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Formulation in Clinical and Counselling Psychology

This is a super techy presentation for psychology and psychotherapy trainees. Psychoanalytic technique is different, so people from that world might look more at my stuff on case construction. I hope this is useful!
by Dr Jay Watts on 28 May 2013

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Transcript of Formulation in Clinical and Counselling Psychology

Foundation Socio-Political Formulation Questions Family History

Transgenerational history.
Why the child. Why then. Whose desire.
Stories and scripts around the baby when in the womb.
Identifications spotted. Transference
Countertransference Formulation in Clinical and Counselling Psychology Positions of:
Gender
Race
Age
Ability
Class
Education
Ethnicity
Sexuality

Material reality and power A short narrative to hypothesise
what is happening for the direction
of treatment.

Constantly being revised by its
usefulness.

Revised by lots of clues such as
level of rapport, and level of
material produced (if we take
the unconscious seriously). Dr Jay Watts
Shrink at Large Early early experiences

Breastfeeding
Weaning
Reaction to early separations
Relation to triad
Relation to siblings
Separation-individuation Is this just another type of diagnosis?
Is the level of rapport between shrink and
patient the best way to measure utility?
How we can intervene at a socio-political
level whilst recognising the real of money
and power?
Would we want our own shrinks to be formulating
us? Schemas What ways or modes we tend to use.
The angry child
The bitter husband etc

and the recriprocal roles
they link with From a relational perspective:
Who we are for the patient at that moment
Our reactions to the patient Process Comments Curiosity about what is going on in
the relationship
Using any live material
Using voice, prosody, silences, facial expressions, etc as objects of curiosity Moments of Rupture and Repair, connection and mourning. The Therapeutic
Relationship Work on your self is crucial here. The biggies are:
- to have enough experience of a personal therapy to know its tough, imperfect and deeply specific to the two people in the room.
- to be able to tolerate lots of anxiety so you don't colonize the room with your own stuff Current Difficulties What is the problem
Why is the client coming now
Why has the suffering changed
Whose problem is it
Is this really a psychological
therapy form of suffering
What keeps the problem going
What protects the client Formulations have
a number of levels: 1.The Individual 2. The Relational 3.The Socio-Political You want to develop a loose relationship to your formulations. They are a tool for thinking, exploring, and knowing where you might focus.
Beware of looking for the 'right' formulation. You want something 'useful, which you can juggle loosely, distractedly (whilst the relationship does all the healing work - ssh!). But how will I hold this all in mind? How do I do this? You might loosely bring in some difference between you and your client. For example, that you are a young caucasian woman working with an older asian male.
The key is to show you are primed to hear difference and think about it (eg a slight reference to slavery) without infliclicting your political correctness on the space..
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