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Title: Formulation in Clinical Psychology
Author: Brown, Helen
Awarding Body: The University of Warwick
Current Institution: University of Warwick
Date of Award: 2008
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Abstract:
This thesis includes a literature review, empirical paper, and reflective paper, which explore different aspects of formulation within Clinical Psychology. Chapter one reviews literature to answer the question 'Why Formulate? Why not Formulate?' This review considers the idea that formulation is a defining skill within clinical psychology, before discussing the function, reliability and validity of formulating across differentsituations. Literature suggests that individual differences and client characteristics determine the focus of the formulation, as well as the amount ofinformation shared and how the information is delivered. The basis for not formulating was considered, although it seems to be a tenuous premise to suggest that some clinical psychologists do not formulate just because these' hypotheses are not shared with clients. There is a shortage of evidence to support the notion that formulation is unique to clinical psychology but it is without contention that the skills involved in formulating are integral to the profession. The review raises a number of important research questions, including reaching a better understanding of who does and does not use formulation in everyday practice, comparing the value of formulating and not formulating, and illuminating client's experiences ofreceiving formulations. There are a number ofvalidity considerations to be examined and there is also a shortage of empirical evidence regarding the use offormulation within integrative frameworks. These research questions suggest qualitative analyses in the first instance and it seems likely that in most cases the clients themselves will Chapter two reports the findings of an empirical paper, exploring clients' experience of formulation with the use ofa grounded theory approach to methodology. Views from clients and therapists were sought respectively and the emergent theories highlighted two subtly different models. A linear model was proposed to describe clients' views, detailing a journey of growth. This consisted ofthree core constructs: initial doubt, assimilation and empowerment. Each construct was understood on a continuum to represent the fluctuating nature of the process. A circular model was proposed to describe therapists' views of clients' experience of formulation. Connection with the process, self, and other was thought to result from interaction in the 'dance'. This enabled clients to view formulation as tangible, providing them with the opportunity to integrate the formulation. Integration was thought to continue throughout clients' lives, whereby understanding and connectivity contributed to a reflexive loop of development. Similarities and differences between the models are considered, as are limitations and ideas for future research. Clinical implications are made, and include the use ofthe models to offer guidance to training programmes on the areas on which to focus when teaching formulation. The role of the models in developing measures to assess clients' experiences, to ensure that therapists are focussing on the elements thought to be central to formulations, in addition to reassuring individuals new to the process of formulation is also considered. This study also draws attention to the presentation of a formulation, how it might be used, the audience who might have access to it, and the importance of not forcing a model on a client. Chapter three reports a reflective paper, which consists of therapeutic letters to therapists', clients' and myself. This chapter (and the letters contained within it) is XIII 1111111111'11111 ttl XIV Consideration is made ~fhowmy own training mirrors the models derived from the .........-=.:---.:~--------~.'.-,,-, .U1I I the impact that this research has had on my personal and professional development. empirical paper, alongside reflections on why the topic of formulation was chosen and experiences, interests, beliefs and social identity has shape~ this research. J therefore reflexive, enabling me to reflect upon ways in which my own values experiences, interests, beliefs and social identity has shape~ this research. Consideration is made ~fhowmy own training mirrors the models derived from the .........-=.:---.:~--------~.'.-,,-, .U1I I the impact that this research has had on my personal and professional development. empirical paper, alongside reflections on why the topic of formulation was chosen and the impact that this research has had on my personal and professional development.
Supervisor: Not available Sponsor: Not available
Qualification Name: D.Clin,Psychol. Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.502447  DOI: Not available
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