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What is CBT formulation? CBT formulation is

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What is CBT formulation?

CBT formulation is a joint enterprise between the client and
the psychological practitioner. It summerises the information gathered at the
assessment including possible biological factors, psychological factors and
social factors. A good formulation combines all the factors to explain why
problems may be happening and begins to identify for suitable/appropriate ways
to help , it is the blueprint .

CBT formulation typicaly has a few ingredients  in no particular order;

Presenting the problem- issues
and goals

Gathering information how the
client perceives ‘their world ‘

Obtain demographic information

Explore social , historical, and
cultural context

Assess clients strength, coping
skills

Triggers-things that can set the
problem off

Modifiers things that can make
the problem better or worse

Vulnerability factors (childhood
experiences ,genetic factors)

Typical cycle of event

Alternative beliefs, assumptions
and policies

Apply theotorical orientation and
hypothesize about the nature of the problem

Identified goals (SMART)

Plan  intervention

What is open and closed questions?

Open questions

Questions will be asked with ‘what
,how,why,could’Encourges the client to talk and provide you
with maximum information.Cannot be answered in a few words

Closed questions

Questions begin with words such as
‘is,are,do,when’Focus the session and help gather specific
information.The guiding of the talk is Can be answered in a few words example ;intake
or interrogation

Typical questions asked within a session

What are the problems and symptoms you would
like to work on?How often have you felt like this . In the last
month or a minority of days?Could you think of a recent example when you
felt this way; thoughts & images emotions and behaviours, physical
sensations?In this situation typical of what happens?
Location/Surroundings? How does this problem affect your daily
life?work,home,friends, study?Do you enjoy your own company?What helps i.e what makes it better e.g
avoidance , substances and safety behaviours What helps you cope genuinely? Enjoyments/relationships
/friendships/spiritual , religious practices?What brings you to this sessionAre you happy to be here?What do you hope to achieve in therapy? what
will be different ?Do you use alcohol,drugs,tobacco other
substance?Do you ever experience thoughts of harming
yourself or ending your life?Have you tried therapy before ?what helped? What
didn’t ?We have come to the end of the session do you
feel as though you feel comfortable and positive that with working together
this could be an positive impact for yourself?

 

The questions I have used I have chosen to use a variety to
be able to gain enough knowledge to create the perfect formulation for the
patient to defer what is the most suitable treatment for them.

A role of a therapist at this certain time is to be
listening carefully and if/when necessarily to guide the patients through their
own ‘story telling’. The reasoning why I chose these questions because the aim
is to;

Understand the patients ‘problem’ from their perspective
Aware of the frequency how it  affects the patient To see whether there is a familiar sequence or
trigger Stage frequency and surroundings of the episode Be aware of the impact and the severity of how
this affects the patient day to day life  Acknowledge
whether the client prefers solitary which could enhance the risk factor Acknowledge whether the client uses any other
alternative / risk of drugs / more chance of creating psychotic/ paranoia
tendencies To see whether the patient is able to enjoy
certain activities to help/ let off steam (escape)Asking from their perspective to why they are
here at the session and not just from ‘ medical reasons/written ‘Understand the patients feelings to see their
outlook on this session that it is there decision and not felt as though they
have been pressured Acknowledge what the patients personal goals and
also apart of the treatment planIf using substances can defer whether patient
would be beneficial to other therapy/treatment Evaluate the risk level for the patientEnsure that the ‘problems’  techniques they had previously with  a therapist can be highly prevented  from having a  repeated eventAt the end of the session it is good to see if
the client has felt comfortable with how the session and the content what has
happened