Formulation in cognitive behavior therapy for obsessive–compulsive disorder: Aligning therapists, perceptions and practice.

Abstract

The aim was to examine the impact of training on cognitive behavior therapy (CBT) formulation skills.Eighty-five clinicians were randomly assigned to two experimental conditions. The experimental manipulation was the timing of assessment of formulation skills, that is, either before or after participation in a training workshop. The preworkshop results suggest that there may be a gap between self-appraisal and actual performance on a formulation task. Formulation skills of clinicians were significantly better after they had undertaken the workshop compared with the preworkshop group, as measured by the Rating the Quality of Case Formulation for Obsessive-Compulsive Disorder (RQCFO). The current research suggests that time-limited, low-cost training can be effective in improving formulation competence for clinicians with previous knowledge.

Measures Assessing the Quality of Case Conceptualization: A Systematic Review

“…Case conceptualization is viewed as a "first principle" of CBT (Beck, 1985;Johnstone & Dallos, 2013). As such, most published measures designed to assess the quality of case conceptualizations are grounded in the CBT tradition and this ended up being the focus of the current review; the majority of quality scales reviewed were grounded in a CBT framework (Dudley et al, 2010;Fothergill & Kuyken, 2002;Haarhoff et al, 2011;Padesky et al, 2011;Page et al, 2008;Zivor et al, 2013), with one scale theoretically neutral (Eells et al, 2005) and another embedded in the five Ps formulation template (McMurran et al, 2012).…”

“…However, RQCFO's use within OCD is limited and is therefore not easily applicable in routine clinical services and to clients who present with a range of mental health problems. Zivor et al (2013) found the correlation between two blind raters on the "overall quality" dimension to be significant (r = .70, p < .005). The scale has not undergone rigorous psychometric evaluation, limiting conclusions that can be drawn about the validity of the measure.…”

“…After development of the scale, two raters assessed the inter-rater reliability and acceptable rate of agreement was obtained (kappa = 0.85), but as yet other psychometrics properties have not been reported. Obsessive-Compulsive Disorder (RQCFO;Zivor, Salkovskis, Oldfield, & Kushnir, 2013). The RQCFO was developed from the QCCFRS to examine the effect of training in CBT conceptualizations for obsessivecompulsive disorder (OCD).…”

Evidence-Based Practices in Cognitive Behaviour Therapy (CBT) Case Formulation: What Do Practitioners Believe is Important, and What Do They Do?

“…Second, it was predicted that more experienced clinicians would be more likely to endorse practices related to using evidence in CF, as these practices may reflect higher levels of skill using theory to inform practice. Furthermore, research has documented that training also seems to improve CBT-based CF skills (e.g., Dudley, Ingham, Sowerby, & Freeston, 2015; Haarhoff, Gibson, & Flett, 2011; Zivor, Salkovis, Oldfield, & Kushir, 2013). Accordingly, the third hypothesis tested was that clinicians with higher levels of training would endorse more practices related to use of external evidence, on the basis that use of external evidence may be considered a more advanced CF skill.…”

Case Mis‐Conceptualization in Psychological Treatment: An Enduring Clinical Problem

“…While case formulation skills can improve with instruction, the current quality of training itself is of question (Berry, Barrowclough, & Wearden, ; Sim et al., ; Zivor, Salkovskis, & Kushnir, ). Sim et al.…”