The action formulation: A proposed heuristic for clinical case formulation

Abstract

The authors propose the action formulation (TAF), a heuristic for clinical case formulation. The action formulation relies on the action perspective, which depicts individuals as actively shaping their environment, and is premised upon four guidelines: (a) map the client's social environment, focusing on sources of support, chronic interpersonal difficulties, and negative and positive life events; (b) identify how the clients, in the context of their personalities, psychopathologies, and strengths, actively influence their environment; (c) differentiate between maladaptive, risk-related, interpersonal cycles, and adaptive, protective-based ones; and (d) tailor integrative techniques to short-circuit the former cycles and bolster the latter ones. Links between TAF and emerging issues in clinical assessment are discussed.

Risky Resilience and Resilient Risk: The Key Role of Intentionality in an Emerging Dialectics

“…However, such an assessment should be nuanced and contextual. That is, once clinical factors are documented using psychometrically sound measures, it is left to up to the assessor to weight their relative importance, and more importantly-their interrelationships-for the purpose of tailoring evidence based treatment (Handler & Hilsenroth, 1998;Haynes, Leisen, & Blaine, 1997;Shahar & Porcerelli, 2006;Westmeyer, 2003). From the present point of view, it is important to consider the role of each factor assessed clinically in the risk/resilience dialectics.…”

“…The diagram is inspired by functional approaches to case formulation, which integrate psychological assessment principles with the logic of causal modeling (see Haynes et al, 1997;Shahar & Davidson, 2009;Shahar, Horesh, & Cohen, 2008;Shahar & Porcerelli, 2006). As shown in the figure, the girl's self-criticism is functional in the sense that it upholds her possible self: it regulates her goals in the direction of creating clean living.…”

A conqueror by stealth: Introduction to the special issue on humanism, existentialism, and psychotherapy integration.

“…Of course, the humanistic-existential movement has given the field some priceless, "purified" experiential therapeutic modalities, which have been shown, empirically and compellingly, to ddress multiple symptoms and syndromes (e.g., emotion focus therapy; see Greenberg & Watson, 2006). Additionally, in the field of clinical assessment, which was once considered incompatible with the humanistic-existential focus on holism and freedom, the third force has been making important strides (Fischer, 1994;Lopez & Snyder, 2003;Shahar & Davidson, 2009;Shahar & Porcerelli, 2006), showing that rather than objectifying clients, the rigor and structure of assessment might actually open vistas to the un-derstanding of individuality, intersubjectivity, and human strengths.…”

The Nature of the Beast: Commentary on “Can There Be a Recovery-Oriented Diagnostic Practice?”

“…This is fine with me. I am closer to their diagnostic position than I am to most others (e.g., Shahar, 2015a; Shahar & Porcerelli, 2006). In fact, they and I are (at least) in two other important agreements, namely, that diagnostic practice entails understanding the person’s inner world , and that it should be governed by humanistic values .…”