Formulation

Question 1

What are the 4 key themes (4 paras)?

Answer 1

Religious world view,
motivation to endure treatment, isolating from friends,
recovery to you.

Question 2

What is the key theme of the first para

Answer 2

Religious world veiw

Question 3

What is the key theme of the second para

Answer 3

Motivation to endure treatment

Question 4

What is the theme of the third para

Answer 4

Isolating from friends

Question 5

What is the theme of the forth para

Answer 5

Recovery to you

Question 6

What reference are in the first para

Answer 6

Miscarriage blame (Hale 2007)

Low self esteem feeding into anxiety and mood (Wigman et al 2012)

Question 7

What references are in the second para

Answer 7

Heritability of schizophrenia (NHS 2019)

Exercise is beneficial to mood (MHF 2022)

Question 8

What references are in para 3

Answer 8

None. It is about the common theme that she isolates herself when she is overwhelmed, and how this is irrational coz her friends have been supportive in the past

Question 9

What references are in para 4

Answer 9

Recovery to you (Dorrer 2006)

Talking therapy (NICE 2014)

Question 10

Summarise para 1 : religious world veiw

Answer 10

You feel the voices are punishment from god. Blame around your miscarriage (Hale 2007) is reducing your self esteem.

You acknowledged that your self esteem has stemmed from the invalidating environment your mother has created. I think your poor self worth is feeding into your anxiety and mod (Wigman et al 2012).

Question 11

Summarise para 2 : motivation to endure treatment

Answer 11

Don’t want to turn out like father (heritability NHS 2019)

Fiancé and his fam are supportive. Do activities like exercising with them. Exercise helps mood (MHF 2022)

Question 12

Summarise para 3 - isolating from friends

Answer 12

Increased anxiety around them due to her wanting kids and scared god will never allow her.

She isolated herself in the past with her childhood friends. This is a pattern.

Current friends have been supportive about miscarriage in the past so should speak to them.

Try journalling as alternative coping mechanism or speaking to them.

Question 13

Summarise para 4 : recovery to you

Answer 13

• stop being punished by god
• improve self esteem and feel less blame. Talking therapy (NICE 2014) might help with this

Question 14

What are the 11 sections of the assessment

Answer 14

Reason for referral
Current situation
Physical health
Past psychiatric history
Family history
Social history
Substances and alcohol
Risk assessment
MSE
Formulation
Recommendations

Question 15

What do you need to include in the MSE

Answer 15

Appearance
Behaviour
Speech
Mood
Emotional reactivity
Thoughts
Perceptions

Question 16

3 points of the summary

Answer 16

1) your self esteem could be a reflection of your mothers opinions

2) blame is not helpful

3) you could have a tendency to isolate yourself from others