Psychological Formulation: How it Works and Why It’s Beneficial

Psychological formulation is a practice that is gaining more and more popularity as it might be a better alternative to a mental health diagnosis. Let’s talk about what it means and how it works.

What Does Psychological Formulation Mean?

To put it simply, a formulation is a process that allows a therapist to make sense of their client’s struggles by learning about key experiences in their lives and taking factors such as social circumstances into consideration. A history of a patient’s difficulties reveals their strengths and allows the therapist to come up with strategies to begin the recovery.

How Does Psychological Formulation Work?

Formulation typically begins during an assessment appointment with your therapist. You might be asked to discuss what’s currently going on in your life and what you think contributes to your mood. You’ll be encouraged to consider when your distress started and talk about your past experiences and relationships. When a therapist has a better idea of your difficulties, they can decide how to move forward.

For example, a lot of patients turn to therapy after going through a difficult breakup. As they talk about their past and present struggles, it might turn out that one of the key experiences in their lives was bullying which made them feel like they aren’t good enough, a belief that they unknowingly carried from childhood on to adulthood. Since they never had a chance to work through their trauma, ending a relationship might affect their sense of self and lead to depression or self-destructive behaviours. A therapist and client might then agree that the main goal is to address their low self-esteem and strengthen their sense of identity. If the focus was on providing a mental health diagnosis, a patient with such struggles might be diagnosed with depression or even borderline personality disorder which might make them feel ‘broken’ instead of encouraging them to focus on improving their coping skills.

Can Formulation Be Used Instead of Diagnosis?

While the formulation is often used in combination with a mental health diagnosis, it can stand on its own. A lot of mental health professionals believe that labelling their patients might do more harm than good and see the formulation approach as the most beneficial.

How Can Formulation Be More Beneficial Than a Diagnosis?

According to a lot of mental health professionals, diagnosis labels patients as ‘people with illnesses’ instead of ‘people with problems’. [1] Formulation is an alternative that gets rid of the stigma and focusses on people’s strengths and resources as the assumption of this approach is that a patient is having a normal response to an abnormal situation.

Additionally, the formulation method is a joint effort between you and your therapist. While they might draw conclusions from what you tell them, it’s important that you both agree on what’s causing you distress. In other words, you have a say in how your therapist makes sense of your experience. Unlike diagnosis that won’t change any time soon, formulation constantly evolves as you share new information and experience new struggles.


If you’re struggling or simply need someone to talk to, contact My Family Psychologist for a confidential chat

References
[1] https://www.researchgate.net/publication/318734743_Psychological_Formulation_as_an_Alternative_to_Psychiatric_Diagnosis