Formulation
Formulation is a collaborative, evidence-informed process used to develop a
holistic understanding of an individual's difficulties by integrating biological,
psychological, social and environmental factors. Rather than simply identifying a
diagnosis or describing presenting problems, formulation seeks to explain why
difficulties have developed, what is maintaining them and what interventions are
most likely to be effective. It is an ongoing and dynamic process that evolves as
new information becomes available. Within social work, formulation supports
analytical thinking, professional judgement and person-centred assessment by
helping practitioners understand individuals within the context of their life
experiences, relationships and wider social circumstances (Division of Clinical
Psychology, 2011).
Psychological formulation originated within clinical psychology as an alternative
or complement to diagnosis. While diagnosis categorises symptoms according to
recognised criteria, formulation aims to explain an individual's unique
experiences and circumstances. During the late twentieth century, clinical
psychologists increasingly promoted formulation because many people with
similar diagnoses had very different life histories, strengths and support needs.
Formulation has since become widely used within mental health, social work,
healthcare and multidisciplinary practice because it promotes individualised,
holistic and collaborative understanding rather than relying solely on diagnostic
labels (Johnstone & Dallos, 2014).
A central principle of formulation is that people's experiences are
understandable within the context of their lives. Rather than asking, "What
diagnosis does this person have?", formulation asks questions such as:
What has happened to this person?
Why have these difficulties developed?
What factors are maintaining them?
What strengths and protective factors exist?
What interventions are most likely to help?
This approach promotes curiosity, empathy and critical thinking while avoiding
simplistic explanations.
Most formulations adopt a biopsychosocial perspective, recognising that
difficulties arise through interactions between:
Formulation is a collaborative, evidence-informed process used to develop a
holistic understanding of an individual's difficulties by integrating biological,
psychological, social and environmental factors. Rather than simply identifying a
diagnosis or describing presenting problems, formulation seeks to explain why
difficulties have developed, what is maintaining them and what interventions are
most likely to be effective. It is an ongoing and dynamic process that evolves as
new information becomes available. Within social work, formulation supports
analytical thinking, professional judgement and person-centred assessment by
helping practitioners understand individuals within the context of their life
experiences, relationships and wider social circumstances (Division of Clinical
Psychology, 2011).
Psychological formulation originated within clinical psychology as an alternative
or complement to diagnosis. While diagnosis categorises symptoms according to
recognised criteria, formulation aims to explain an individual's unique
experiences and circumstances. During the late twentieth century, clinical
psychologists increasingly promoted formulation because many people with
similar diagnoses had very different life histories, strengths and support needs.
Formulation has since become widely used within mental health, social work,
healthcare and multidisciplinary practice because it promotes individualised,
holistic and collaborative understanding rather than relying solely on diagnostic
labels (Johnstone & Dallos, 2014).
A central principle of formulation is that people's experiences are
understandable within the context of their lives. Rather than asking, "What
diagnosis does this person have?", formulation asks questions such as:
What has happened to this person?
Why have these difficulties developed?
What factors are maintaining them?
What strengths and protective factors exist?
What interventions are most likely to help?
This approach promotes curiosity, empathy and critical thinking while avoiding
simplistic explanations.
Most formulations adopt a biopsychosocial perspective, recognising that
difficulties arise through interactions between:
