intervention Objectives 25 3.5.3 Intervention Plan 26 3.5.3.1 Social Interaction 28 3.5.3.2 Depression 28 3.5.3.3 Evaluation 29 3.5.3.4 Potential Difficulties 30 Roger Bretherton & Rachel Sabin-Farrell 3.6 CBA Formulation: Critical Commentary 30 David M Gresswell, David L Dawson & Nima G Moghaddam 3.7 Author Response 32 References 33 Nima G Moghaddam & David L Dawson 4 Cognitive-Behavioural Therapy 36 4.1 Beckian CBT 37 4.2 Historical Origins 38 4.3 Defining Features 39 4.4 Empirical Evidence 40 4.5 Critique 41 4.6 Formulation in Action 42 4.6.1 Initial Formulation 44 4.6.1.1 Early Life 44 4.6.1.2 Core Beliefs 44 4.6.1.3 Conditional Assumptions 45 4.6.1.4 Compensatory Strategies, Presentation, and Maintenance 46 4.6.2 Situational Formulation 49 4.6.3 Intervention Objectives and Evaluation 51 4.6.4 Intervention Plan 52 4.6.4.1 Potential Difficulties 53 David M Gresswell 4.7 CBT Formulation: Critical Commentary 54 Nima G Moghaddam & David L Dawson 4.8 Author Response 56 References 57 Aidan J P Hart 5 Acceptance and Commitment Therapy 60 5.1 Defining Features 60 5.1.1 Experiential Avoidance and Psychological Flexibility 61 5.2 Core Processes 61 5.2.1 Acceptance 61 5.2.2 Cognitive Defusion 62 5.2.3 Contact With the Present Moment 63 5.2.4 Self as Context (Over Content) 64 5.2.5 Values 64 5.2.6 Committed Action 65 5.3 Evidence Base 66 5.4 Formulation in Action 66 5.4.1 Assess the Scope and Nature of the Presenting Problem 66 5.4.2 Identify what Experiences the Client is Attempting to Avoid 68 5.4.3 What Behaviours/Methods is the Client Using to Facilitate Their Avoidance? 68 5.4.4 Assess the Factors That May be Reducing Motivation for Change 68 5.4.5 Assess any Environmental Barriers to Change 69 5.4.6 Consider the Factors Contributing to Psychological Inflexibility 69 5.4.7 Intervention Objectives 70 5.4.7.1 Normalisation 71 5.4.7.2 Values 71 5.4.7.3 Acceptance 72 5.4.7.4 Contact With the Present Moment 72 5.4.7.5 Defusion and Self-as-Context 73 5.4.7.6 Goal Orientation and Committed Action 73 5.4.7.7 Treatment Summary 74 5.4.8 Measuring Effectiveness 74 Kerry Beckley 5.5 ACT Formulation: Critical Commentary 74 Aidan J P Hart 5.6 Author Response 76 References 77 Kerry Beckley 6 Schema Therapy 79 6.1 Early Maladaptive Schemas 79 6.2 Historical Origins of Schema Therapy 80 6.3 Key Techniques 81 6.4 Goals of Schema Therapy 82 6.5 The Schema Therapist 82 6.6 Who Does it Work for? 83 6.7 Criticisms of Schema Therapy 84 6.8 Formulation in Action 85 6.8.1 Schema Formulation 88 6.8.2 Intervention Objectives 89 6.8.3 Challenges in Therapy 91 6.8.4 How is Effectiveness Evidenced? 91 Aidan J P Hart 6.9 Schema Therapy Formulation: Critical Commentary 92 6.9.1 Evidence-base 93 6.9.2 Categorisation and the Concept of Schemas 93 6.9.3 Comparison to ACT Formulation 94 6.9.4 Final Thoughts 95 Kerry Beckley 6.10 Author Response 95 References 96 Thomas Schröder, Angela Cooper & Rohan Naidoo 7 Intensive Short-term Dynamic Psychotherapy (ISTDP) 99 7.1 Historical Origins 102 7.2 Unique Features 102 7.3 Empirical Evidence 103 7.4 Critiques and limitations of ISTDP 104 7.5 Formulation in Action 104 7.5.1 Initial Formulation Diagram 107 7.5.2 Intervention Objectives 108 7.5.3 Potential Problems 109 7.5.4 Indicators for the Achievement of Intervention Objective 110 7.5.5 Effectiveness 111 7.5.6 Practical Interventions 112 7.5.7 Techniques 112 7.5.8 Fit of Techniques With Theoretical Approach, Formulation, and Intervention Objectives 114 Anna Tickle & Michael Rennoldson 7.6 ISTDP Formulation: Critical Commentary 116 7.6.1 Formulation Content 117 IX 7.6.2 Role of Formulation 118 7.6.3 Client Experience 118 Thomas Schröder, Angela Cooper & Rohan Naidoo 7.7 Author Response 118 References 120 Anna Tickle and Michael Rennoldson 8 Systemic Family Therapy 123 8.1 The Central Tenets of Systemic Family Therapy 124 8.1.1 Systems Theory 124 8.1.2 The stance of the therapist 125 8.1.3 Formulation Within Family Therapy 125 8.1.4 Theories About ‘Problems’ 126 8.1.5 Structural Concepts 126 8.1.6 Strategic Concepts 127 8.1.7 Social Constructionist Concepts 127 8.2 Moving Towards Integration of Systemic Approaches to Formulation 128 8.3 Empirical Evidence of Effectiveness 128 8.4 Critique 129 8.5 Formulation in Action 130 8.5.1 Deconstruction of the Problem 131 8.5.2 Problem-maintaining Patterns and Feedback Loops 132 8.5.3 Beliefs and Explanations 133 8.5.4 Emotions and Attachments 133 8.5.5 Contextual Factors 134 8.5.6 Initial Formulation 134 8.5.7 Intervention Objectives 135 8.5.8 Intervention Plan 136 Thomas Schröder, Angela Cooper & Rohan Naidoo 8.6 Systemic Family Therapy Formulation: Critical Commentary 137 Anna Tickle & Michael Rennoldson 8.7 Author Response 139 References 140 X Rachel Sabin-Farrell & Roger Bretherton 9 Body-Centred Psychotherapy (BCP) 142 9.1 Empirical Evidence 143 9.2 Formulation in Action 144 9.2.1 Character Strategies 144 9.2.2 Trauma 145 9.2.3 Present Moment Experience 146 9.2.4 Initial Formulation 146 9.2.4.1 Developmental Issues–Attachment and Character 146 9.2.4.2 Trauma 149 9.2.5 Intervention Objectives 149 9.2.5.1 Trauma 150 9.2.5.2 Development & Attachment 151 9.2.6 Intervention Plan 152 9.2.6.1 Trauma 153 9.2.6.2 Development, Attachment, and Character 154 David M Gresswell 9.3 BCP Formulation: Critical Commentary 155 Rachel Sabin-Farrell & Roger Bretherton 9.4 Author response 157 References 158 Vanessa Dale-Hewitt & Chris Irons 10 Compassion Focused Therapy 161 10.1 Historical Origins of Compassion Focused Therapy 161 10.2 Theoretical Underpinnings and Central Tenets 162 10.2.1 Principle 1: Our Complex Minds and Motives Emerge from Evolutionary Processes 162 10.2.2 Principle 2: Our Sense of ‘Self’ is a Product of Our Genes and Socio- cultural Experiences 163 10.2.3 Principle 3: We Have Evolved Three Basic Emotion-regulation Systems 164 10.2.4 Principle 4: Bringing Our Emotion-regulation Systems Into Balance Increases Well-being 165 10.3 What is Compassion? 165 10.4 CFT Interventions 167 10.4.1 Attention Training and Mindfulness 167 XI 10.4.2 Soothing Breathing Rhythm 168 10.4.3 Imagery 168 10.4.4 Directing the ‘Compassionate Mind’ 168 10.5 CFT: Who Does it Work For and How? 169 10.6 Criticisms of Compassion Focused Therapy 169 10.7 Formulation in Action 170 10.7.1 Initial Formulations 171 10.7.1.1 Threat Focused Formulation 171 10.7.1.2 Three System Formulation 175 10.7.1.3 Further Information 177 10.7.2 Intervention Objectives 178 10.7.3 Potential Difficulties Working with Molly 179 10.7.4 How Would We Measure Progress? 179 Louise Braham & Sharron Smith 10.8 CFT Formulation: Critical Commentary 180 Vanessa Dale-Hewitt & Chris Irons 10.9 Author response 182 References 183 Louise Braham, Danielle De Boos & Sharron Smith 11 Integrative Approaches 185 11.1 The Origins of Integrative Working 186 11.2 Approaches to Integrative Working 187 11.3 What Evidence is There for Integrative Working? 189 11.4 Formulation in Action 189 11.4.1 Initial Formulation 190 11.4.1.1 Stage 1: CBT Model 190 11.4.1.2 Stage 2: Addition of Systemic Ideas 190 11.4.1.3 Stage 3: Addition of Relational Psychodynamic Ideas 192 11.4.2 Theoretical Congruence 194 11.4.3 Meaning in Practice 195 11.4.4 Intervention Objectives 195 11.4.5 Intervention Plan 196 11.4.6 Effectiveness 198 XII David M Gresswell 11.5 Integrative Formulation: Critical Commentary 199 Louise Braham & Sharron Smith 11.6 Author Response 201 References 202 Contributors 204 List of Figures 210 List of Tables 210 Index 210 List of contributing authors David L Dawson Rachel Sabin-Farrell University of Lincoln, UK The University of Nottingham / Nottinghamshire Chapters 1, 2, 3, 4 Healthcare
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