Eels Chapter 1 & 4 - Case Conceptualization Flashcards
Eels mentions planning as the basis for useful psychopathology, what should go into ones plan?
Theory, evidence and expert practice
Why is case conceptualization needed?
Because diagnosis do not give proper direction on proper treatment nor do they adress etiology
What are the basics of what is included in case conceptualization? (4)
- full context that is the client (problems, history, environment, etc.)
- Explanatory account(s)
- Treatment plan(s)
- Treatment response + evaluation
Process aspects of case conceptualization (CC)?
therapist activities involved in eliciting information necessary to formulate
Content aspects of CC? (4)
- Problems identified
- Diagnosis
- Explanation of problems
- Treatment
Case vs. event vs. prototype formulations in CC?
- Event = particular episode or event in therapy, not the entire treatment
- Prototype = theoretical conception of a psychological disorder (e.g., attachment theory of depression)
- case = the full shit
The four reasons Eels presents for formulating cases?
- Guides treatment
- Increased treatment efficacy
- Tailors treatment to the specific circumstances of the client
- Should enhance therapist empathy
(by creating an overarching perspective of the treatment)
What are two classic medical traditions that can still be seen in CC? How so?
Hippocratic and Galenic medicine (through observation, holistic perspective and considering multiple facets of functionings + inference, testing & experimentation)
Which four contemporary developments in psych have influenced CC?
basic.
- Nature and classification of psychopathology
- theories of psychotherapy
- psychometric tradition
- structured case formulation models
How do decisions about normality and abnormality affect CC?
- Shape identification of problems/symptoms
- Explanations of those problems
- Treatment goals
- Intervention strategies
Basically provide a reference point for understanding clients in a culture
How does the nature and classification of psychopathology affect CC?
- abnormal vs normal distinctions
- dimensional vs taxonomical views on disorders inform different measures/treatments
How do theories of psychotherapy affect CC?
It provides a framework for the clinician’s explanation (which can, of course, wildly differ)
Four major models of psychotherapy?
- Psychodynamic
- Cognitive
- Behavioural
- Humanistic and phenomenological
Psychometric tradition effects on CC?
- The concepts in general affect formulation (norming, reliability, etc.), but also the treatments informed, monitoring throughout, etc.
Why might psychometric effects be limited on CC?
- mostly because psychometrics and psychotherapy are viewed as wholly different fields
- configurational/narrative structure of some case formulations (differs from itemized structure of most psychometrics)
Why did structured case formulation models come to be?
Because therapists, even with similar theoretical orientations, disagreed more than they agreed when formulating clients (even with the same clinical material)
Common factors between different case formulation models/methods? (4)
- Identify problems
- Infer maladaptive relationship transactions
- Infer maladaptive concepts of selfs/others/world
- Rely primarily on clinical observation
Which 5 tensions are to be balanced in case formulation?
- Immediacy vs. comprehensiveness
- Complexity vs. simplicity
- Bias vs. objectivity
- Observation vs. inference
- Individual vs. general
Why is an integrative approach as a basis for CC more useful? (3)
- The majority of clinicians do not abide by a singular theoretical approach
- Can be tailored to the unique client, in a way that unitheoretical approaches cannot
- No theoretical approach outperforms another (i.e., common factors seem more impactful)
What four common factors did Frank identify for psychotherapy?
- Therapeutic relationship (emotionally charged and confiding relationship)
- Relationships exists in a circumscribed, culturally sanctioned context in which well-delineated roles are played
- Credible and persuasive account of the reasons for the client’s symptoms/problems is collaboratively accepted by client and therapist
- Prescribed treatment enseus with active participation of both therapist and client
What are the four main steps in Eels’ CC model?
- Gather information
- Formulation
- Treat (+ monitor progress)
- Terminate (lol)
What are the sub-steps of formulation in Eels’ CC model?
- Create problem list
- Diagnose
- Develop explanatory hypothesis
- Plan treatment
Sub-steps of the sub-step “create problem list” in Eels’ CC model?
- Red flags (chemical dependence, domestic violence, suicidality, homicidality and neglect)
- Functioning (self, interpersonal, societal)
Sub-steps of the sub-step “develop explanatory hypothesis” in Eels’ CC model?
- Sources (theory, evidence)
- Components (precipitants, origins, resources, obstacles and core hypothesis)
Sub-steps of the sub-step “plan treatment” in Eels’ CC model?
- Set point considerations (reactance, preferences, culture and readiness)
- Goal identification (process/outcome goals and short-term/long-term goals)
- Plan interventions
When does one monitor progress and at what level is this done in Eels’ CC model?
Start after treatment start, done for each level (gather info, formulation and treatment)
Is Eels’ CC model sequantial?
Nope, obviously
Which three factors are present within Case Conceptualization?
- Predisposing factors (family history, past experiences, temperament, etc.)
- Inducing (precipitating?) factors (trigger for current struggles, etc.)
- Maintaining factors (avoidance, certain emotions, interpersonal, etc.)
