Formulating a coherent narrative
The BPS has produced very helpful Good Practice Guidelines on the use of formulation, and the ﬁrst part of this chapter should be considered alongside these guidelines (BPS, 2011). Formulation has been described succinctly as ‘a hypothesis about a person’s difﬁculties, which draws from psychological theory’ (Johnstone and Dallos, 2006: 4). I think of it as a coherent story that helps to make sense of the person’s problems and provides a foundation for working with them to develop an effective intervention plan. We consider formulation to be a distinctively psychological competence, and it is seen by the Division of Clinical Psychology as a core skill (Division of Clinical Psychology, 2001). Without it we might be inclined to jump from assessment to intervention without an explicit theoretical rationale, or even ignore the assessment phase completely (‘have you thought of . . .?’; ‘ I always ﬁnd . . . very helpful’).