GUIDELINES: Case Study 1 - Formulation



Appendix 5.1

Guidelines:  Clinical Study 1 - Formulation (Submitted at mid-point of year 1)

 

Overview

 

Please submit with a Signed Declaration and a completed Coursework Confidentiality Checklist.

In this clinical study report you are required to formulate one piece of clinical work from either the Child and Family or Learning Disability component of your placement from the perspective of two different psychological models.  These models will normally be chosen from Family Systemic, Psychodynamic/Attachment, Behavioural and CBT models and Community/ Social Inequalities. You need to bear in mind that the different models require different types of information to be gathered at assessment from a range of levels: individual, inter-personal and social/cultural. Therefore, the assessment of the client/s’ presenting problems and strengths/ resources and their circumstances will need to be quite comprehensive in order that adequate information is available from which to formulate using two models.  Your formulation is a guide to thinking and understanding, and while not predominantly concerned with being ‘correct’, it should be supported by evidence.

 

You are not required to set out the details of the interventions, but should indicate some of the potential implications of your formulations for intervention(s) and for further avenues of information seeking.  

 

The work will usually be based on assessment for possible psychological therapy and/or other interventions for an individual or couple/ family, but it may be based on assessment for possible psychological interventions (e.g. group work, supervision or consultation) for groups, team/s or organisation/s.

You may wish to discuss the suitability of your choice of clinical work with your academic/appraisal tutor, and you may submit a preliminary draft to them for feedback and comment.

 

General aim

 

To assess your ability to succinctly formulate a piece of clinical work from two different theoretical approaches

 

Word limit: 3,500 words, including tables and references, but excluding appendices. Word guidance for sections is indicative only – you can be flexible with these. If you go more than 10% over word limit this will normally automatically mean a conditional pass and the work will be returned for shortening.

Format of report

Abstract: (word guidance 250 words)

 

 Background and assessment:  Include the process of referral, the client/s’ initial presenting problems and strengths/resources and, where relevant, information gained from liaison with client/s’ family members, carers and/or other professionals. Consider the client/s’ and/or key network members’ perspectives on their current situation and expressed needs and hopes. Describe qualitative methods of gathering information and any psychometric measures used at assessment. Note any limitations to opportunities to gather relevant information.  Where relevant, the assessment should include a genogram and time-line clarifying key events in the client/family’s life that are relevant to the issues to be addressed in the work. Summarise the information gained in terms of predisposing, precipitating, maintaining and protective factors at a range of levels. Ensure that you include all the relevant information that is drawn on in the subsequent formulations. Ensure that you address issues of consent and confidentially (word guidance 1000 words).

Brief review of relevant literature:  Briefly summarise key relevant theoretical and empirical background information to the two models chosen. This will require conceptualisations of the kinds of problems displayed by the client/s within each model, including reference to the evidence base for practice and, where relevant, practice-based evidence which supports the application of each model to an understanding and treatment of the presenting issues (word guidance 500 words).

 Formulation: Describe the formulation from each model in turn - formulations should be presented succinctly. They should draw on and be clearly supported by the information presented in the background/assessment of the case (do not repeat material presented in background section though). Offer an indication of how the formulations can complement each other and where they suggest contrasts, competing explanations and clinical implications.  Give an indication of how you might negotiate and share your thinking on the formulation with your client or with key people in the client’s network.  Describe the development of your thinking, for example in moving from initial impressions to preliminary to subsequent formulations (word guidance 500 words).

 

Implications: Give an indication of implications of the formulations in terms of possible routes for intervention and action including what further avenues of information the formulations would lead you to pursue. Include consideration of how you might evaluate the effectiveness of the work you would undertake (word guidance 500 words).

 

Critical appraisal and reflection: Attempt to identify both strengths and potential weaknesses in the formulations and how weaknesses might be remedied. Consider how your assessment process was constrained and enabled by your choice of models. Consider the relevance of the formulations for the client’s particular life, circumstances and expressed needs and hopes. Identify any personal factors for yourself and contextual factors that may have impacted on your choice and use of the models. Discuss the relative contributions of the models, and the opportunities and constraints for their integration. Ensure that throughout the work you have been sensitive and thoughtful about issues of social inequalities and cultural diversity (word guidance 750 words).    

 

Appendices

Include an actual or potential summary letter back to the referrer or client, including succinct summary of reason for referral, client (s) priorities and agreed aims/intentions for the work, key findings from assessment, succinct summary of working formulation, and initial plans for intervention. The letter should be no more than 2 sides of A4.

If appropriate, include anonymised copies of any questionnaires used or written information gained from the client which is relevant (e.g. behavioural diary), as well as referral letter and any correspondence by yourself e.g. letter back to referrer.

 

NB. Information about the actual intervention following the assessment and formulation should not be included.

 

  |Presentation |Abstract |Background and assessment (incl risk) |Use of Literature |Formulation |Implications |Critical

appraisal and reflection |Referral letter | |

Excellent |Material exceptionally well organised

according to format in

handbook. Tables,

figures, etc. very

well placed &

labelled. References all in acceptable format. Excellent writing style.

No typographical

spelling, grammatical

errors.

Well within word limit.

|Excellent clear

succinct

summary that

covers all of the

main points.

|The difficulties/issues to be explained in the formulation are very clearly described. Sufficient background

information is provided in a very ordered and

structured way to

enable reader to easily follow the formulations. Includes excellent attention to issues of inequality and diversity.

Consent and confidentially very well addressed.

Issues of risk and risk management are thoroughly addressed. |General claims and

assumptions are very well supported

by references to appropriate

literature. Shows excellent awareness

of key ideas in the relevant area.

The difficulties/issues to be explained in the formulation are very clearly described. Sufficient background

information is provided in a very ordered and

structured way to

enable reader to easily follow the formulations. Includes excellent attention to issues of inequality and diversity.

Consent and confidentially very well addressed.

Issues of risk and risk management are thoroughly addressed. |Demonstrates very sound grasp of the models being used. Offers a very plausible and coherent account of the development maintenance of the identified difficulties. The formulation is very well supported by assessment data or other appropriate means.

Excellent awareness of the connections and contrasts between the models in terms of their conceptualisations of the problems.  Excellent ability to consider how they can complement each other in guiding further gathering of information. |Intervention plans very clearly grounded in formulation(s). Excellent consideration of what further avenues of information seeking the formulations would lead to. Excellent plans for evaluation of the work: maybe shows particular attention to innovative methods of evaluation and/or particular attention to psychometric properties of any tools proposed. |Shows excellent

awareness of

potential

weaknesses in the formulation

and indicates

how these might be remedied. Excellent discussion of personal position regarding the choices regarding the models, 

differential use of the models, e.g. in how personal factors may have influenced gathering of information and analysis.   |Outstanding

letter

to referrer or client; very succinct, very

well structured,

very clearly

written and

including all

relevant key

points. | |

Good

|Material well organised

according to format in

handbook. Tables, figures, etc. appropriately placed and

labelled. References in

acceptable format. Clear writing style.

Very few, if any, typographical

spelling, grammatical

errors. Within word limit.

|Clear

succinct

summary that

covers most

of the main points.

  |The difficulties/issues to be explained in the formulation are clearly

described. Sufficient background

information is provided in an ordered and

structured way to

enable reader to follow the formulations. Includes good attention to issues of inequality and diversity.

Consent and confidentially well addressed.

Issues of risk and risk management are well-addressed. 

  |General claims and

assumptions are supported

by references to appropriate

literature. Shows good awareness

of key ideas in the relevant area.

|Demonstrates sound grasp of the models being used. Offers a plausible and coherent account of the development maintenance of the identified difficulties. The formulation is adequately supported by assessment data or other appropriate means.

Good awareness of the connections and contrasts between the models in terms of their conceptualisations of the problems.  Good ability to consider how they can complement each other in guiding further gathering of information.

  |Intervention plans clearly grounded in formulation(s). Good consideration of what further avenues of information seeking the formulations would lead to. Good plans for evaluation of the work. |Shows good

awareness of

potential

weaknesses in the formulation

and indicates

how these might be remedied. Good discussion of personal position regarding the choices regarding the models, differential use of the models, e.g. in how personal factors may have influenced gathering of information and analysis.  

|Good letter to referrer or client;

quite succinct,

fairly

well structured,

reasonably

clearly

written and

including

most relevant

key

points. | |                   

         

Satisfactory |Material reasonably organised

according to format in

handbook. Tables,

figures, etc.

reasonably placed and

labelled. Most references in

acceptable format. Fair writing style.

May be a few typographical

spelling, grammatical

errors. Word limit exceeded by more than 10% but is otherwise reasonably presented.

. |Reasonably clear/concise

summary that

Includes some key points.

  |The difficulties/issues to be explained in the formulation are reasonably

described. Sufficient background

information is provided in a fairly ordered and

structured way to

enable reader to follow the formulations. Includes some attention to issues of inequality and diversity.

Consent and confidentially are reasonably addressed.

Issues of risk and risk management are reasonably addressed.  

  |Some general claims and

assumptions are unsupported

by references. Some

references are inappropriate

or irrelevant. Some key ideas have been overlooked. |Minor misunderstandings

of the models or their application in formulation. Some parts of the formulation are not adequately explained, or lack

clear support, or rely on misinterpretations of the evidence.

Some attempt is made at considering issues for integration but some issues regarding compatibility are not adequately explained.

Some misunderstandings

of how the models are compatible or otherwise

  |Intervention plans reasonably grounded in formulation(s). Fair consideration of what further avenues of information seeking the formulations would lead to. Fair plans for evaluation of the work. |Some gaps in

the

identification of

weaknesses or

the account of

how these might

be remedied. Evidence of personal reflection but limited and not differentiated between the models.  

 

  |Fair letter to referrer or client;

could be more

succinct or

better structured,

or more clearly written.

Includes some

relevant key

points. | |            

     

 Weak |Unacceptable level of

presentation throughout

the work.. Word limit exceeded by more than 10% and work is rambling or disorganised.

  |Summary is

Incoherent or

otherwise fails

to convey an understanding of the work.  |Difficulties/issues to be explained in the formulation are insufficiently

described; and/or background

information is provided in incoherent or unstructured way that does not lead on to the formulations; and/or no attention to issues of inequality and diversity; and/or

consent and/or confidentially are insufficiently addressed. Issues of risk and risk management are insufficiently addressed. NB if confidentiality is completely compromised i.e. client identity is clear through full name, address or identifying number, this normally leads to a refer; if partially compromised i.e. first name, service or worker names given, this normally leads to conditional pass. |Insufficient references to

appropriate literature; and/or many unsupported general claims and assumptions; and/or most key

ideas have been overlooked; and/or

general claims are made that have no support in existing literature.

 

  |Serious misunderstandings or poor grasp of the models are

evident; and/or major aspects of the

formulation lack sufficient supportive

evidence; and/or formulation is

incoherent, self-contradictory; and/or insufficient attempt made to consider integrations; and/or serious misunderstandings in explaining or considering questions of compatibility between the models.

  |Intervention plans insufficiently grounded in formulation(s); and/or insufficient consideration of what further avenues of information seeking the formulations would lead to; and/or insufficient plans for evaluation of the work. |No significant attempt made to

critically

evaluate the

formulation; and/or little evidence of awareness of personal factors in the selection and application of the models in the process of formulation.

 

  |Poor letter to referrer or client; insufficiently succinct

and/or poorly

structured/ written;

and/or misses most essential key points. | |

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