The Case Formulation Approach to Cognitive-Behavior Therapy

by Jacqueline B Persons PhD

Overview

This eagerly awaited book shows how skillful case formulation addresses a critical challenge in psychotherapy today: how to use empirically supported therapies (ESTs) in real-world clinical contexts. The author explains the basic theories of cognition, learning, and emotion that underlie available ESTs and shows how the theories also guide systematic case formulation. By crafting a sound formulation and continually refining and monitoring it as treatment progresses, the therapist can smoothly "shift theoretical gears" and weave together elements of different ESTs to meet the needs of individual patients, who typically present with multiple problems. Hands-on tools, reproducibles, and many concrete examples are included.

Product Details

ISBN-13:	9781593858759
Publisher:	Guilford Publications, Inc.
Publication date:	08/01/2008
Series:	Guides to Individualized Evidence-Based Treatment
Edition description:	New Edition
Pages:	273
Product dimensions:	6.80(w) x 10.00(h) x 1.20(d)

About the Author

Jacqueline B. Persons, PhD, is Director of the San Francisco Bay Area Center for Cognitive Therapy and Clinical Professor in the Department of Psychology at the University of California, Berkeley. She is a clinician, teacher, researcher, writer, and scientist-practitioner. She maintains an active clinical practice, providing cognitive-behavior therapy for mood and anxiety disorders and related problems, and teaches and provides clinical supervision to students and professionals in many settings. Dr. Persons conducts research on the mechanisms underpinning symptoms of depression and anxiety and on the process and outcome of cognitive-behavior therapy, especially as it is implemented in routine clinical practice. Her first book, Cognitive Therapy in Practice: A Case Formulation Approach, published by W. W. Norton in 1989, is widely considered a classic. She is past president of the Association for Advancement of Behavior Therapy (now the Association for Behavioral and Cognitive Therapies) and of the Society for a Science of Clinical Psychology, a section of the Society of Clinical Psychology of the American Psychological Association.

Table of Contents

1. What Is the Case Formulation Approach to Cognitive-Behavior Therapy?

2. Cognitive Theories and Their Clinical Implications

3. Learning Theories and Their Clinical Implications

4. Emotion Theories and Their Clinical Implications

5. Beginning the Therapeutic Relationship and Obtaining a Problem List and Diagnosis

6. Developing an Initial Case Formulation and Setting Treatment Goals

7. Using the Formulation to Develop a Treatment Plan and Obtain the Patient’s Consent to It

8. The Therapeutic Relationship

9. Monitoring Progress

10. Decision Making in the Therapy Session

11. Handling Nonadherence and Treatment Failure

12. Decision Making over the Course of Therapy

Interviews

Practitioners, students, and residents in clinical psychology, psychiatry, counseling, social work, and related mental health fields. Serves as a supplemental text in graduate-level CBT courses and clinical practica.

Editorial Reviews

"Persons's insights into case formulation are second to none. This book brilliantly demonstrates that you don't have to sacrifice good science to be an excellent clinician, and vice versa. I recommend it to psychotherapists and students at all levels of experience who are interested in using the best theories and clinical techniques to help their patients achieve real and lasting change. Persons's rare combination of clinical practicality and scientific dedication makes her a role model for every young scientist-clinician."—Marsha M. Linehan, PhD, ABPP, Professor and Director Emeritus, Behavioral Research and Therapy Clinics, University of Washington; developer of DBT
 
"This groundbreaking volume will train the next generation of cognitive-behavioral therapists. Its sophisticated blending of case-level formulation with empirical principles of behavior change is a threshold event in CBT's ongoing engagement with clinical complexity, comorbidity, and nonadherence."—Zindel Segal, PhD, Distinguished Professor of Psychology in Mood Disorders, University of Toronto–Scarborough, Canada

"Decades of research and clinical experience meet in this seminal book. Persons provides a guide for both the novice and experienced practitioner to deal with even the most complex of cases. This significant work will no doubt become the shining light by which the idiographic approach to CBT will be guided in the future. One of the few books that is worth even more than the purchase price!"—Nicholas Tarrier, PhD, FBPsS, Department of Psychology, Institute of Psychiatry, King's College, London, UK

"There is no greater challenge facing mental health professionals than moving from scientific theory and research to clinical practice. Persons has addressed this critical issue for many years, and has come up with solutions that demand the attention of serious health professionals. She convincingly shows how to analyze complex cases in ways that are both scientifically sound and practically feasible and effective. Persons is the consummate scientist-practitioner. This book is a 'must read' for students, academics, and practitioners."—Gerald C. Davison, PhD, William and Sylvia Kugel Dean's Chair, and Professor of Gerontology and Psychology, University of Southern California

From the Publisher

Reviewer: Gary B Kaniuk, PsyD (Cermak Health Services)
Description: This book describes how to apply empirically supported therapies (ESTs) within the cognitive-behavioral tradition to individual clients. The author encourages therapists to understand formulations and techniques that underlie the various therapies. However, Dr. Persons urges the reader to not merely use a step-by-step manualized approach, which may not fit all clients, but design a plan that will meet the needs of the individual.
Purpose: The author notes that this book expands and elaborates on her earlier writings on case formulation, including a 1989 book, Cognitive Therapy in Practice: A Case Formulation Approach (W.W. Norton, 1989). She points out, "the most significant advance over my earlier work is that I now embed the case formulation in a larger framework of clinical hypotheses testing." She recommends that "clinicians examine the EST protocols to understand the formulations that underpin them and how the interventions in the protocol flow out of the formulations. Then they can use that information (not the step-by-step procedures of the protocol itself) to guide their work."
Audience: The intended audience includes practitioners, students, and residents in clinical psychology, psychiatry, counseling, and social work. It can serve as a text in graduate-level courses on cognitive-behavior therapy and in clinical practice. The author, director of the San Francisco Bay Area Center for Cognitive Therapy and professor at the University of California, Berkeley, conducts research in cognitive-behavior therapy.
Features: An introduction to case formulation begins the book. Next, three theoretical orientations are discussed including cognitive theories, learning theories, and emotion theories. Finally, the therapeutic process is explored in depth. This part looks at assessing the problem and formulating personality dynamics and treatment goals. The author discusses how to monitor treatment progress and deal with treatment failure. The figures are extremely helpful in understanding what case formulation is all about and there is a limited photocopy license to reproduce certain forms, which include thought record, treatment/evaluation agreement, adult intake questionnaire, and case formulation worksheet. These forms are invaluable, especially to beginning therapists who get a chance to see how a seasoned veteran designs basic documents. The book is easy to read and walks the reader slowly but surely through the process of formulating treatment cases. Chapter six is a great example of where to start when developing a comprehensive treatment program. It uses case material and explains the rationale so readers can understand exactly how to do it. Chapter eight, on the therapeutic relationship, is also well done. It's not common to see a cognitive-behavioral approach focus on the therapeutic relationship. The author shows how to use the relationship effectively in therapy and how to handle problems.
Assessment: This excellent book describes treatment formulation and the therapeutic process well, from a cognitive-behavioral framework. The reproducible forms are extremely helpful, especially for new therapists who are beginning a private practice. All-in-all, the author helps us to look at the therapeutic process in cognitive-behavioral terms and design it with each specific client in mind, and not in terms of a general protocol. This is very refreshing, to say the least.

Doody's Review Service

Reviewer: Gary B Kaniuk, Psy.D.(Cermak Health Services)
Description: This book describes how to apply empirically supported therapies (ESTs) within the cognitive-behavioral tradition to individual clients. The author encourages therapists to understand formulations and techniques that underlie the various therapies. However, Dr. Persons urges the reader to not merely use a step-by-step manualized approach, which may not fit all clients, but design a plan that will meet the needs of the individual.
Purpose: The author notes that this book expands and elaborates on her earlier writings on case formulation, including a 1989 book, Cognitive Therapy in Practice: A Case Formulation Approach (W.W. Norton, 1989). She points out, "the most significant advance over my earlier work is that I now embed the case formulation in a larger framework of clinical hypotheses testing." She recommends that "clinicians examine the EST protocols to understand the formulations that underpin them and how the interventions in the protocol flow out of the formulations. Then they can use that information (not the step-by-step procedures of the protocol itself) to guide their work.
Audience: The intended audience includes practitioners, students, and residents in clinical psychology, psychiatry, counseling, and social work. It can serve as a text in graduate-level courses on cognitive-behavior therapy and in clinical practice. The author, director of the San Francisco Bay Area Center for Cognitive Therapy and professor at the University of California, Berkeley, conducts research in cognitive-behavior therapy.
Features: An introduction to case formulation begins the book. Next, three theoretical orientations are discussed including cognitive theories, learning theories, and emotion theories. Finally, the therapeutic process is explored in depth. This part looks at assessing the problem and formulating personality dynamics and treatment goals. The author discusses how to monitor treatment progress and deal with treatment failure. The figures are extremely helpful in understanding what case formulation is all about and there is a limited photocopy license to reproduce certain forms, which include thought record, treatment/evaluation agreement, adult intake questionnaire, and case formulation worksheet. These forms are invaluable, especially to beginning therapists who get a chance to see how a seasoned veteran designs basic documents. The book is easy to read and walks the reader slowly but surely through the process of formulating treatment cases. Chapter six is a great example of where to start when developing a comprehensive treatment program. It uses case material and explains the rationale so readers can understand exactly how to do it. Chapter eight, on the therapeutic relationship, is also well done. It's not common to see a cognitive-behavioral approach focus on the therapeutic relationship. The author shows how to use the relationship effectively in therapy and how to handle problems.
Assessment: This excellent book describes treatment formulation and the therapeutic process well, from a cognitive-behavioral framework. The reproducible forms are extremely helpful, especially for new therapists who are beginning a private practice. All-in-all, the author helps us to look at the therapeutic process in cognitive-behavioral terms and design it with each specific client in mind, and not in terms of a general protocol. This is very refreshing, to say the least.