The Case Formulation Approach
This reading presents the concept of case formulation in cognitive-behavior therapy (CBT) and explains its importance as well as its main elements. In the beginning, Persons (2008) describes the scheme on which every case formulation is built. Such elements as assessment, case formulation and diagnosis, treatment planning and informed consent, treatment, progress monitoring, termination, and the therapeutic relationship create a full cycle of CBT (Persons, 2008).
Another major point that the author addresses is the vital role of formulation – it addresses the limitations and pitfalls of empirically supported treatments (ESTs). Persons (2008) points out that formulation is effective in addressing multiple problems, dealing with several providers, and lowering the risks of treatment failure, lack of ESTs, and nonadherence. In the end, the scholar lists the elements of case formulation (symptoms, disorders, problems, mechanisms, precipitants, and origins), using Back’s theory as the primary technique.
The text contains multiple vignettes that demonstrate the points made by the author – the vital role of the described approach, the limitations of ESTs, and the process of case formulation. For instance, the case formulation for Jon uses Beck’s theory and shows how the elements of formulation help one to personalize CBT to the patient’s needs (Persons, 2008). The majority of other vignettes is short, showing small examples of the effects that formulation can have on the success of CBT.
The abundance of examples is the strength of this reading – the author explains each problem and idea with a sample of formulation, helping one to understand the fundamental nature of this approach in CBT. Moreover, Persons (2008) presents all elements of formulation and discusses all issues that this method helps solve, allowing one to understand why formulation is needed fully. For instance, the scholar points out that ETS cannot assist clinicians in treating patients with multiple disorders that are often connected by origins and mechanisms, while formulation allows one to see these ties (Persons, 2008).
The text does not appear to have any significant weaknesses. The author presents a sufficient number of cases from the professional practice and explains the mechanisms behind each procedure, adequately introducing case formulation. Nonetheless, it might benefit the reading to contain more extended vignettes where all elements of the formulation are present to depict the full process of CBT.
Social Cognitive Theory
In their article, Benight and Bandura (2004) investigate the effect of perceived self-efficacy on posttraumatic recovery through the lens of social cognitive theory. The main finding that the authors pose is that self-efficacy – one’s belief in the ability to overcome a previous traumatic event – can aid people in recovery, lowering the damage that stress may have on their mental and physical health.
To examine this idea, Benight and Bandura (2004) use a variety of examples describing reasons for long-lasting trauma, including natural disasters, military combat, terrorist attacks, spousal death, sexual assault, and others. In each of these cases, the studies gathered by the scholars reveal a substantial role of self-efficacy in helping people to surmount their traumatization. Thus, Benight and Bandura (2004) conclude that self-efficacy can be used as a tool in both preventing and treating posttraumatic stress disorder (PTSD) and its symptoms.
The authors employ information synthesis as the central methodology to arrive at the mentioned above conclusions. The collection of studies that measure people’s coping efficacy and stress-related symptoms following a range of traumatic experiences serve as the basis for the investigation. The vignettes do not deal with treatment options for individuals experiencing stress. However, it can be seen that the social cognitive theory is the foundation of the techniques described by the authors. According to this framework, people’s role in the adaptation to circumstances is proactive, and they act as agents, making decisions to respond to stressors (Benight & Bandura, 2004). As the researchers use this model to guide their study, the view that people shape their behaviors and thoughts and not merely react to situations is the basis of the arguments.
The article offers a significant amount of information and utilizes several studies that come to the same conclusion. Moreover, a clear framework and set of hypotheses show the direction in which the authors moved when searching for analyzing data. These factors are the study’s strengths. Nevertheless, the majority of data showcased by the authors consider people’s initial resilience to trauma based on their self-efficacy rather than their use of this characteristic in dealing with the diagnosed PTSD. Therefore, it remains unclear whether the development of PTSD and its absence can be approached with one framework in mind. To improve the contents of this reading, one could propose a way of improving self-efficacy in people with PTSD and researching studies that investigate the effect of this strategy.
Developing and Using a Case Formulation
The article by Jacqueline and Lisa (2015) is similar to the text by Persons (2008) as it presents the concept of case formulation and provides an overview of its main steps. The authors explain that formulation is a useful technique in CBT since it uses the information provided by the ESTs while also resolving the problems that they do not address. The pitfalls of ESTs are the assumptions that all patients are treated for one condition to remission, although, in many cases, both of these statements are not correct (Jacqueline & Lisa, 2015).
Then, the scholars focus on the elements of formulation, distinguishing assessment, initial formulation, treatment planning and consent, treatment, and termination. Jacqueline and Lisa (2015) also discuss the need for the therapeutic relationship, stating that it is a supporting factor for all processes in CBT. Notably, the researchers list other approaches to case formulation, such as functional analysis, Beck’s cognitive model, and Nezu, Nezy, and Lombardo’s problem-solving approach (Jacqueline & Lisa, 2015). These strategies are brought up to contrast their main points and show that case formulation is only one of the solutions in CBT.
It is apparent that Jacqueline and Lisa (2015) use the approach similar to other authors when presenting the information about case formulation. The list of reasons for using this method, as well as its steps, it the same as in other publications.
However, there is a lack of vignettes providing clear examples of using case formulation in particular cases. The only case present in the text describes how initial case formulation using Beck’s theory is completed. While this part of the paper is informative, the absence of similar vignettes in other parts of the text limits one’s comprehension of the topic. Overall, the text could be improved by providing more information that would help a clinician to adapt the general information in practice – personal clinical experiences, potential problems, and hypothetical cases can be added.
References
Benight, C. C., & Bandura, A. (2004). Social cognitive theory of posttraumatic recovery: The role of perceived self-efficacy. Behaviour Research and Therapy, 42(10), 1129-1148. Web.
Jacqueline, B. P., & Lisa, S. T. (2015). Developing and using a case formulation to guide cognitive-behavior therapy. Journal of Psychology & Psychotherapy, 5(3), 179. Web.
Persons, J. B. (2008). The case formulation approach to cognitive-behavior therapy. New York, NY: Guilford.