ABSTRACT
In line with the current evidence base and much of the current best practice literature on formulation (e.g. Kuyken et al., 2009), we have adopted a largely cognitive therapy-based model for constructing our shared person level formulation template. We have been most influenced in this regard by the work of Chadwick et al. (1996), who have developed a clear cognitive model for explaining and treating belief-related distress in psychosis. We utilise their ABC format, adapted from rational emotive behaviour therapy, where the ‘A’ is seen as the activating event, ‘B’ represents the beliefs about ‘A’ and ‘C’ the emotional and behavioural consequences (Ce and Cb) of the beliefs, given the activating event. Structuring the model in this way clarifies how distress and problematic behaviour is a consequence at C, and as such becomes the ‘problem’, the relief of which becomes the goal of treatment. It also identifies the beliefs (B) as mainly responsible for the consequent distress and behaviour at C. This simple but elegant and powerful explanatory framework is used in later chapters for formulating both the client’s beliefs and staff beliefs. It further provides a framework for the staff’s day-to-day interactions for managing distress and problematic behaviours in their clients.
