A qualitative analysis of Clinical Psychologists’ use of psychological formulation with clients who have had ‘psychotic’ experiences

Part One: Literature Review : Introduction: The current paper provides a systematic review of the current evidence into the impact of sharing the formulation with clients. Method: A systematic literature search using five databases was carried out. Resulting papers were screened leaving fourteen papers to be included in the final review Results: Evidence to support the claim that sharing formulation impacts on clients is limited and the picture is complex. There was some evidence that differences in the content and process of formulation, and the quality of a person’s interpersonal functioning, could have a differential impact on outcome. Discussion: There is some evidence that formulation has a differential impact on different people. This suggests a level of clinical judgement should be used when deciding what to share, based on therapists’ understanding of the client. Part Two: Research Report : Introduction: The aim of the current study was to use grounded theory to produce a model of how clinical psychologists use formulation in sessions with clients who have experienced ‘psychosis’. Method: Two therapy sessions between a clinical psychologist and a client were audio recorded and analysed. The clinical psychologist was then interviewed about their use of formulation within the sessions. Results: A model of formulation was produced with a core category of formulation as purposeful action. Discussion: Many current definitions of formulation do not sufficiently capture the active purposeful process identified in the current research. Extensions to definitions of formulation are discussed. Part Three: Critical Appraisal The critical appraisal describes a reflexive account of the research process.