5 ps formulation example

Family therapy and the treatment of substance use disorders: The family matters model. National Center on Addiction and Substance Abuse at Columbia University. Addiction Science and Clinical Practice, 13(8), 115. The patient may have a strong family history of the disease, a sedentary job, environmental exposures, and/or a nutritionally-poor diet. Jane has been working at a start up company for the past 2 years. Do you have a 2:1 degree or higher? McHugh, R. K., Hearon, B. - attachment theory, cognitive behavioural therapy, dialectical behavioural therapy, interpersonal therapy, psychodynamic therapy). endstream endobj 1263 0 obj <>/Filter/FlateDecode/Index[262 927]/Length 50/Size 1189/Type/XRef/W[1 1 1]>>stream Long-term, Jane might also benefit from a more in-depth understanding of how her past trauma affects her present self and symptoms. Following formulation, there should be an identification of the prioritised areas of focus for care - to inform the Care Plan. We would anticipate when engaging in treatment, the patient may have [resistance/transference/countertransference]. CBT case formulations often have 5 ingredients: Presenting problem (s) Predisposing factors which made the individual vulnerable to the problem Precipitating factors which triggered the problem Perpetuating factors such as mechanisms which keep a problem going or unintended consequences of an attempt to cope with the problem Protective factors There are numerous methods and combinations of methods to address substance use and misuse, such as family therapy, cognitive behavioral therapy, and self-help groups. Following is a case illustration demonstrating how the Five Ps may be helpful in formulating and engaging in a clinical application. Substance Use & Misuse, 49(5), 492512. We've received widespread press coverage since 2003, Your UKEssays purchase is secure and we're rated 4.4/5 on reviews.co.uk. B., Twohig, M. P., Waltz, T., Hayes, S. C., Roget, N., Padilla, M., & Fisher, G. (2007). https://www.apa.org/pubs/journals/pas/index This population often experiences stigma and suboptimal health care results (McNeely et al., 2018; van Boekel et al., 2013). She notably has a past history of childhood trauma and abuse. Executive functioning in alcohol use studies: A brief review of findings and challenges in assessment. It can assist both novice and experienced clinicians working with clients who present for counseling with substance use and misuse. Type. 1. It acknowledges your strengths and resources. 0000007722 00000 n W. W. Norton. Oxford University Press. This can result in lack of access to treatment services, contributing to increased stress. Hussaarts, P., Roozen, H. G., Meyers, R. J., van de Wetering, B. J. M., & McCrady, B. S. (2012). (2017). Behaviour and Research Therapy, 41(6), 671680. 0000004805 00000 n Sara is unequivocal in her confidence in Zoes cardiologist and his competence. might you consider? Engel, G. L. (1977). (2013). As part of his adjudication, Dax was required to attend five counseling sessions and have a clinicians report provided to the court. This can be even more problematic given the lack of health care access for large numbers of Americans (Schoen, 2013). In psychiatry, formulation appears more complicated because human behaviour and the brain itself is extraordinarily complex. Based on these factors, dialectical behavioural therapy would be the most helpful for this patient. It also provides opportunities for a variety of interventions and strategies targeted to clients and their substance use and misuse or contributing factors. Like most things in medicine, there are multifactorial causes of diseases, illnesses, and disorders. As you get better and more expert at formulating, you may not need to use this rigid structured format, and instead, will be able to present a more intuitive and organic formulation of the patient instead (see other methods below). Formulation in psychology and psychotherapy: Making sense of peoples problems (2nd ed.). Additionally, many individuals who engage in substance use and misuse have co-occurring major medical conditions, such as cancers, cardiovascular accidents (strokes), and respiratory and cardiac illnesses (Bahorik et al., 2017). https//doi.org/10.1016/j.drugalcdep.2013.02.018 0000066425 00000 n Annals of Family Medicine. https://www.centeronaddiction.org/addiction-research/reports/behind-bars-ii-substance-abuse-and-americas-prison-population 107127). The 5 P's of Strategy is a planning process. 0000002760 00000 n 0000016414 00000 n Additionally, there may be a discussion using aspects of existentialism to process inherent anxiety and its connection to unknowable future events (May, 1950; Wu et al., 2015). How do you present all this information and data? https://doi.org/10.1016/j.addbeh.2006.09.008 Dallos, R. and Vetere, A., 2018. The biopsychosocial model considers the 4 Ps for each of the biological, psychological, and social factors: The 4 Ps can be laid out in a 3 x 4 table to systematically do formulation and identity factors. 0000012631 00000 n The essay will now look at the key ideas underpinning the process of CBT. They conceptualized a way to look at clients and their problems, systematically and holistically taking into consideration the (1) Presenting problem, (2) Predisposing factors, (3) Precipitating factors, (4) Perpetuating factors, and (5) Protective factors. Access, affordability, and insurance complexity are often worse in the United States compared to ten other countries. There are limitations to the Five Ps framework as a way to formulate and intervene with clients substance use and misuse. What we understand today is shaped by what we believe and what we have experienced in our life. (Johnstone & Dallos 2009). What can be done, realistically speaking. Of course, the Mintzberg 5 P's of Strategy are part of an organisation's strategy, but it's also wise to look at the 5 P's as separate standpoints that all need to be considered for developing a strong and successful strategy. 0000010825 00000 n Rachman, S. and de Silva, P., 1978. Further, substance use and misuse is a significant risk factor for suicidality (Poorolajal et al., 2016). Becks States that life experiences play a part in people dysfunctional beliefs and assumptions about themselves, others and the world around them (Beck 1967, 1979). Some of these evidence-based approaches will be demonstrated later in a case illustration. In his report on alcohol, drugs, and health, the U.S. It can be changed and reviewed as the treatment is in progress if any new information come to light. ), The science of cognitive behavioral therapy (pp. Study for free with our range of university lectures! The genetics of alcohol and other drug dependence. or funding contributions for the development Treating complex cases: The cognitive behavioural. Strategy as a Plan Planning comes naturally to many managers and as such, has become the default first step. Journal of Marital and Family Therapy, 38(1), 122144. Conflict of Interest and Funding Disclosure Correspondence may be addressed to Scott Peters, One University Way, San Antonio, TX 78224, scott.peters@tamusa.edu. Mental health professionals evaluations of the Integral Intake, a metatheory-based, idiographic intake instrument. The five perspectives are: A strategy has a PLAN A strategy has a PLOY A strategy has a PATTERN A strategy has a POSITION A strategy has a PERSPECTIVE Let's examine each of the 5 Ps of Strategy in turn 1. What is the purpose of formulation? This involves explaining that interactions can act as a kind of back-and-forth loop of actionreactionaction without any resolution, leaving both parties feeling unheard, misunderstood, and frustrated. Current stressors, plus salient developmental history, The patient presents at this time with [problem and symptoms], in the context of [situation and stressors], Genetics, temperament, medical history, substances, medications, The patient has the following [genetic vulnerabilities, medical history], The patient grew up in a family characterized by [factors], with a caregiver who was [distant/available/invalidating], Capacity for interaction, communication, empathy, and attachment, The patient may have had difficulty in [stage of development], and this is reflected in [examples from adult relationships], It appears that the patient may have struggled with conflicts in early life. Drugs and drug policy: What everyone needs to know. Based on these factors, the following [treatment and management] would be the most helpful for this patient. (2014). The idiographic/nomothetic dichotomy: Tracing historical origins of contemporary confusions. 0000241644 00000 n These symptoms have been maintained by [psychological factors/personality factors], and [social/environmental factors]. Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust These can be in the form of personal characteristics such as tenacity, intellect, or insight. Barriers and facilitators affecting the implementation of substance use screenings in primary care clinics: A qualitative study of patients, providers, and staff. Substance use and misuse is exceedingly common and has numerous implications, both individual and societal, impacting millions of Americans directly and indirectly every year. (Goldman & Greenberg 1997). Etoom, Y., & Ratnapalan, S. (2014). This is where you'll need to be creative and also think more in-depth about your patient. 0000119085 00000 n 0000016707 00000 n The next step Precipitating is used to look at both internal and external factors and discover where they are linked, from this you get a greater picture of the overall problem. Sample #1: Conceptualization for CBT case This is a 35-year-old Caucasian man referred by his physician for treatment of generalized anxiety. Perpetuating factors are those that sustain and possibly reinforce clients current substance use and misuse challenges. https://doi.org/10.1111/j.1521-0391.2011.00187.x The effects of treatment for substance use problems on intimate partner violence: A review of empirical data. 0000238570 00000 n Those who engage in substance use and misuse often have higher rates of unemployment (Compton et al., 2014; Dieter, 2011). (Ed.). (Persons, 1998). It's useful to employ the 5 Ps throughout the planning process. https://doi.org/10.1080/02699931.2012.739998 https://www.ncbi.nlm.nih.gov/books/NBK343542 As shown above, there are numerous ways to examine and treat client substance use and misuse. Jane Doe is a 30-year-old female who presents with acute suicidal ideation in the context of a job loss. The Five Ps permits counselors to both assess and intervene essentially simultaneously. Murphy, C. M., & Ting, L. (2010). Case Formulation DSM-5 Criteria Sets DSM-5 Background Information Treatment Planning Best practice guidelines are often tied to a diagnosis DSM-5 measures to monitor progress . 0000012481 00000 n Current Drug Abuse Reviews, 4(1), 427. Episodic future thinking in generalized anxiety disorder. For example, many precipitating and perpetuating factors may overlap and fit in other boxes. SNACIy` iOUOb&U}+v$]MH"{8v%h= _ These psychological symptoms/factors are then observed by the clinician to give a psychiatric diagnosis. Introduction to formulation. Her mood was stable prior to this job loss, and she had no self-harm or suicidal thoughts in the past 1 year. https://doi.org/10.1111/j.1752-0606.2011.00242.x Participants: The leader of a meeting should carefully consider who he or she invites. Positive relationships, supportive community, and/or extended family/friends? [1][2] Biopsychosocial formulation combines biological, psychological, and social factors to understand a patient, and uses this to guide both treatment and prognosis. https://www.cdc.gov/drugoverdose/pdf/pubs/2018-cdc-drug-surveillance-report.pdf She has the following protective factors, including a supportive psychiatrist and friend. Fundamental Changes in DSM-5 Dimensional Approach The conundrum with categories After being told she was fired from her job, she went home and self-harmed to cope with the distress of this loss. Psychotherapy, 52(2), 190194. therapy for psychosis. Case formulation in process-experiential therapy. White, M., & Epston, D. (1990). Fundamental Changes in DSM-5 Dimensional Approach The conundrum with categories Do they have ability to be reflective or modulate their affect? Disclaimer: This is an example of a student written essay.Click here for sample essays written by our professional writers. Seminars in the Psychotherapies , pp. 0000239101 00000 n In addition, the vast majority of those with an SUD never receive treatment (Han et al., 2015). (2017). Addictive Behaviors, 32(7), 13311346. 0000238491 00000 n https://doi.org/10.1016/S0740-5472(03)00212-5 Presenting Problem Routledge. She subsequently planned to overdose on her medications. Chadwick, P., Williams, C., & Mackenzie, J. Humphreys, K., Wing, S., McCarty, D., Chappel, J., Gallant, L., Haberle, B., Horvath, A. T., Kaskutas, L. A., Kirk, T., Kivlahan, D., Laudet, A., McCrady, B. S., McLellan, A. T., Morganstern, J., Townsend, M., & Weiss, R. (2004). This area explores significant occurrences that preceded or triggered the presenting problem and its consequences. and Clark, D.M., 1989. The internal and external factors that maintain the current problems. The more cases you go through (and more of the sample formulations below) the more comfortable you will be with formulating! The Biopsychosocial Model and Case Formulation (also known as the Biopsychosocial Formulation) in psychiatry is a way of understanding a patient as more than a diagnostic label. Here are some examples: A good formulation should be integrative, and let you understand how all of the patient's factors interact to lead to the current situation. She also appears to use alcohol as a way of managing distressing emotions, but does not have any psychological coping strategies. Alcohol Research Current Reviews, 31(2), 111118. 0000180256 00000 n Are mindfulness-based interventions effective for substance use disorders? 2004;2(6):576-582. doi:10.1370/afm.245. (2017). The CBT formulation consists of 5 key stages which is known as the 5 Ps model. Twelve-step attendance is most beneficial with inpatient substance use and misuse treatment (Karriker-Jaffe et al., 2018). The 4 Ps formulation table can be a very rigid and systematized way of presenting a formulation. As Chadwick et al. I will go into further detail of the 5 Ps Model below. Here you can choose which regional hub you wish to view, providing you with the most relevant information we have for your specific region. Another weakness is that sometimes the client might not want to disclose some information in their past which might assist the therapist in making the client understand that sometimes important part of their history in fluence the way they view the world. She has several early developmental and pathogenic psychological factors, including growing up in a family characterized by invalidation, with parents who were distant and unavailable. The goal here is to build Daxs competence in communicating, both in listening and expressing. Research on the success of family-based interventions has methodological challenges, such as small sample sizes and the difficulty of examining long-term outcomes (Rowe, 2012). This has further exacerbated her alcohol use disorder. This research could point to populations for whom the Five Ps is more and less effective. Lack of adaptive coping mechanisms resulted in using self-harm to cope and avoid further emotional dysregulation. 0000013350 00000 n But the most important thing about formulation is that it should be intuitive and flow logically. BMC Medicine, 10(111), 13. Alcohol, cannabis, and opioid use disorders, and disease burden in an integrated healthcare system. 3. Effects of treatment type on alcohol consumption partially mediated by Alcoholics Anonymous attendance. https://www.samhsa.gov/treatment Impact of case formulation in cognitive behaviour This is often the opportunity for the client to share what may help them move forward, what their assets are, who can support them, and any other self-identified skills (de Shazer, 1985). Compton, W. M., Gfroerer, J., Conway, K. P., & Finger, M. S. (2014). 0000241121 00000 n Current dose of sertraline is subtherapeutic, Ongoing discord in her romantic relationship, Good interpersonal support from her best friend who brought her to hospital, Re-experienced these feelings of abandonment after being fired from work. Journal of Public Health, 38(3), e282e291. Scott W. Peters, PhD, LPC-S, is an associate professor at Texas A&M University San Antonio. 0000156014 00000 n Dax can then share his and his wifes perspectives on their daughters care. One of the strengths of this formulation is that it is not fixed. Substance use disorder and risk of suicidal ideation, suicide attempt and suicide death: A meta-analysis. 0000017180 00000 n Current Psychiatry Reports, 15(11), 211. https://doi.org/10.1097/ADM.0000000000000260 Bacon, M. 0000241723 00000 n They conceptualized a way to look at clients and their problems, systematically and holistically taking into consideration the (1) Presenting problem, (2) Predisposing factors, (3) Precipitating factors, (4) Perpetuating factors, and (5) Protective factors. He denies any significant increase in alcohol use or any other substance use. You've got your table all filled out now. Good interpersonal support from her best friend who brought her to hospital. New York: WW Norton. These approaches can be accomplished via outpatient counseling, partial hospitalization programs, inpatient and medically managed substance treatment programs, as well as residential and therapeutic communities. de Shazer, S. (1985).