Although it is generally acknowledged and accepted that case formulations are useful in psychotherapy treatment, there is significantly little research illustrating how case formulations are useful in treatment. Research also suggests that case formulations are seldom used in practice after initial training (Eells, 1997; Sim, Gwee, & Bateman, 2005). This research was premised on a particular case study which appeared to highlight shifts in psychotherapy treatment in the sessions directly after the writing or revising of the case formulation, thus prompting the inquiry into the influence of the case formulation on therapeutic work. The research utilised a qualitative methodology and focused on a single case which was a 19 year old university student who expressed a problem with binge eating. The data was drawn from five original and revised case formulations. The participant was seen for 27 therapy sessions, over which time five case formulations were developed and revised. The findings in this study highlight the process of how a psychodynamic case formulation can influence therapeutic work, as reflected in three broad themes of adherence to the case formulation, the confidence of the therapist, and using the formulation as an intervention. The study contributes to arguments for the revival of the case formulation as a necessary therapeutic tool. / KMBT_363 / Adobe Acrobat 9.54 Paper Capture Plug-in

Cognitive-behavioral treatments are the most well-documented, and apparently most effective, treatments for childhood depression. Efforts to translate these findings to clinical practice are thwarted by the large number of strategies (and sessions) included in empirically supported treatment packages and a lack of guidance regarding differential selection of strategies. The aim of this study was to determine the impact of case formulation on the selection of individual treatments for childhood depression. Two hundred thirty-seven Ph.D.-level mental health professionals with knowledge of behavioral and/or cognitive behavioral theory and practice were recruited via e-mail to participate in this study. Candidates were asked to indicate the likelihood that they would select each of 9 cognitive-behavioral treatments based on one of twelve fictional vignettes. The vignettes were designed to represent children of ages 6, 10, and 14, and presenting with depression based on Cognitive Distortion, Social Skills Deficit, or Environmental Deficit etiologies. Three "Control" vignettes, in which the age of the child was varied but no case formulation was provided, were also included. Our results provide confirmation that case formulation is an important step in the treatment of childhood disorder. Participants successfully matched cognitive treatments to cognitive etiologies, social skills treatments to social skills deficit etiologies, and environmental treatments to environmental deficit etiologies of childhood depression. Differences in treatment selection were also noted with regard to age of the child being treated, in a manner consistent with developmental theory. Here, we have confirmed that the case formulation approach is useful in the differential selection of empirically supported cognitive-behavioral treatments for childhood depression. / Ph. D.

This research evaluated the reliability and validity of a procedure for identifying and assessing core beliefs, the Core Beliefs Assessment Procedure (CAP). The CAP comprised a semi-structured interview, set of markers, and rating system. Twenty participants were administered the CAP. Participants were clients receiving psychotherapy from a community-based mental health service. Core and peripheral case formulations were developed for each participant. Ten participants completed a second assessment session, with a different interviewer, one week later. The CAP showed strong interviewer reliability. In addition, high inter-rater reliability regarding the intensity of affect (r =.87) and the commonness (r =.96) and vividness (r =.93) of metaphor was achieved. Findings suggested that 8 of 12 markers, proposed in the study, adequately distinguished between core and peripheral self-knowledge. Interviewer ratings showed that core self-representations had significantly higher levels of affect, metaphor, and redundancy (i.e., process markers) than peripheral self-representations. Participant ratings showed that core self-representations had significantly higher levels of self-worth contingency, temporal stability, cross-situational consistency and problem relevance (i.e., content markers) than peripheral self-representations. Significant differences were not observed between core and peripheral self-representations on participant ratings of developmental primacy. The relevance of core and peripheral case formulations to the participants' problems were rated both from the perspective of participants and the participants' therapists in order to determine the validity of the CAP. Core case formulations were rated as being more relevant to the participants' problems and as having more utility for guiding treatment than peripheral case formulations. Therapists may find case formulations derived from the CAP useful for guiding treatment. Future research should test the hypothesis that a therapist following a core case formulation has greater treatment success than a therapist following a peripheral case formulation.

The purpose of the study was to examine the effect of STIPS case note documentation and SOAP case note documentation on counseling trainees' perceived case conceptualization abilities. By training master's level counseling students in the use of case note writing and then asking them to rate their perceived conceptualization this study looked at an area of training that has received little attention in the past. This study attempted to begin the process of understanding if case note documentation could be an area that could help counseling students develop their case conceptualization skills.Quantitative and qualitative data analysis was utilized due to the exploratory nature of this study. The quantitative portion examined how the case note documentation affected trainees' perceived case conceptualization abilities while the qualitative portion examined patterns in the responses of participants to open-ended questions about case note documentation.The quantitative results showed that there was no significant difference between the groups in terms of their perceived case conceptualization. The qualitative results indicated that there are benefits and drawbacks to both the STIPS and the SOAP case note formats. / Department of Counseling Psychology and Guidance Services

The following thesis analyses the form and importance of extreme case formulations based on more than 10 research interviews. Extreme case formulations, i.e. formulations comprising expressions such as "nothing", "everything" or "noone", which present a phenomenon or a circumstance according to its minimal or maximal properties, can constitute a complication in the analysis of research interviews. This thesis expand the existing hypothesis of extreme case formulations by adding new findings, for example the bipolarity of extreme case formulations. In the analysed data, these do often occur together with different clasifiers, which either weaken (softeners) or strengthen (intensifiers) their extreme force. At the same time the following thesis broadens the research of extreme case formulations of interdisciplinary approach, which uses the findings from psychology and rhetoric. The conducted research is furthermore completed with the acoustic analysis of semantically extreme formulations, whose results show that extreme case formulations often tend to be acoustically emphasized. Keywords: extreme case formulation, conversation analysis, discourse analysis, interview, Czech

The purpose of this quantitative, quasi-experimental study was to examine the effects of a standardized case conceptualization training workshop on 104 psychotherapy practitioners recruited from the community. A secondary purpose was to examine the relationship between participants’ attitudes about evidence-based practice and the effects of the training. Participants attended two 3-hour training workshops, which taught the integrative case conceptualization model developed by Sperry (2010b). Pre- and postintervention case conceptualization skills were assessed using the Case Conceptualization Evaluation Form (CCEF) 2.0, an updated version of the instrument used in previous studies. Additionally, participants’ views about case conceptualization were assessed before and after training using the Views about Case Conceptualization (VACC) instrument. Participants’ attitudes about evidence-based practice were also examined as a possible mediating variable between training and effect. These attitudes were assessed using the Evidence-Based Practice Attitudes Scale (EBPAS). Workshops were separated by four weeks in order to assess whether initial training effects persisted over time. Change in case conceptualization skill was analyzed using repeated measures ANOVA. Participants’ mean CCEF 2.0 scores significantly increased (p < .001) from pre-test (M = 11.9; SD = 7.74) to post-test (M = 36.7; SD = 7.80) following the first workshop. The second workshop took place four weeks later with 74 of the original 104 participants. It built on the content of the first workshop and introduced advanced concepts such as client culture, strengths and protective factors, and predictive ability. Participants’ mean CCEF 2.0 scores also significantly increased (p < .001) from pre-test (M = 35.1; SD = 8.11) to post-test (M = 66.3; SD = 10.95) following the second workshop. There was a small but statistically significant (p < .005) decrease of 1.5 points in mean scores from the end of Workshop I to Workshop II, indicating that the effects of the training deteriorate slowly over time. Participants’ attitudes about evidence based practice and some demographic variables were significantly related to training effects. Stepwise hierarchical regression analysis determined that these individual variables account for various portions of the variance in CCEF 2.0 scores. This study’s theoretical, practice, and research implications are discussed in detail. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2016. / FAU Electronic Theses and Dissertations Collection

Endometrios är en vanlig gynekologisk problematik som ofta är smärtsam. Trots att flera studier påpekar hög prevalens av psykiatrisk komorbiditet bland kvinnor med endometrios och att psykoterapeutiska och psykologiska insatser förordas så finns mycket lite forskning kring psykologisk behandling vid endometrios. Den här studien var explorativ och undersökte kvantitativa effekter och kvalitativa detaljer från tre fallstudier av kognitiv beteendeterapi vid smärtsam endometrios. Behandlingen innehöll fyra behandlingsmoment; psyko-edukation, fallformulering, beteendeförändring/exponering samt mindfulness och gavs i komprimerad form vid fem behandlingssessioner. Behandlingarna föll väl ut och fick positiva utvärderingar av samtliga patienter. Resultaten var blandade men vissa förbättringar kunde ses. En patient hade i slutet av studien ökad livskvalitet, sänkt nedstämdhet, minskad katastrofiering, ökad aktivitet och sänkt funktionsnedsättning. Den andra patienten beskrev behandlingen positivt men fick få utslag i mätningar utöver tendens till minskad katastrofiering. I slutet av studien färgades hennes mätningar av förändrat hälsotillstånd, som antagligen överskuggade eventuella positiva effekter av behandlingen. Den tredje patienten hade svårigheter med att följa behandlingsplanen och hade en varierande funktionsnivå. Problem uppstod kring hennes mätresultat men de visade tendens till ökad livskvalitet, minskad katastrofiering och minskad funktionsnedsättning. Resultaten ses som lovande och ytterligare utveckling av kognitiv beteendeterapeutisk behandling vid smärtsam endometrios föreslås. / Endometriosis is a common gynecological disorder which is often painful. Dispite several studies remarking on the high prevelence of psychiatric comorbidity among women with endometriosis, and that psychological treatments are recommended, there is very little research of psychological treatment of endometriosis. This study was explorative and investigated quantitative effects and qualitative details from three case studies of cognitive behavioural therapy for painful endometriosis. The treatment contained four components: psychoeducation, case formulation, behavioural change/exposure, and mindfulness. The treatment was given in a short form of five sessions. The treatments went well and reseaved positive evalutations from all patients. The results were mixed, but some improvements were noticed. One patient had at the end of the study elevated life quality, reduced depression, reduced catastrophizing, increased activity and reduced disability. The second patient described the treatment positively, but showed few changes apart from tendency to reduced catastrophizing. At the end of the study her results were affected by changes in her physical condition, which probably overshadowed any positive results from the treatment. The third patient had difficulties with following the treatment plan, and had a variable level of functioning. Problems arose with her measures, but the measures showed tendency to improved life quality, reduced catastophizing and reduced disability. The results of the study are promising and further development of cognitive behavioural therapy for painful endometriosis are suggested.