Biopsychosocial Model and Case Formulation

NB: We do not resell your papers. Upon ordering, we do an original paper exclusively for you.

NB: All your data is kept safe from the public.

Table of Contents

Symptoms & Problems
Precipitating stressors or events
Predisposing life events or stressors
Inferred mechanisms
Bibliography

Elles et al. in 1998 reviewed 52 intakes and psychosocial assessments completed by social workers, psych residents, and psych nurses. They found that case formulations were dominated by descriptive information with a primary focus on symptoms and past psychiatric history. Only 21% considered positive treatment indicators (e.g., strengths); 42.9 inferred a psychological mechanism, compared to 1.8% who inferred a biological and/or socio-cultural mechanism. Predisposing factors were noted only 37.5% of the time and precipitating factors even less (16.1%).

Case formulation is a hypothesis about what predispositional, precipitating, and perpetuating factors and mechanisms influence and impact a persons psychological, interpersonal, and behavioral problems/struggles. Case formulation in this sense is a tool that helps to organize complex and sometimes contradictory information about a person.

In addition the case formulation can serve the following purposes:

A blueprint that guides intervention
A marker for change
A narrative that deepens the practitioners understanding of the client
A mechanism that generates the practitioners empathy for a client

Features common to case formulation:

Case formulation is compartmentalized into preset components (e.g., identifying information, reason for referral, relevant history, current functioning, etc.) that are addressed individually in the biopsychosocial assessment and then assembled into a comprehensive formulation.
The formulation emphasizes levels of inference about a case that can readily be supported by:

Client statements in therapy
Collateral information and opinion
Socio-cultural and environmental information and observation
Case histories

NB Case formulations in other clinical disciplines contain information that is based largely on clinical judgment versus patient self report!

The goal of case formulation is to integrate rather than summarize descriptive information about the client.

Four components of case formulation (meaning things you will want to cover):

Symptoms and problems
Precipitating stressors or events
Predisposing life events or stressors
A mechanism that links the preceding categories together and offers an explanation of the precipitants maintaining influence on the individuals symptoms and problems (this mechanism is your hypothesis and it MUST be theoretically informed)

Symptoms & Problems

Identification of signs, symptoms, and other phenomenon that is clinically important. This includes the clients presenting symptoms and chief complaints as well as problems that may be apparent to the clinician, but not to the patient. This is where skilled interviewing needs to be utilized bc a patients problem may not always be apparent to them though may be apparent in their presentation. NOTE What you as the practitioner want to rely on in making this assessment is not just your intuition (e.g. the client is struggling with grief though not aware of it because this is something I know, or I can tell, or I am guessing), but on two things. One, your observations about the client (for example his/her mood, whether or not it is congruent with what he/she is saying, whether or not it contextually and culturally makes sense), and two, your knowledge (for example what you know from the empirical and theoretical literature about grief, trauma, addiction, whatever the case may be). Now some of us may have personal experience with grief, trauma, addiction, etc. - it is our responsibility to be able to distinguish the difference between our personal knowing and our formal knowing making sure that our formal knowing is used to primarily guide our assessment and hypothesis making, and that our personal knowing is used primarily to guide our reflexivity and self-awareness about our interpretations and our hypotheses. These two processes (our formal and personal knowing) work together and depend on one another. They are not mutually exclusive. Learning how to differentiate between them is the Practitioners responsibility. Developing skill in this area evolves over time, however, in the beginning, this can be done simply by asking oneself: How do I know what I know? On what am I making these conclusions? Does what I am writing or saying and thinking about my client reflect her/his experience, or does it reflect my experience of him/her? What are my own personal values about the issues that I have partialized and prioritized as significant for my client? Are my values different from or similar to my clients values on these issues? How does that impact how I am thinking about the case?

Precipitating stressors or events

These are seen as events that either exacerbate or catalyze the clients current problems. They can be events that are seen as directly causing or leading to the chief complaint, or as increasing the severity of the pre-existing problem to the level of clinical significance.

Predisposing life events or stressors

These are traumatic events or stressors that have occurred in the persons past and that are assumed to have produced an increased vulnerability to developing symptoms. These can be separated into three categories: early life (childhood and adolescence), past adulthood, and recent adulthood (meaning in the last 2 years).

Inferred mechanisms

This factor, the most important, represents an attempt to link together and explain information in the preceding three categories. The inferred mechanism is the practitioners hypothesis of the cause of the persons current difficulties. There are three major categories under preferred mechanisms:

Psychological mechanisms
Biological mechanisms
Sociocultural mechanisms

Psychological mechanisms may include a core conflict; a set of dysfunctional thoughts, beliefs, or schemas; skills or behavioral deficits; problematic aspects or traits of the self; problematic aspects of relatedness to others; defense mechanisms or coping style; and problems with affect regulation. See how these mechanisms are related to a body of theory (here you see remnants of psychodynamic, cognitive behavioral, attachment, development which we have not covered this semester. For psychological mechanisms that we have covered this semester you can think of internalized oppression from empowerment theory, poor recognition of ones strengths and potential from strengths based perspective, lack of agency that stems from internalized oppression from Freire, unawareness about solutions which stems from SFBT).

Biological mechanisms refer to both genetic and acquired conditions that cause or contribute to the clients problems. Examples include a genetic predisposition for depression, a depression associated with hypothyroidism, or a presumed predisposition for anxiety.

Sociocultural mechanisms are factors such as ethnicity, socioeconomic status, gender, religious beliefs, degree of acculturation, nature of social relations and support. This includes examining cultural norms, power analyses, intergenerational family dynamics, etc. (This is where language and theoretical assumptions from ecological perspective can be applied).

Finally, the case formulation concludes with a brief paragraph about prognosis (which is the practitioners hypothesis or prediction about how things might turn out in the future). In this 1-2 paragraph summary, you might want to capture things like:

Positive treatment indicators such as strengths and adaptive skills
Practitioners treatment expectations
Inferences about clients overall level of adjustment
Negative treatment indicators
Past history of mental health care
Developmental history
Social or educational history
Mental status

Click Here To Order Now!

Biopsychosocial Model and Case Formulation

Do you need this or any other assignment done for you from scratch?

We have qualified writers to help you.

We assure you a quality paper that is 100% free from plagiarism and AI.

You can choose either format of your choice ( Apa, Mla, Havard, Chicago, or any other)