Appendix 5.1

Guidelines: Clinical Study 1 - Formulation (Submitted at mid- point of year 1)

Overview

Please submit with a Signed Declaration and a completed Coursework Confidentiality Checklist. In this clinical study report you are required to formulate one piece of clinical work from either the Child and Family or Learning Disability component of your placement from the perspective of two different psychological models. These models will normally be chosen from Family Systemic, Psychodynamic/Attachment, Behavioural and CBT models and Community/ Social Inequalities. You need to bear in mind that the different models require different types of information to be gathered at assessment from a range of levels: individual, inter-personal and social/cultural. Therefore, the assessment of the client/s’ presenting problems and strengths/ resources and their circumstances will need to be quite comprehensive in order that adequate information is available from which to formulate using two models. Your formulation is a guide to thinking and understanding, and while not predominantly concerned with being ‘correct’, it should be supported by evidence.

You are not required to set out the details of the interventions, but should indicate some of the potential implications of your formulations for intervention(s) and for further avenues of information seeking.

The work will usually be based on assessment for possible psychological therapy and/or other interventions for an individual or couple/ family, but it may be based on assessment for possible psychological interventions (e.g. group work, supervision or consultation) for groups, team/s or organisation/s.

You may wish to discuss the suitability of your choice of clinical work with your academic/appraisal tutor, and you may submit a preliminary draft to them for feedback and comment.

General aim

To assess your ability to succinctly formulate a piece of clinical work from two different theoretical approaches

Word limit: 3,500 words, including tables and references, but excluding appendices. Word guidance for sections is indicative only – you can be flexible with these. If you go more than 10% over word limit this will normally automatically mean a conditional pass and the work will be returned for shortening. Format of report

Abstract: (word guidance 250 words)

Background and assessment: Include the process of referral, the client/s’ initial presenting problems and strengths/resources and, where relevant, information gained from liaison with client/s’ family members, carers and/or other professionals. Consider the client/s’ and/or key network members’ perspectives on their current situation and expressed needs and hopes. Describe qualitative methods of gathering information and any psychometric measures used at assessment. Note any limitations to opportunities to gather relevant information. Where relevant, the assessment should include a genogram and time-line clarifying key events in the client/family’s life that are relevant to the issues to be addressed in the work. Summarise the information gained in terms of predisposing, precipitating, maintaining and protective factors at a range of levels. Ensure that you include all the relevant information that is drawn on in the subsequent formulations. Ensure that you address issues of consent and confidentially (word guidance 1000 words).

Brief review of relevant literature: Briefly summarise key relevant theoretical and empirical background information to the two models chosen. This will require conceptualisations of the kinds of problems displayed by the client/s within each model, including reference to the evidence base for practice and, where relevant, practice-based evidence which supports the application of each model to an understanding and treatment of the presenting issues (word guidance 500 words).

Formulation: Describe the formulation from each model in turn - formulations should be presented succinctly. They should draw on and be clearly supported by the information presented in the background/assessment of the case (do not repeat material presented in background section though). Offer an indication of how the formulations can complement each other and where they suggest contrasts, competing explanations and clinical implications. Give an indication of how you might negotiate and share your thinking on the formulation with your client or with key people in the client’s network. Describe the development of your thinking, for example in moving from initial impressions to preliminary to subsequent formulations (word guidance 500 words).

Implications: Give an indication of implications of the formulations in terms of possible routes for intervention and action including what further avenues of information the formulations would lead you to pursue. Include consideration of how you might evaluate the effectiveness of the work you would undertake (word guidance 500 words).

Critical appraisal and reflection: Attempt to identify both strengths and potential weaknesses in the formulations and how weaknesses might be remedied. Consider how your assessment process was constrained and enabled by your choice of models. Consider the relevance of the formulations for the client’s particular life, circumstances and expressed needs and hopes. Identify any personal factors for yourself and contextual factors that may have impacted on your choice and use of the models. Discuss the relative contributions of the models, and the opportunities and constraints for their integration. Ensure that throughout the work you have been sensitive and thoughtful about issues of social inequalities and cultural diversity (word guidance 750 words).

Appendices

Include an actual or potential summary letter back to the referrer or client, including succinct summary of reason for referral, client (s) priorities and agreed aims/intentions for the work, key findings from assessment, succinct summary of working formulation, and initial plans for intervention. The letter should be no more than 2 sides of A4.

If appropriate, include anonymised copies of any questionnaires used or written information gained from the client which is relevant (e.g. behavioural diary), as well as referral letter and any correspondence by yourself e.g. letter back to referrer.

NB. Information about the actual intervention following the assessment and formulation should not be included.

Presentation Abstract Background Use of Formulation Implications Critical Referral letter and assessmentLiterature appraisal (incl risk) and reflection Material Excellent The General Demonstrates Intervention Shows Outstanding exceptionally clear difficulties/issues claims and very sound plans very clearly excellent letter Excellent well succinct to be explained inassumption grasp of the grounded in awareness to referrer or organised summary the formulation s are very models being formulation(s). of client; very according to that are very clearly well used. Offers a Excellent potential succinct, very format in covers all of described. supported very plausible consideration of weaknesses well structured, handbook. the Sufficient by and coherent what further in the very clearly Tables, main points.background references account of the avenues of formulation written and figures, etc. information is to development information and including all very provided in a appropriate maintenance of seeking the indicates relevant key well placed & very ordered and literature. the identified formulations how these points. labelled. structured way to Shows difficulties. The would lead to. might be References enable reader to excellent formulation is Excellent plans remedied. all in easily follow the awareness very well for evaluation of Excellent acceptable formulations. of key ideas supported by the work: maybe discussion of format. Includes in the assessment shows particular personal Excellent excellent relevant data or other attention to position writing style. attention to area. appropriate innovative regarding No issues of The means. methods of the choices typographical inequality and difficulties/isExcellent evaluation and/or regarding spelling, diversity. sues to be awareness of particular the models, grammatical Consent and explained in the connectionsattention to differential errors. confidentially the and contrasts psychometric use of the Well within very well formulation between the properties of any models, e.g. word limit. addressed. are very models in termstools proposed. in how Issues of risk andclearly of their personal risk management described. conceptualisati factors may are thoroughly Sufficient ons of the have addressed. background problems. influenced information Excellent ability gathering of is provided to consider how information in a very they can and analysis. ordered andcomplement structured each other in way to guiding further enable gathering of reader to information. easily follow the formulations . Includes excellent attention to issues of inequality and diversity. Consent and confidentiall y very well addressed. Issues of risk and risk manageme nt are thoroughly addressed. Material well Clear The General Demonstrates Intervention Shows good Good letter to organised succinct difficulties/issues claims and sound grasp of plans clearly awareness referrer or Good according to summary to be explained inassumption the grounded in of client; format in that the formulation s are models being formulation(s). potential quite succinct, handbook. covers mostare clearly supported used. Offers a Good weaknesses fairly Tables, of the main described. by plausible and consideration of in the well structured, figures, etc. points. Sufficient references coherent what further formulation reasonably appropriately background to account of the avenues of and clearly placed and information is appropriate development information indicates written and labelled. provided in an literature. maintenance of seeking the how these including References in ordered and Shows goodthe identified formulations might be most relevant acceptable structured way to awareness difficulties. The would lead to. remedied. key format. Clear enable reader to of key ideas formulation is Good plans for Good points. writing style. follow the in the adequately evaluation of the discussion of Very few, if formulations. relevant supported by work. personal any, Includes good area. assessment position typographical attention to data or other regarding spelling, issues of appropriate the choices grammatical inequality and means. regarding errors. Within diversity. Good the models, word limit. Consent and awareness of differential confidentially well the connections use of the addressed. and contrasts models, e.g. Issues of risk and between the in how risk management models in terms personal are well- of their factors may addressed. conceptualisati have ons of the influenced problems. gathering of Good ability to information consider how and analysis. they can complement ea ch other in guiding further gathering of information.

Material Reasonably The Some Minor Intervention Some gaps Fair letter to reasonably clear/concis difficulties/issues general misunderstandi plans reasonably in referrer or Satisfactory organised e to be explained inclaims and ngs grounded in the client; according to summary the formulation assumption of the models formulation(s). identification could be more format in that are reasonably s are or Fair of succinct or handbook. Includes described. unsupporte their applicationconsideration of weaknesses better Tables, some key Sufficient d in formulation. what further or structured, figures, etc. points. background by Some parts of avenues of the account or more clearly reasonably information is references. the formulation information of written. placed and provided in a Some are not seeking the how these Includes some labelled. Most fairly ordered andreferences adequately formulations might relevant key references in structured way to are explained, or would lead to. be remedied. points. acceptable enable reader to inappropriat lack Fair plans for Evidence of format. Fair follow the e clear support, evaluation of the personal writing style. formulations. or or rely on work. reflection but May be a few Includes some irrelevant. misinterpretatio limited and typographical attention to Some key ns of the not spelling, issues of ideas have evidence. differentiated grammatical inequality and been Some attempt between the errors. Word diversity. overlooked. is made at models. limit Consent and considering exceeded by confidentially are issues for more than reasonably integration but 10% but is addressed. some issues otherwise Issues of risk and regarding reasonably risk management compatibility presented. are reasonably are not . addressed. adequately explained. Some misunderstandi ngs of how the models are compatible or otherwise

Unacceptable Summary is Difficulties/issues Insufficient Serious Intervention No Poor letter to level of Incoherent to be explained inreferences misunderstandi plans significant referrer or Weak presentation or the formulation to ngs or poor insufficiently attempt client; throughout otherwise are insufficiently appropriate grasp of the grounded in made to insufficiently the work.. fails described; and/or literature; models are formulation(s); critically succinct Word limit to convey background and/or evident; and/or and/or insufficient evaluate the and/or poorly exceeded by an information is many major aspects consideration of formulation; structured/ more than understandi provided in unsupporte of the what further and/or little written; 10% and ng of the incoherent or d general formulation lackavenues of evidence of and/or misses work is work. unstructured way claims and sufficient information awareness most essential rambling or that does not assumption supportive seeking the of key points. disorganised. lead on to the s; and/or evidence; formulations personal fact formulations; most key and/or would lead to; ors in the and/or no ideas have formulation is and/or insufficient selection attention to been incoherent, plans for and issues of overlooked; self- evaluation of the application inequality and and/or contradictory; work. of the diversity; and/or general and/or models in consent and/or claims are insufficient the process confidentially are made that attempt made of insufficiently have no to consider formulation. addressed. support in integrations; Issues of risk andexisting and/or serious risk management literature. misunderstandi are insufficiently ngs in addressed. NB if explaining or confidentiality considering is completely questions of compromised compatibility i.e. client between the identity is clear models. through full name, address or identifying number, this normally leads to a refer; if partially compromised i.e. first name, service or worker names given, this normally leads to conditional pass.