Case formulation

Question 1

What is a case formulation

Answer 1

Eliciting appropriate information and application and integration of theoretical psychological knowledge to a specific clinical problem to understand the origins, maintenance and development of that problem

Question 2

Content of a case formulation

Answer 2

presentation (symptoms and problems)
predisposing life events or stressors
precipitating life events or stressors
perpetuating factors
a mechanism that links the preceding categories together

Question 3

Diagnosis based treatment

Answer 3

Assessment - diagnosis - treatment

Question 4

Formulation based treatment

Answer 4

Assessment - diagnosis/formulation (interrelated) - treatment (which also feeds back to assessment)

Question 5

factors for CC

Answer 5

pairing is most likely if the CS precedes UCS by 0.5s, if UCS even slightly precedes CS then conditioning will usually not occur
greater the number of pairings, more likely CS is to elicit CR
Consistent pairing will make it more likely
conditioning stronger if both are intense

Question 6

Clinical application of CC

Answer 6

Stimulus control techniques in alcohol/drug problems
Extinction techniques in exposure therapy for phobia
Use of cue word ‘relax’ in applied RT

Question 7

Clinical applications of OC

Answer 7

Reinforcement of positive behaviour in children with behaviour problems
punishment of drinking behaviour through disulfiram
use of random intermittent reinforcement of good behaviour, leading to resilience of this behaviour to extinction when reinforcers are faded

Question 8

reinforcement schedules

Answer 8

continuous reinforcement (rapid acquisition, poor resistance)
variable ratio reinforcement (slower acquisition, stronger resistance)

Question 9

habituation

Answer 9

gradual reduction in anxiety associated with novel or anxiety provoking stimuli over time

Question 10

performance of behaviour from modelling depends on

Answer 10

observed consequences of actions
nature of behaviour observed
nature of organism performing behaviour

Question 11

skills deficits and skills training

Answer 11

deficits in skills may contribute to origin and perpetuation of psychopathology
some may have deficits in ability to select appropriate skills from their behavioural repertoire
applications: training in assertiveness skills, parenting skills etc.

Question 12

cognitive content

Answer 12

content of individuals thoughts and beliefs may contribute to origin and perpetuation of psychopathology (negative automatic thoughts, catastrophic cognitions, responsibility beliefs)

Question 13

cognitive restructuring

Answer 13

training client to monitor, evaluate and modify cognitive content
objectivity, utility, consistency

Question 14

objectivity

Answer 14

is this belief objectively true
what is the evidence for/against this belief
is there an alternative explanation

Question 16

utility

Answer 16

what is the effect of my thinking this way
what would be the effect of changing my thinking

Question 17

consistency

Answer 17

do i always believe this
do others believe the same thing

Question 18

cognitive restructuring

Answer 18

collaborative
increasing awareness of content
facilitation of evaluation of content
assistance in exploring rationality of beliefs
assistance in planning tests of beliefs
discussion of utility of beliefs
collaborative investigation of effects of changing beliefs

Question 19

core belief

Answer 19

most central ideas about self

Question 20

early maladaptive schema

Answer 20

broad pervasive theme or pattern
comprised of memories, emotions, cognitions and bodily sensations
regarding oneself and one’s relationship with others
developed during childhood or adolescence
elaborated throughout one’s lifetime
dysfunctional to a significant degree

Question 21

schemas

Answer 21

triggged/activated by events consistent with the schema
distort thinking and behaviour
schema-driven behaviour can produce outcomes that provide evidence to confirm the schema
symptom typography reflects schema content
schemas are learned through early experience
schemas do not easily change in response to conflicting evidence
schema change requires schema activation

Question 22

self efficacy beliefs

Answer 22

perceived ability to effectively carry out a particular behaviour
domain specfic

Question 23

expectancies

Answer 23

if then contingencies about the perceived outcomes of actions or events
can become self fulfilling prophecies that contribute to maintenance of problem behaviour

Question 24

metacognition

Answer 24

cognition applied to cognition
monitors, controls and appraises the products and processes of awareness

Question 25

thought suppression

Answer 25

voluntary conscious attempt to exclude certain cognitive content from consciousness

Question 26

attention biases

Answer 26

may arise out of information processing errors associated with beliefs/schemas

Question 27

memory biases

Answer 27

schemas, beliefs and emotions lead to retrieval of memories that are consistent with these beliefs/states state dependent memory

Question 28

six p's

Answer 28

presentation predisposing precipitating perpetuating positive/stregnths predictions/prognosis

Question 29

MDD formulation

Answer 29

early experience - dysfunctional assumptions - critical incident - negative automatic thoughts related with symptoms - behavioural/motivational/affective/cognitive/somatic

Question 30

panic disorder formulation

Answer 30

trigger - normal psychiological changes - catastophic misappraisal - increased anxiety and arousal symptoms (feeds back to normal physiological changes) - exhaustion and decreased anxiety - hypervigilance - hypersensitivity to symptoms- back to normal physiological changes in cycle

Question 31

GAD formulation

Answer 31

trigger - positive meta beliefs (strategy choice) - type 1 worry - negative meta beliefs - type 2 worry (meta worry) - emotion/thought control/behaviour

Question 32

SORCK analysis

Answer 32

stimuli (historical, contextual, imediate) organism response consequences (immediate, long term/delayed) kontingencies

Question 33

SORCK- historical stimuli

Answer 33

Stimuli that historically precede the behaviour, but are not sufficient to elicit it directly

Question 34

SORCK contextual stimuli

Answer 34

These stimuli are not sufficient to elicit the behaviour under scrutiny, but increase the likelihood that it will occur.

Question 35

SORCK immediate stimuli

Answer 35

These stimuli directly elicit the target behaviour * Conditioned Stimulus * Discriminative Stimulus

Question 36

SORCK organismic variables

Answer 36

The current state of the organism, related to factors moderating the relationship between antecedents and the response. * Cognitions * Drugs * Illness * Affective state * etc., etc.

Question 37

SORCK long term/delayed consequences

Answer 37

Consequences which do not affect the frequency of the target behaviour, but instead serve to alter the contextual stimuli, changing the likelihood of it occurring

Question 38

SORCK kontingency

Answer 38

Formulation ideas about the maintenance of the behaviour under scrutiny.

Question 39

SORCK

Answer 39

SORCK allows detailed investigation of single discrete target behaviours, their antecedents and consequences * SORCK allows integration of cognitive content to a minimal level * A series of SORCKs may be done where several behaviours are under scrutiny * More complex cases with broader determinants of psychopathology may be too complex to conceptualise in a long series of SORCKs