Case Formulation & Treatment Planning Flashcards
What are the differences between behavioral assessment and a manualized treatment?
Often the client does not have one disorder where a specific therapy manual is appropriate. Thus, we need a flexible and eclectic approach.
- Behavioral Assessment is individually conducted and treatment is tailored to client’s individual representation rather than going through a fixed manual that is centred around the diagnosis and fits all
- Process of assessment is ongoing, hypotheses and interventions may change, flexible
What are the phases of Behavioral Assessment?
Broad Survey of Problem Areas
- Screening for problems besides main complaint
Description of Problem Areas
- Conceptualization of client’s problem in terms of diagnostic label and roughly which therapy
Identification of Behaviour Patterns
- Specific behaviours are targeted with concrete interventions
Implementation of Interventions and Continuous Assessment
- Continuous updating of hypothesis and interventions
Post-Treatment Assessment of Behaviour Patterns
- Have there been therapeutic gains?
What is a Case Formulation?
A case formulation is a report that identifies the client’s problem areas and includes hypothesis about factors associated with their development and maintenance
What are central assumptions regarding behaviour assessment and therapy?
Behaviour and Context are one unit, not analysed separately
The past cannot be changed, so the focus is on new learning that is possible.
There is a distinction between the etiology and the maintaining factors of a disorder. There may be separate factors now maintaining it and the focus should be on them, consistent with the here-and-now approach of Behavior Therapy.
Problematic behaviour are indicative of the absence of alternative behaviours that would be more effective OR of the current environmental factors. Treatment should be tailored accordingly.
What are outcome expectations?
Outcome expectations refer to an individual’s trust that a given behaviour will result in a certain outcome. They can be positive and thus function as incentives to perform the behaviour, or negative and thus reduce the likelihood of engaging in the behaviour.
Somehow similar to Beck’s core beliefs.
What is prioritized: Broadening behavioural repertoires or eliminating unwanted behaviours?
Building new behaviours so that the client can respond with more flexibility to arising situations. This reduces the frequency, intensity and duration
What is a functional response class?
A functional response class describes a group of behaviours that share functional relatedness in that they often occur under the same environmental influences (e.g. being stressed) and produce similar outcomes (e.g. reducing the stress). For example, excessive house cleaning, binge eating, or excessive alcohol consumption may all occur when an individual is stressed and all serve the function of reducing that stress, i.e. as negative reinforcers. Experiential avoidance is such a functional response class as it describes the group of behaviour that serves to prevent the experience of unpleasantness.
What is the most common way to address problematic behaviour that is maintained by positive reinforcement?
Change the environment in such a way that it promotes new or infrequent behaviour and ceases to reinforce the problematic behaviour
A common client reaction is that CBT is superficial and does not deal with the “real problem”. What response can you give?
It is important to distinguish between the factors causing a problem and the factors maintaining it. One of the central assumptions of Behavior Therapy is that these factors need not be the same.
Why a problem has developed is usually complex and multifaceted. Addressing the CURRENT determinants of the problem will likely be effective, given that there is no evidence that suggest an underlying problem of it all.
