Using team formulation in mental health practice

Abstract

This article aims to enhance nurses' understanding of team formulation, including its ideas, implementation and potential effects. It explores some of the evidence supporting team formulation, provides examples of techniques that may be used and reflects on team formulation in practice. It is hoped that this article will enable readers to develop an enhanced awareness of the concepts and issues involved, feel increasingly confident when engaging in team formulation and recognise its value and challenges in clinical practice. After reading this article and completing the time out activities you should be able to: » Describe team formulation and explain what it entails. » Recognise the different ways team formulation can be implemented in practice.» Understand how to apply the 5Ps model to team formulation. » Reflect on the effects of team formulation on those involved. The reader is encouraged to read a previous CPD article outlining the process, value and challenges of individual formulation in

Staff views about involving service users in team formulation

“…This suggests recognition that the issue of service user involvement in team formulation is important. Similarly, Clare (2022) and Hartley (2021) have raised ethical questions about the potential for disempowerment if service users are not meaningfully involved. Additionally, these participants believed that having the service user present could be a valuable experience for all parties, as suggested by Lewis-Morton et al's (2017) thematic analysis of a service user's co-production of their formulation alongside their team.…”

“…It is clear that the issue of service user inclusion in the team formulation process is becoming increasingly relevant as the practice is adopted across specialties, including Adult Mental Health (Johnstone, 2014), Learning Disabilities (Ingham, 2012), Child and Adolescent Mental Health (Hartley, 2021) and Older Adults (Jackman & Beatty, 2015). For example, the Association of Cognitive Analytic Therapy (ACAT) states ‘One of the key issues in debates/controversies around team formulation is collaboration and the extent to which service users are centred, included and involved in the process’ (Carradice, 2004, p. 20) A number of professionals have expressed concerns about the absence of service users, as well as on‐going questions about how to ensure service users are involved in a way that is meaningful and collaborative (ACP, 2022).…”

“…For example, the Association of Cognitive Analytic Therapy (ACAT) states ‘One of the key issues in debates/controversies around team formulation is collaboration and the extent to which service users are centred, included and involved in the process’ (Carradice, 2004, p. 20) A number of professionals have expressed concerns about the absence of service users, as well as on‐going questions about how to ensure service users are involved in a way that is meaningful and collaborative (ACP, 2022). However, some have argued that having the service user present is not always appropriate, for example if staff counter‐transference feelings are being explored, and have suggested that there are a number of other ways to include their views (Hartley, 2021; Johnstone, 2014).…”

Building relational trust and hope: The experiences of counsellors in a service for birth relatives whose children have been adopted or taken into care

“…This has the potential to produce a more psychological, trauma-informed and contextual formulation of families' difficulties across services, enable a more collaborative relationship with the birth relatives and discourage more reactive responses from the wider system. Team formulation (Hartley, 2021;Johnstone, 2013) would be one way of achieving this. This is a trauma-informed approach where a team collectively identifies the difficulties faced by a client or family and the reasons for them and then draws on this shared understanding to consider possible helpful responses (Johnstone, 2019).…”