5 ps formulation example

Routledge. Impact of case formulation in cognitive behaviour He was recently driving home from work in the evening and law enforcement stopped him because of erratic driving. May, R. (1950). She subsequently planned to overdose on her medications. The 5 P's of Strategy is a planning process. In the Five Ps context, protective factors are used to potentially prevent substance use and misuse from having more negative impact as well as to increase client resilience. Mintzberg's 5 Ps of Strategy with Examples 1. Ingram, B. L. (2012). Annual surveillance report of drug-related risks and outcomes. SAMHSA (2020) pointed out the significance of addressing clients individually based on their distinctive needs in order to provide the best chance for recovery from substance use and misuse. What are the 5 Ps in psychology? In implementing the Five Ps framework with Dax, the clinician chose to use psychoeducation and strategies borrowed from acceptance and commitment, reality, Bowenian family systems, and solution-focused brief therapies to assist Dax with his substance use and misuse. Furthermore, the Five Ps helps clients and counselors explore relationships between each factor and the presenting problem. https://doi.org/10.1177/0017896918763462 University-educated. Following is a case illustration demonstrating how the Five Ps may be helpful in formulating and engaging in a clinical application. Keys to solution in brief therapy. Precepting factors draw upon the ABC model (Burns, 1989; Ellis, 1977; Trower et al 1998) which refers to A- activating event, B Beliefs and C- consequences. Information. Client substance use and misuse can be quite challenging for counselors, both novice and experienced. The officers evaluated him, detained him, and subsequently arrested him for driving while intoxicated. After being told she was fired from her job, she went home and self-harmed to cope with the distress of this loss. It's useful to employ the 5 Ps throughout the planning process. It has been documented that 90% of the population at some point have intrusive thoughts, or feel paranoid and feel people are doing things on purpose towards them. Strategy as a Plan Planning comes naturally to many managers and as such, has become the default first step. The 5 P which I will be mentioning are: presenting issues, precipitating, perpetuating, predisposing and protective factors. We're here to answer any questions you have about our services. (2015). Substance Abuse and Mental Health Services Administration. 0000239180 00000 n Formulation in psychology and psychotherapy: Making sense of peoples problems (2nd ed.). As Chadwick et al. Clinical case formulations: Matching the integrative treatment plan to the client (2nd ed.). Based on what I have reviewed in this essay. 0000156014 00000 n 0000008644 00000 n 0000187506 00000 n Presenting Issue(s) - please use the DSM-What assessment tools. 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). Correspondence may be addressed to Scott Peters, One University Way, San Antonio, TX 78224, scott.peters@tamusa.edu. Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust If present categories are used, formulation can be limiting and dangerous. 0000118792 00000 n Now that you've filled in the easy parts from the history, the hardest part is conceptualizing the predisposing social factors (Step 3), and all of the psychological factors (Steps 4, 5, 6, 7). British Journal of Clinical Psychology, 37(3), pp.269-284. However, formulation tells us how the person became depressed as a result of their genetics, personality, psychological factors, biological factors, social circumstances (childhood adverse events and social determinants of health), and their environment. 0000010825 00000 n For example, the clinician may ask Dax if they can share how genes are passed on and expressed, like genes for eye color or hypertension. https://doi.org/10.1016/S0740-5472(03)00212-5 The more cases you go through (and more of the sample formulations below) the more comfortable you will be with formulating! https://www.apa.org/pubs/journals/pas/index Morin, J.-F. G., Harris, M., & Conrod, P. J. 0000200735 00000 n The ball in the pool metaphor (i.e., holding a beach ball under the water works temporarily, but eventually it pops back up) can be compared to alcohol temporarily holding those painful emotions down, eventually to resurface. First and foremost, it should be emphasized that this particular framework has not been empirically tested with client substance use and misuse. He then withdraws and becomes sullen for a few days. Liao, J.-Y., Huang, C.-M., Lee, C. T.-C., Hsu, H.-P., Chang, C.-C., Chuang, C.-J., & Guo, J.-L. (2018). Formulation: A multiperspective model. Case Formulation with the Biopsychosocial Model The biopsychosocial model ensures that your case formulation will be holistic, and will capture biological, psychological and social factors. Psychological Assessment, 9(4), 334348. Additionally, the lack of coping mechanisms leading to intense thoughts of suicide. Motivational interviewing: Building rapport with clients to encourage desirable behavioral and lifestyle changes. 0000241121 00000 n One or more perpetuating psychological processes: Chronic marital/relationship discord, lack of empathy from family/friends, developmentally inappropriate expectations. https://doi.org/10.1080/02699931.2012.739998 A course of action you intend to take or a series of guidelines you intend to follow. (2017). 0000010086 00000 n 0000004805 00000 n History & Philosophy of Psychology, 13(2), 3239. However, the patient has protective factors including psychological mindedness and previous response to therapy, which is a good prognostic factor. More ominously, substance use and misuse has been correlated with intimate partner violence (Murphy & Ting, 2010). Following formulation, there should be an identification of the prioritised areas of focus for care - to inform the Care Plan. She has also previously responded well to psychotherapy and appears to be psychologically-minded. 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. It would be difficult to say which formulation is correct, and if there is such a thing as a correct one, since everyone has an individual view of what is right or wrong. Case conceptualization research in cognitive behavior therapy: A state of the science review. Wiley. Protective factors move away from the problem areas that need interventions to hope and optimism and look to future success and competence (Macneil et al., 2012). https//doi.org/10.1016/j.drugalcdep.2013.02.018 Five additional elements are often added to this (referred to as 'the five Ps'): presenting problem (s) predisposing factors precipitating factors perpetuating factors protective factors. Evidence-based approaches, such as cognitive behavioral therapy, tend to be nomothetic, assuming homogeneity and generally geared toward symptom amelioration (Robinson, 2011). The Five Ps can be used in a variety of settings such as a community mental health agency, primary care clinic, and inpatient or residential treatment centers. Marquis, A., & Holden, J. 2004;2(6):576-582. doi:10.1370/afm.245. 2008). (2017, September 7). Drugs and drug policy: What everyone needs to know. headspace recommends a formulation framework using the five Ps, as follows: Presenting problem (s): Initial signs, symptoms or other difficulties that are clinically important for the young person. Effects of treatment type on alcohol consumption partially mediated by Alcoholics Anonymous attendance. The Essay Writing ExpertsUK Essay Experts. [Patient] presents with a [diagnosis]. The simplest format looks at just three key areas: thoughts, feelings (emotions and physical sensations) and behaviours. This factor differs markedly from the first four. Some different presentation styles are suggested here. Social isolation and withdrawn from family members, Ongoing social isolation due to psychosis causing him to be fearful of others, Followed by an early intervention in psychosis team, History of immigration (increases risk for psychosis), Long-standing feelings of isolation and insecurity since childhood, Joined a gang, entering a stressful lifestyle, led to increased hyper-vigilance and paranoia in the past few months, Ongoing delusions leading patient become suspicious of healthcare workers/family, Previously responded well to CBT for psychosis, Family history of psychosis and schizophrenia. Ronald Press. 0000006779 00000 n https://doi.org/10.3389/fpsyt.2013.00173 Alcohol Research Current Reviews, 31(2), 111118. 0000013321 00000 n It is important to remember that not everything will fit neatly into each box. 1189 76 Jane Doe is a 30-year-old female who presents with acute suicidal ideation in the context of a job loss. Substance use and misuse carries numerous potential repercussions. It can be changed and reviewed as the treatment is in progress if any new information come to light. One way to do this is to use the "5 Ps.". Once the protective factors are identified, the ensuing conversation provides opportunities to imagine future outcomes in which protective factors may come into play should situations occur that the client finds problematic. Kuyken, W., Padesky, C. A., & Dudley, R. (2009). Routledge. all (2004) it is essential to reduce stress and traumatic events for people recovering from Paranoid Schizophrenia, and start to contribute in social activities. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860452/ By examining and exploring clients use or misuse within the context of a multidimensional framework, interventions can be personalized, and areas of concern can be targeted. Plate, A. J., & Aldao, A. For Dax, he shares that when he and his wife argue, it follows a very predictable pattern. Cognitive and Behavioral Practice, 20(4), 399409. Here's what the completed table would look like with the psychological factors incorporated. Please refer to an authoritative source if you require up-to-date information on any health or medical issue. Hussaarts, P., Roozen, H. G., Meyers, R. J., van de Wetering, B. J. M., & McCrady, B. S. (2012). (Goldman & Greenberg 1997). There are several approaches to managing client substance use and misuse that have demonstrated effectiveness. )jB' */NNM;2=Kc.w}9XXtj+%]{IF UA_ This is where you'll need to be creative and also think more in-depth about your patient. 5 Ps Formulation Example. Examining the two groups experiences using the Five Ps may provide insight to assist counselor training programs related to substance use and misuse skill development. https://doi.org/10.1002/jclp.22516 (2019). Note that this table is extremely comprehensive and long, and not everything will (or should!) In Formulation in psychology and psychotherapy (pp. From a biological perspective, the patient is vulnerable because, The patient's early childhood and developmental history suggest, Used substances as a coping style in [the past], and now this is occurring again (or there is a relapse) due to [social factor]., Used substances as a coping style in [the past], and now this is occurring again (or there is a relapse) due to [psychological vulnerability]., I wonder if [psychological factor] is contributing to [current symptoms/struggles], Tell a story and narrative that is unique to your patient, Be specific and demonstrate your understanding of the patient as a, Use words like precipitating, protective, and perpetuating factors to anchor your listener, Focus on the most salient features and be concise, Try and use a psychological theory (but only if you understand it), Try to be perfect only to overwhelm yourself, Be generic (your formulation needs to be unique to your patient), Tell the patient's whole story all over again, Mention life events or trauma without an understanding of its meaning or impact, Try to formulate a grand unified theory of the patient and over-reach with your theory (if it doesnt fit, it doesnt fit! Journal of Mental Health Counseling, 30(1), 6794. (2010, February). The following pages describe two approaches to documenting the formulation using the 5Ps structure, including a narrative and flowchart. Jane could benefit from accessing support from her company's HR department to understand what options she has after her job termination, Substance use groups such as Alcoholic's Anonymous, Increasing connections to her friends and social supports, Biopsychosocial Model and Case Formulation, The Parable of Panic: Suffocation, Social Attachment, and the Critical Role of an Integrative, Biopsychosocial Formulation, family act and what is the family structure, Childhood exposure to maternal depression, domestic violence, late adoption, temperament mismatch, or marital conflicts, Family history of mental disorders and substance use, Early parental divorce, unstable home life, history of trauma. It is systematic, while allowing for flexibility and creativity. Delivery of mindfulness-based interventions may help to address stressful events that previously triggered substance use (Garland et al., 2014). Perpetuating factors are those that sustain and possibly reinforce clients current substance use and misuse challenges. The following samples can be taken as basic templates for case conceptualization, in the context of Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and family therapy. Dax reports a strong paternal history of substance use and misuse. The Diagnostic and Statistical Manual of Mental Disorders (5th ed. https://doi.org/10.1016/j.janxdis.2015.09.005 A review of CBT treatments for substance use disorders. https://doi.org/10.1016/j.avb.2010.01.006 The persons resilience and strengths that help maintain emotional health. Self-help organizations for alcohol and drug problems: Toward evidence-based practice and policy. Evaluation of children with heart murmurs. No plagiarism, guaranteed! Penguin. %%EOF Substance Abuse and Mental Health Services Administration. Using case formulation in clinical practice. Addiction treatment: A strengths perspective (4th ed.). The National Survey on Drug Use and Health asserted that close to 30% of respondents aged 12 and older reported use of illicit substances in the past month (Substance Abuse and Mental Health Services Administration [SAMHSA], 2017). It can be used in outpatient, inpatient, and residential settings and possibly as part of an aftercare program. Dax presents as extremely frustrated and embarrassed at being mandated to attend counseling sessions. Following is a case illustration demonstrating how the Five Ps may be helpful in formulating and engaging in a clinical application. Additionally, its holistic and creative style provides opportunities to address concerns at various points with a variety of strategies and interventions that will best suit clients unique situations. Addressing client substance use and misuse can be quite complicated, and as mentioned previously, substance use and misuse impacts users and society in a variety of ways beyond substance intake. The case formulation in child and adolescent psychiatry. This condition did not develop six months ago but developed during childhood when he failed to meet his father's expectations. Macneil, C. A., Hasty, M. K., Conus, P., & Berk, M. (2012). of this manuscript. It can assist both novice and experienced clinicians working with clients who present for counseling with substance use and misuse. Additionally, as it is a continuous process it allows the therapist to revise any incorrect hypothesis about any underlying mechanism at any stage. Further, substance use and misuse is a significant risk factor for suicidality (Poorolajal et al., 2016). What are perpetuating factors? 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 .

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