Case formulation in CBT according to a finalistic model of mind
DOI:
https://doi.org/10.33898/rdp.v33i123.35674Keywords:
case formulation, cognitive therapy, hyper-invested goals, dysfunctional beliefs, cognitive acceptanceAbstract
Case formulation (CF) is the necessary prerequisite for any psychotherapeutic treatment, regardless of the theoretical orientation of the clinician. This article presents a five-point CF method tailored to the uniqueness of the patient that takes into account the description of the problem, its diagnostic classification and above all its explanation. The explanation concerns the immediate and remote psychological causes of the specific problem, those that determine its maintenance and finally the precipitating ones, that is, which caused its onset. We call the five points of CF: 1) description of the problem and clinical diagnosis; 2) internal profile; 3) maintenance; 4) decompensation; 5) vulnerability. The theoretical framework within which this type of CF takes shape is that of a cognitive psychotherapy (CT) inspired by a finalistic model of the mind (Miller, Galanter, Pribram 1960), in which the explanation of individual behavior is based not only on beliefs but especially on the hyper-invested goals of the person. Therefore, ample space will be given to the second point of CF, the internal profile, the real beating heart of a good formulation, and illustrated how to proceed starting from the patient's wishes and fears (his goals and anti-goals) to reach his pathogenic beliefs. expressed as inferential rules (ie, as "if ... then ..." sentences). Finally, the important implications for the therapeutic strategy that this type of conceptualization entails and the need to know and apply the principles that regulate the processes of cognitive acceptance will be discussed.
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