Evaluation of collaborative cognitive-behavioural case formulations in a clinical psychology program: a client perspective

ABSTRACT

Objective

Cognitive behavioural case formulations (CBCFs) have been widely used in Cognitive Behavioural Therapy (CBT). However, sparse research has examined how clients experience the shared formulation process. The current study aimed explored the role of CBCFs in an outpatient student-staffed community clinic.

Method

A 30 adult participants aged 18 - 67 (M = 37.50, SD = 11.20), with a range of mental health concerns, completed a CBCF session as a part of routine therapy, with their treating provisional psychologist. Immediately following the session, participants completed a questionnaire that included five items, 5-point Likert scale questionnaire measuring clients’ experience of the collaborative CBCF, and two open questions captured further information.

Results

High scores across all questions on the Likert scale, and a total of nine themes was identified from the qualitative data. Six themes related to a broadly positive emotional response, two themes had a broadly negative emotional response, and one theme was a neutral emotional response.

Conclusions

The visual process of CBCF is a positive experience for clients that may help them to better understand their difficulties, elicit positive emotions, and feel understood by their treating therapist. Limitations of the current study and recommendations for future research are discussed.

KEY POINTS

What is already known about this topic:

1. Cognitive behavioural case formulations (CBCFs) are frequently utilised in Cognitive Behavioural Therapy to develop an individualised approach to therapy.

2. CBCFs aim to strengthen the client’s and the therapist’s understanding of the client’s presenting problem(s) within a cognitive behavioural framework and enhance the therapeutic relationship.

3. Surprisingly, there is limited research on how clients experience the shared formulation process.

What this topic adds:

1. Results from our quantitative analyses found that clients reported widely positive experiences with CBCFs.

2. Qualitative analysis revealed that nine themes emerged from participants’ experiences with CBCFs.

3. CBCFs appears to enable clients to better understand their difficulties, CBCFs tend to elicit positive emotions, and CBCFs help clients to feel understood by their therapist.

KEYWORDS:

• Case formulation
• cognitive behavioural therapy
• clinical psychology trainees
• client experience

Acknowledgments

We thank the participants of this study; the time taken by clients to complete our questionnaire and participate within the research is appreciated. Thanks to the therapists and administration staff at the USC Psychology Clinic for assistance with recruitment and the procedures of the research project.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.