ABSTRACT
This chapter examines the inpatient setting as a system, where the dominant conceptualization of behaviour is as manifestation of illness, but confused messages are sent to clients. Psychological formulations offer alternative understandings of clients' problems. The nature and status of the activity of formulating is discussed and CBT formulations are used as illustrations. The need to formulate client±staff±environment interactions is emphasized, as well as transitions between inpatient and outpatient life. Psychological formulation, it is argued, should provide a more compassionate narrative than the medical model, leading to bene®ts for the client and for those in helping roles. Shared formulation is seen as an intervention in itself, which can be effective at many levels, from the individual client, through staff thinking, to organizational structure and power relations.
