Also during treatment the therapist might face resistance from the clients/ patients, all of this must be noted as this data too is useful and adds to the improvement of therapy. It is said that the two criteria for evaluation of therapy formulation are- effectiveness and cost effectiveness. Effectiveness can be seen only when a formulation prescribed interventions lead to desired change in the clients functioning and achievement of the client’s goals; and by cost-effectiveness it is meant that, different therapy formulations are compared to alternative effective approaches; it achieves the desired outcome with less time and effort and in a more economical manner. These steps to case formulation are used as a springboard to evaluate the multiple …show more content…
Those working from a primarily cognitive orientation are likely to form hypotheses about a client’s maladaptive beliefs that contribute to the development and maintenance of their disorder. For instance, clinicians providing cognitive therapy for obsessive compulsive disorder (OCD) will emphasize a client’s unhealthy interpretations about the meaning of their intrusive thoughts (see Frost & Steketee, 2002; Rachman, 1998). Analogously, a therapist working from cognitive models of social phobia will highlight the onset of fears of negative evaluation and beliefs that one will fall short of an expected standard (Clark & Wells, 1995; Rapee & Heimberg, 1997). On the other hand, when working primarily from a behavioral perspective, maladaptive behaviors and environmental contingencies, such as reinforcements for avoidance, will likely feature prominently in case …show more content…
These include an emphasis on unobservable mental entities or forces, a focus on classification per se, and concerns about lack of utility in helping individuals (Hayes & Follette, 1992). These therapists prefer to focus on a “functional analysis” of behavior, which involves identifying relevant characteristics of the individual in question, his or her behavior, and environmental contingencies or reinforcement, then applying behavioral principles to make alterations. Some behaviorists have acknowledged limitations in the functional analysis approach to case formulation, primarily due to difficulties in replicability and resulting problems in studying patients scientifically (Hayes & Follette, 1992). More recently, behavior therapists have broadened the notion of functional analysis and focused it into a case formulation format (Haynes & Williams, 2003; Nezu, Nezu, & Cos, Chapter 12). Notwithstanding the criticisms just cited, behaviorists have made at least three major contributions to the case formulation process. First is an emphasis on symptoms. Behaviorists have strived to understand the “topography” of symptomatology, including relevant stimulus–response associations and contingencies of reinforcement. In contrast to dynamic thinkers who view symptoms as symbolic of a more fundamental problem,