Case Formulation and Treatment Concepts Among Novice, Experienced, and Expert Cognitive-Behavioral and Psychodynamic Therapists

Abstract

The authors examined conceptions among cognitive-behavioral and psychodynamic therapists regarding case conceptualization and treatment. Therapists were classified as novices, experienced, or experts. After constructing formulations in response to 6 vignettes, varying by mental disorder (anxiety, affective, personality) and prototypicality (high, low), therapists completed a questionnaire for each vignette. The investigators then studied differences in the importance of specific formulation factors, conceptualization difficulty, problem severity and expected change, recommended treatment length and session frequency, etiology, and views regarding patient control over problems and solutions. They found that therapy mode, level of experience and expertise, and their interaction predicted differences in case formulation and treatment preconceptions.